Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways
Identifieur interne : 000179 ( Istex/Corpus ); précédent : 000178; suivant : 000180Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways
Auteurs : Yanqing Ding ; Li He ; Qingling Zhang ; Zhongxi Huang ; Xiaoyan Che ; Jinlin Hou ; Huijun Wang ; Hong Shen ; Liwen Qiu ; Zhuguo Li ; Jian Geng ; Junjie Cai ; Huixia Han ; Xin Li ; Wei Kang ; Desheng Weng ; Ping Liang ; Shibo JiangSource :
- The Journal of Pathology [ 0022-3417 ] ; 2004-06.
English descriptors
- Teeft :
- Ace2, Acidophilic cells, Adrenal gland, Assay, Autopsy tissues, Bone marrow, Central vein, Cerebral neurones, Control patients, Coronavirus, Cytopathic effect, Ding, Eighth hospital, Epithelial, Epithelial cells, Epithelium, Family members, Fang hospital, Functional receptor, Gastric parietal cells, Gastrointestinal system, Gastrointestinal tract, Gene fragments, Great britain, Guangdong province, Guangzhou, Guangzhou city, Guangzhou institute, Health administration, Inclusion bodies, Infectious diseases, John wiley sons, Kimball research institute, Light microscope, Little information, Lung tissue, Lung tissues, Lymph node, Medical university, Natural sciences, Neutral formaldehyde, Novel coronavirus, Organ distribution, Other diseases, Other organs, Other people, Pancreatic acinar cells, Pathol, Pathological changes, Pathological society, Polymerase, Polymerase gene expression, Polymerase gene fragment, Polymerase gene fragments, Positive cells, Positive signal, Present study, Primary target, Protein expression, Protein gene, Receptor, Renal tubule, Respiratory diseases, Respiratory syndrome, Respiratory system, Sars, Sars cases, Sars coronavirus, Sars epidemics, Sars patients, Second hospital, Small intestine, Standard saline citrate, Sweat gland, Sweat gland cells, Syndrome, Testis, Thoracic aortic aneurysm, Tissue sections, Total number, Transmission electron microscopy, Tubule, Uninfected vero, Viral, Viral immunology, Viral inclusion body, Virus particles, Yanqing ding, York blood center, Zhongshan university.
Abstract
We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Url:
DOI: 10.1002/path.1560
Links to Exploration step
ISTEX:B5A3FD797EFDC1F2207E62737B7A846A0F3E34CDLe document en format XML
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Kimball Research Institute, New York Blood Center, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: sjiang@nybloodcenter.org</mods:affiliation></affiliation><affiliation><mods:affiliation>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B5A3FD797EFDC1F2207E62737B7A846A0F3E34CD</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1002/path.1560</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-R04BCWC9-K/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000179</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000179</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title><author><name sortKey="Ding, Yanqing" sort="Ding, Yanqing" uniqKey="Ding Y" first="Yanqing" last="Ding">Yanqing Ding</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: dyq@fimmu.com</mods:affiliation></affiliation><affiliation><mods:affiliation>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</mods:affiliation></affiliation></author><author><name sortKey="He, Li" sort="He, Li" uniqKey="He L" first="Li" last="He">Li He</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Qingling" sort="Zhang, Qingling" uniqKey="Zhang Q" first="Qingling" last="Zhang">Qingling Zhang</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Huang, Zhongxi" sort="Huang, Zhongxi" uniqKey="Huang Z" first="Zhongxi" last="Huang">Zhongxi Huang</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Che, Xiaoyan" sort="Che, Xiaoyan" uniqKey="Che X" first="Xiaoyan" last="Che">Xiaoyan Che</name><affiliation><mods:affiliation>Department of Infectious Diseases, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Hou, Jinlin" sort="Hou, Jinlin" uniqKey="Hou J" first="Jinlin" last="Hou">Jinlin Hou</name><affiliation><mods:affiliation>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Wang, Huijun" sort="Wang, Huijun" uniqKey="Wang H" first="Huijun" last="Wang">Huijun Wang</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Shen, Hong" sort="Shen, Hong" uniqKey="Shen H" first="Hong" last="Shen">Hong Shen</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Qiu, Liwen" sort="Qiu, Liwen" uniqKey="Qiu L" first="Liwen" last="Qiu">Liwen Qiu</name><affiliation><mods:affiliation>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Li, Zhuguo" sort="Li, Zhuguo" uniqKey="Li Z" first="Zhuguo" last="Li">Zhuguo Li</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Geng, Jian" sort="Geng, Jian" uniqKey="Geng J" first="Jian" last="Geng">Jian Geng</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Cai, Junjie" sort="Cai, Junjie" uniqKey="Cai J" first="Junjie" last="Cai">Junjie Cai</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Han, Huixia" sort="Han, Huixia" uniqKey="Han H" first="Huixia" last="Han">Huixia Han</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Li, Xin" sort="Li, Xin" uniqKey="Li