Persistence of lung inflammation and lung cytokines with high-resolution CT abnormalities during recovery from SARS
Identifieur interne : 004995 ( Main/Merge ); précédent : 004994; suivant : 004996Persistence of lung inflammation and lung cytokines with high-resolution CT abnormalities during recovery from SARS
Auteurs : Chun-Hua Wang [Taïwan] ; Chien-Ying Liu [Taïwan] ; Yung-Liang Wan [Taïwan] ; Chun-Liang Chou [Taïwan] ; Kuo-Hsiung Huang [Taïwan] ; Horng-Chyuan Lin [Taïwan] ; Shu-Min Lin [Taïwan] ; Tzou-Yien Lin [Taïwan] ; Kian Fan Chung [Royaume-Uni] ; Han-Pin Kuo [Taïwan]Source :
- Respiratory Research [ 1465-9921 ] ; 2005.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Cytokines (immunologie), Facteurs temps, Femelle, Humains, Liquide de lavage bronchoalvéolaire (immunologie), Liquide de lavage bronchoalvéolaire (microbiologie), Mâle, Pneumopathie infectieuse (diagnostic), Pneumopathie infectieuse (immunologie), Pneumopathie infectieuse (microbiologie), Poumon (imagerie diagnostique), Poumon (immunologie), Poumon (microbiologie), Récupération fonctionnelle (immunologie), Syndrome respiratoire aigu sévère (diagnostic), Syndrome respiratoire aigu sévère (immunologie), Syndrome respiratoire aigu sévère (microbiologie), Tomodensitométrie, Virus du SRAS (isolement et purification), Études rétrospectives.
- MESH :
- diagnostic : Pneumopathie infectieuse, Syndrome respiratoire aigu sévère.
- imagerie diagnostique : Poumon.
- immunologie : Cytokines, Liquide de lavage bronchoalvéolaire, Pneumopathie infectieuse, Poumon, Récupération fonctionnelle, Syndrome respiratoire aigu sévère.
- isolement et purification : Virus du SRAS.
- microbiologie : Liquide de lavage bronchoalvéolaire, Pneumopathie infectieuse, Poumon, Syndrome respiratoire aigu sévère.
- Adolescent, Adulte, Adulte d'âge moyen, Facteurs temps, Femelle, Humains, Mâle, Tomodensitométrie, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent, Adult, Bronchoalveolar Lavage Fluid (immunology), Bronchoalveolar Lavage Fluid (microbiology), Cytokines (immunology), Female, Humans, Lung (diagnostic imaging), Lung (immunology), Lung (microbiology), Male, Middle Aged, Pneumonia (diagnosis), Pneumonia (immunology), Pneumonia (microbiology), Recovery of Function (immunology), Retrospective Studies, SARS Virus (isolation & purification), Severe Acute Respiratory Syndrome (diagnosis), Severe Acute Respiratory Syndrome (immunology), Severe Acute Respiratory Syndrome (microbiology), Time Factors, Tomography, X-Ray Computed.
- MESH :
- chemical , immunology : Cytokines.
- diagnosis : Pneumonia, Severe Acute Respiratory Syndrome.
- diagnostic imaging : Lung.
- immunology : Bronchoalveolar Lavage Fluid, Lung, Pneumonia, Recovery of Function, Severe Acute Respiratory Syndrome.
- isolation & purification : SARS Virus.
- microbiology : Bronchoalveolar Lavage Fluid, Lung, Pneumonia, Severe Acute Respiratory Syndrome.
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Tomography, X-Ray Computed.
Abstract
During the acute phase of severe acute respiratory syndrome (SARS), mononuclear cells infiltration, alveolar cell desquamation and hyaline membrane formation have been described, together with dysregulation of plasma cytokine levels. Persistent high-resolution computed tomography (HRCT) abnormalities occur in SARS patients up to 40 days after recovery.
To determine further the time course of recovery of lung inflammation, we investigated the HRCT and inflammatory profiles, and coronavirus persistence in bronchoalveolar lavage fluid (BALF) of 12 patients at recovery at 60 and 90 days.
At 60 days, compared to normal controls, SARS patients had increased cellularity of BALF with increased alveolar macrophages (AM) and CD8 cells. HRCT scores were increased and correlated with T-cell numbers and their subpopulations, and inversely with CD4/CD8 ratio. TNF-α, IL-6, IL-8, RANTES and MCP-1 levels were increased. Viral particles in AM were detected by electron microscopy in 7 of 12 SARS patients with high HRCT score. On day 90, HRCT scores improved significantly in 10 of 12 patients, with normalization of BALF cell counts in 6 of 12 patients with repeat bronchoscopy. Pulse steroid therapy and prolonged fever were two independent factors associated with delayed resolution of pneumonitis, in this non-randomized, retrospective analysis.
Resolution of pneumonitis is delayed in some patients during SARS recovery and may be associated with delayed clearance of coronavirus, Complete resolution may occur by 90 days or later.
