Mary Wilson
Well-known member
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Revised Date: 8 February 2023
Accepted Date: 13 February 2023
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Published: March 01, 2023
DOI: https://doi.org/10.1016/j.ajpath.2023.02.005
Kangyun Wu, Yong Zhang, Stephen R. Austin, Huqing Yin Declue, Derek E. Byers, Erika C. Crouch,
Michael J. Holtzman
Abstract
Respiratory viruses, including SARS-CoV-2, can trigger chronic lung disease that persists and even progresses after expected clearance of infectious virus. To gain an understanding of this process, we examined a series of consecutive fatal cases of Covid-19 that came to autopsy at 27-51 d after hospital admission. In each patient, we identify a stereotyped bronchiolar-alveolar pattern of lung remodeling with basal epithelial cell hyperplasia, immune activation, and mucinous differentiation. Remodeling regions also feature macrophage infiltration and apoptosis and a marked depletion of alveolar type 1 and 2 epithelial cells. This entire pattern closely resembles findings from an experimental model of post-viral lung disease that requires basal-epithelial stem cell growth, immune activation, and differentiation. Together, the results provide evidence of basal epithelial cell reprogramming in long-term Covid-19 and thereby yield a pathway for explaining and correcting lung dysfunction in this type of disease.
https://ajp.amjpathol.org/action/showPdf?pii=S0002-9440(23)00056-1
Revised Date: 8 February 2023
Accepted Date: 13 February 2023
___________________________
Published: March 01, 2023
DOI: https://doi.org/10.1016/j.ajpath.2023.02.005
Kangyun Wu, Yong Zhang, Stephen R. Austin, Huqing Yin Declue, Derek E. Byers, Erika C. Crouch,
Michael J. Holtzman
Abstract
Respiratory viruses, including SARS-CoV-2, can trigger chronic lung disease that persists and even progresses after expected clearance of infectious virus. To gain an understanding of this process, we examined a series of consecutive fatal cases of Covid-19 that came to autopsy at 27-51 d after hospital admission. In each patient, we identify a stereotyped bronchiolar-alveolar pattern of lung remodeling with basal epithelial cell hyperplasia, immune activation, and mucinous differentiation. Remodeling regions also feature macrophage infiltration and apoptosis and a marked depletion of alveolar type 1 and 2 epithelial cells. This entire pattern closely resembles findings from an experimental model of post-viral lung disease that requires basal-epithelial stem cell growth, immune activation, and differentiation. Together, the results provide evidence of basal epithelial cell reprogramming in long-term Covid-19 and thereby yield a pathway for explaining and correcting lung dysfunction in this type of disease.
https://ajp.amjpathol.org/action/showPdf?pii=S0002-9440(23)00056-1