X" first="Xin" last="Li">Xin Li</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Kang, Wei" sort="Kang, Wei" uniqKey="Kang W" first="Wei" last="Kang">Wei Kang</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Weng, Desheng" sort="Weng, Desheng" uniqKey="Weng D" first="Desheng" last="Weng">Desheng Weng</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Liang, Ping" sort="Liang, Ping" uniqKey="Liang P" first="Ping" last="Liang">Ping Liang</name><affiliation><mods:affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</mods:affiliation></affiliation></author><author><name sortKey="Jiang, Shibo" sort="Jiang, Shibo" uniqKey="Jiang S" first="Shibo" last="Jiang">Shibo Jiang</name><affiliation><mods:affiliation>Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: sjiang@nybloodcenter.org</mods:affiliation></affiliation><affiliation><mods:affiliation>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Journal of Pathology</title><title level="j" type="alt">JOURNAL OF PATHOLOGY, THE</title><idno type="ISSN">0022-3417</idno><idno type="eISSN">1096-9896</idno><imprint><biblScope unit="vol">203</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="622">622</biblScope><biblScope unit="page" to="630">630</biblScope><biblScope unit="page-count">9</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2004-06">2004-06</date></imprint><idno type="ISSN">0022-3417</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3417</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Ace2</term><term>Acidophilic cells</term><term>Adrenal gland</term><term>Assay</term><term>Autopsy tissues</term><term>Bone marrow</term><term>Central vein</term><term>Cerebral neurones</term><term>Control patients</term><term>Coronavirus</term><term>Cytopathic effect</term><term>Ding</term><term>Eighth hospital</term><term>Epithelial</term><term>Epithelial cells</term><term>Epithelium</term><term>Family members</term><term>Fang hospital</term><term>Functional receptor</term><term>Gastric parietal cells</term><term>Gastrointestinal system</term><term>Gastrointestinal tract</term><term>Gene fragments</term><term>Great britain</term><term>Guangdong province</term><term>Guangzhou</term><term>Guangzhou city</term><term>Guangzhou institute</term><term>Health administration</term><term>Inclusion bodies</term><term>Infectious diseases</term><term>John wiley sons</term><term>Kimball research institute</term><term>Light microscope</term><term>Little information</term><term>Lung tissue</term><term>Lung tissues</term><term>Lymph node</term><term>Medical university</term><term>Natural sciences</term><term>Neutral formaldehyde</term><term>Novel coronavirus</term><term>Organ distribution</term><term>Other diseases</term><term>Other organs</term><term>Other people</term><term>Pancreatic acinar cells</term><term>Pathol</term><term>Pathological changes</term><term>Pathological society</term><term>Polymerase</term><term>Polymerase gene expression</term><term>Polymerase gene fragment</term><term>Polymerase gene fragments</term><term>Positive cells</term><term>Positive signal</term><term>Present study</term><term>Primary target</term><term>Protein expression</term><term>Protein gene</term><term>Receptor</term><term>Renal tubule</term><term>Respiratory diseases</term><term>Respiratory syndrome</term><term>Respiratory system</term><term>Sars</term><term>Sars cases</term><term>Sars coronavirus</term><term>Sars epidemics</term><term>Sars patients</term><term>Second hospital</term><term>Small intestine</term><term>Standard saline citrate</term><term>Sweat gland</term><term>Sweat gland cells</term><term>Syndrome</term><term>Testis</term><term>Thoracic aortic aneurysm</term><term>Tissue sections</term><term>Total number</term><term>Transmission electron microscopy</term><term>Tubule</term><term>Uninfected vero</term><term>Viral</term><term>Viral immunology</term><term>Viral inclusion body</term><term>Virus particles</term><term>Yanqing ding</term><term>York blood center</term><term>Zhongshan university</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. 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Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</json:string></affiliations></json:item><json:item><name>Li He</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Qingling Zhang</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Zhongxi Huang</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Xiaoyan Che</name><affiliations><json:string>Department of Infectious Diseases, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Jinlin Hou</name><affiliations><json:string>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Huijun Wang</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Hong Shen</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Liwen Qiu</name><affiliations><json:string>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Zhuguo Li</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Jian Geng</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Junjie Cai</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Huixia Han</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Xin Li</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Wei Kang</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Desheng Weng</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Ping Liang</name><affiliations><json:string>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</json:string></affiliations></json:item><json:item><name>Shibo Jiang</name><affiliations><json:string>Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, New York, USA</json:string><json:string>E-mail: sjiang@nybloodcenter.org</json:string><json:string>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>SARS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SARS‐CoV</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>distribution</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>detection</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pathogenesis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>transmission</value></json:item></subject><articleId><json:string>PATH1560</json:string></articleId><arkIstex>ark:/67375/WNG-R04BCWC9-K</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.</abstract><qualityIndicators><score>9.267</score><pdfWordCount>4267</pdfWordCount><pdfCharCount>26613</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>9</pdfPageCount><pdfPageSize>595 x 842 pts (A4)</pdfPageSize><pdfWordsPerPage>474</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>271</abstractWordCount><abstractCharCount>1881</abstractCharCount><keywordCount>6</keywordCount></qualityIndicators><title>Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title><pmid><json:string>15141376</json:string></pmid><genre><json:string>article</json:string></genre><host><title>The Journal of Pathology</title><language><json:string>unknown</json:string></language><doi><json:string>10.1002/(ISSN)1096-9896</json:string></doi><issn><json:string>0022-3417</json:string></issn><eissn><json:string>1096-9896</json:string></eissn><publisherId><json:string>PATH</json:string></publisherId><volume>203</volume><issue>2</issue><pages><first>622</first><last>630</last><total>9</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Rapid Communication</value></json:item><json:item><value>Rapid Communications</value></json:item></subject></host><namedEntities><unitex><date><json:string>2003</json:string><json:string>2004</json:string></date><geogName></geogName><orgName><json:string>Kimball Research Institute, New York Blood Center</json:string><json:string>Hospital of Zhongshan University, the Guangzhou Institute of Respiratory Diseases, and the Health Administration of Guangdong Province, China</json:string><json:string>WHO</json:string><json:string>Sigma Chemical Co</json:string><json:string>Centre Laboratory, Zhujiang Hospital</json:string><json:string>Military Foundation of Medical Science</json:string><json:string>Military Medical University</json:string><json:string>Kimball Research Institute, New York Blood Center, New York, USA</json:string><json:string>Department of Pathology</json:string><json:string>Research Administration Committees</json:string><json:string>People’s Hospital of Guangzhou City</json:string><json:string>Nan Fang Hospital, Guangzhou, Guangdong and identi</json:string><json:string>Mannheim</json:string><json:string>Sons, Ltd</json:string><json:string>Ltd</json:string><json:string>Hospital of Zhongshan University, and the Guangzhou Institute of Respiratory Diseases</json:string><json:string>and Foundation of Natural Sciences of Guangdong Province</json:string><json:string>Department of Infectious Diseases, Nan Fang Hospital</json:string><json:string>Laboratory of Viral Immunology, Lindsley F</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Jian Geng</json:string><json:string>John Wiley</json:string><json:string>Xin Li</json:string><json:string>Jiang</json:string><json:string>Fisher Scienti</json:string></persName><placeName><json:string>Singapore</json:string><json:string>NY</json:string><json:string>IN</json:string><json:string>Pittsburgh</json:string><json:string>MO</json:string><json:string>China</json:string><json:string>Japan</json:string><json:string>Tokyo</json:string><json:string>York</json:string><json:string>Ireland</json:string><json:string>Indianapolis</json:string><json:string>St Louis</json:string><json:string>Wuhan</json:string><json:string>PA</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>[23]</json:string><json:string>[26,27]</json:string><json:string>[29]</json:string><json:string>Ding et al</json:string><json:string>[22]</json:string><json:string>[17]</json:string><json:string>[1]</json:string><json:string>[21]</json:string><json:string>[16]</json:string><json:string>Lin et al</json:string><json:string>[3]</json:string><json:string>[31]</json:string><json:string>[3,30]</json:string><json:string>Harmer et al</json:string><json:string>[30]</json:string><json:string>[7]</json:string><json:string>[17,18]</json:string><json:string>[14]</json:string><json:string>Leung et al</json:string><json:string>[24]</json:string><json:string>[17,25]</json:string><json:string>[19]</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-R04BCWC9-K</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - pathology</json:string><json:string>2 - oncology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - pathology</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Pathology and Forensic Medicine</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1002/path.1560</json:string></doi><id>B5A3FD797EFDC1F2207E62737B7A846A0F3E34CD</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-R04BCWC9-K/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-R04BCWC9-K/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-R04BCWC9-K/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title><title level="a" type="short" xml:lang="en">Organ distribution of SARS‐CoV</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><availability><licence>Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.</licence></availability><date type="published" when="2004-06"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title><title level="a" type="short" xml:lang="en">Organ distribution of SARS‐CoV</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Yanqing</forename><surname>Ding</surname></persName><email>dyq@fimmu.com</email><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Li</forename><surname>He</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Qingling</forename><surname>Zhang</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Zhongxi</forename><surname>Huang</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Xiaoyan</forename><surname>Che</surname></persName><affiliation><orgName type="division">Department of Infectious Diseases</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical 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xml:id="author-0009"><persName><forename type="first">Zhuguo</forename><surname>Li</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0010"><persName><forename type="first">Jian</forename><surname>Geng</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0011"><persName><forename type="first">Junjie</forename><surname>Cai</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0012"><persName><forename type="first">Huixia</forename><surname>Han</surname></persName><affiliation><orgName type="department">Department of Pathology</orgName><orgName type="institution">Nan Fang Hospital</orgName><orgName type="institution">First Military Medical University</orgName><address><addrLine>Guangzhou</addrLine><addrLine>China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0013"><persName><forename type="first">Xin</forename><surname>Li</surname></persName><affiliation><orgName 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><p>We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and <hi rend="italic">in situ</hi> hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. 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Published by John Wiley & Sons, Ltd.</copyright><eventGroup><event type="manuscriptReceived" date="2004-01-14"></event><event type="manuscriptRevised" date="2004-02-08"></event><event type="manuscriptAccepted" date="2004-02-12"></event><event type="firstOnline" date="2004-05-07"></event><event type="publishedOnlineFinalForm" date="2004-05-07"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:FullText result:FullText" date="2010-02-22"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst">622</numbering><numbering type="pageLast">630</numbering></numberingGroup><correspondenceTo><lineatedText><line>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.</line><line>Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</line></lineatedText></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PATH.PATH1560.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="1"></count><count type="referenceTotal" number="31"></count></countGroup><titleGroup><title type="main" xml:lang="en">Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title><title type="short" xml:lang="en">Organ distribution of SARS‐CoV</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Yanqing</givenNames><familyName>Ding</familyName></personName><contactDetails><email>dyq@fimmu.com</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Li</givenNames><familyName>He</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Qingling</givenNames><familyName>Zhang</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Zhongxi</givenNames><familyName>Huang</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Xiaoyan</givenNames><familyName>Che</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Jinlin</givenNames><familyName>Hou</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Huijun</givenNames><familyName>Wang</familyName></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Hong</givenNames><familyName>Shen</familyName></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Liwen</givenNames><familyName>Qiu</familyName></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Zhuguo</givenNames><familyName>Li</familyName></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jian</givenNames><familyName>Geng</familyName></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Junjie</givenNames><familyName>Cai</familyName></personName></creator><creator xml:id="au13" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Huixia</givenNames><familyName>Han</familyName></personName></creator><creator xml:id="au14" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Xin</givenNames><familyName>Li</familyName></personName></creator><creator xml:id="au15" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Wei</givenNames><familyName>Kang</familyName></personName></creator><creator xml:id="au16" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Desheng</givenNames><familyName>Weng</familyName></personName></creator><creator xml:id="au17" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Ping</givenNames><familyName>Liang</familyName></personName></creator><creator xml:id="au18" creatorRole="author" affiliationRef="#af4" corresponding="yes"><personName><givenNames>Shibo</givenNames><familyName>Jiang</familyName></personName><contactDetails><email>sjiang@nybloodcenter.org</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="CN" type="organization"><unparsedAffiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="CN" type="organization"><unparsedAffiliation>Department of Infectious Diseases, Nan Fang Hospital, First Military Medical University, Guangzhou, China</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="CN" type="organization"><unparsedAffiliation>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Laboratory of Viral Immunology, Lindsley F. 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In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and <i>in situ</i> hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Organ distribution of SARS‐CoV</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways</title></titleInfo><name type="personal"><namePart type="given">Yanqing</namePart><namePart type="family">Ding</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><affiliation>E-mail: dyq@fimmu.com</affiliation><affiliation>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Li</namePart><namePart type="family">He</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Qingling</namePart><namePart type="family">Zhang</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zhongxi</namePart><namePart type="family">Huang</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xiaoyan</namePart><namePart type="family">Che</namePart><affiliation>Department of Infectious Diseases, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jinlin</namePart><namePart type="family">Hou</namePart><affiliation>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Huijun</namePart><namePart type="family">Wang</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hong</namePart><namePart type="family">Shen</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Liwen</namePart><namePart type="family">Qiu</namePart><affiliation>Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zhuguo</namePart><namePart type="family">Li</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jian</namePart><namePart type="family">Geng</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Junjie</namePart><namePart type="family">Cai</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Huixia</namePart><namePart type="family">Han</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xin</namePart><namePart type="family">Li</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wei</namePart><namePart type="family">Kang</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Desheng</namePart><namePart type="family">Weng</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ping</namePart><namePart type="family">Liang</namePart><affiliation>Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shibo</namePart><namePart type="family">Jiang</namePart><affiliation>Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, New York, USA</affiliation><affiliation>E-mail: sjiang@nybloodcenter.org</affiliation><affiliation>Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2004-06</dateIssued><dateCaptured encoding="w3cdtf">2004-01-14</dateCaptured><dateValid encoding="w3cdtf">2004-02-12</dateValid><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">3</extent><extent unit="tables">1</extent><extent unit="references">31</extent></physicalDescription><abstract lang="en">We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.</abstract><note type="funding">Chinese National Foundation of Natural Sciences - No. 30340015; </note><note type="funding">Military Foundation of Medical Science - No. 03F016‐2; </note><note type="funding">Foundation of Natural Sciences of Guangdong Province - No. GD2003‐80; </note><subject lang="en"><genre>keywords</genre><topic>SARS</topic><topic>SARS‐CoV</topic><topic>distribution</topic><topic>detection</topic><topic>pathogenesis</topic><topic>transmission</topic></subject><relatedItem type="host"><titleInfo><title>The Journal of Pathology</title><subTitle>A Journal of the Pathological Society of Great Britain and Ireland</subTitle></titleInfo><titleInfo type="abbreviated"><title>J. 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