Url:
DOI: 10.1186/1465-9921-6-42
PubMed: 15888207
PubMed Central: 1156954
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uniqKey="Kuo H" first="Han-Pin" last="Kuo">Han-Pin Kuo</name><affiliation wicri:level="1"><nlm:aff id="Aff1_280"><institution-wrap><institution-id institution-id-type="GRID">grid.413801.f</institution-id><institution-id institution-id-type="ISNI">0000000107110593</institution-id><institution>Department of Thoracic Medicine II,</institution><institution>Chang Gung Memorial Hospital,</institution></institution-wrap>Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Taipei</wicri:regionArea></affiliation></author></analytic><series><title level="j">Respiratory Research</title><idno type="ISSN">1465-9921</idno><idno type="eISSN">1465-993X</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Bronchoalveolar Lavage Fluid (immunology)</term><term>Bronchoalveolar Lavage Fluid (microbiology)</term><term>Cytokines (immunology)</term><term>Female</term><term>Humans</term><term>Lung (diagnostic imaging)</term><term>Lung (immunology)</term><term>Lung (microbiology)</term><term>Male</term><term>Middle Aged</term><term>Pneumonia (diagnosis)</term><term>Pneumonia (immunology)</term><term>Pneumonia (microbiology)</term><term>Recovery of Function (immunology)</term><term>Retrospective Studies</term><term>SARS Virus (isolation & purification)</term><term>Severe Acute Respiratory Syndrome (diagnosis)</term><term>Severe Acute Respiratory Syndrome (immunology)</term><term>Severe Acute Respiratory Syndrome (microbiology)</term><term>Time Factors</term><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cytokines (immunologie)</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Liquide de lavage bronchoalvéolaire (immunologie)</term><term>Liquide de lavage bronchoalvéolaire (microbiologie)</term><term>Mâle</term><term>Pneumopathie infectieuse (diagnostic)</term><term>Pneumopathie infectieuse (immunologie)</term><term>Pneumopathie infectieuse (microbiologie)</term><term>Poumon (imagerie diagnostique)</term><term>Poumon (immunologie)</term><term>Poumon (microbiologie)</term><term>Récupération fonctionnelle (immunologie)</term><term>Syndrome respiratoire aigu sévère (diagnostic)</term><term>Syndrome respiratoire aigu sévère (immunologie)</term><term>Syndrome respiratoire aigu sévère (microbiologie)</term><term>Tomodensitométrie</term><term>Virus du SRAS (isolement et purification)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Cytokines</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Pneumonia</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Pneumopathie infectieuse</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lung</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Poumon</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Cytokines</term><term>Liquide de lavage bronchoalvéolaire</term><term>Pneumopathie infectieuse</term><term>Poumon</term><term>Récupération fonctionnelle</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Bronchoalveolar Lavage Fluid</term><term>Lung</term><term>Pneumonia</term><term>Recovery of Function</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>SARS Virus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Virus du SRAS</term></keywords><keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Liquide de lavage bronchoalvéolaire</term><term>Pneumopathie infectieuse</term><term>Poumon</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Bronchoalveolar Lavage Fluid</term><term>Lung</term><term>Pneumonia</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Time Factors</term><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Tomodensitométrie</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>During the acute phase of severe acute respiratory syndrome (SARS), mononuclear cells infiltration, alveolar cell desquamation and hyaline membrane formation have been described, together with dysregulation of plasma cytokine levels. Persistent high-resolution computed tomography (HRCT) abnormalities occur in SARS patients up to 40 days after recovery.</p></sec><sec><title>Methods</title><p>To determine further the time course of recovery of lung inflammation, we investigated the HRCT and inflammatory profiles, and coronavirus persistence in bronchoalveolar lavage fluid (BALF) of 12 patients at recovery at 60 and 90 days.</p></sec><sec><title>Results</title><p>At 60 days, compared to normal controls, SARS patients had increased cellularity of BALF with increased alveolar macrophages (AM) and CD8 cells. HRCT scores were increased and correlated with T-cell numbers and their subpopulations, and inversely with CD4/CD8 ratio. TNF-α, IL-6, IL-8, RANTES and MCP-1 levels were increased. Viral particles in AM were detected by electron microscopy in 7 of 12 SARS patients with high HRCT score. On day 90, HRCT scores improved significantly in 10 of 12 patients, with normalization of BALF cell counts in 6 of 12 patients with repeat bronchoscopy. Pulse steroid therapy and prolonged fever were two independent factors associated with delayed resolution of pneumonitis, in this non-randomized, retrospective analysis.</p></sec><sec><title>Conclusion</title><p>Resolution of pneumonitis is delayed in some patients during SARS recovery and may be associated with delayed clearance of coronavirus, Complete resolution may occur by 90 days or later.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ksiazek, Tg" uniqKey="Ksiazek T">TG Ksiazek</name></author><author><name sortKey="Erdman, D" uniqKey="Erdman D">D Erdman</name></author><author><name sortKey="Goldsmith, Cs" uniqKey="Goldsmith C">CS Goldsmith</name></author><author><name sortKey="Zaki, Sr" uniqKey="Zaki S">SR Zaki</name></author><author><name sortKey="Peret, T" uniqKey="Peret T">T Peret</name></author><author><name sortKey="Emery, S" uniqKey="Emery S">S Emery</name></author><author><name 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sortKey="Li, Pc" uniqKey="Li P">PC Li</name></author><author><name sortKey="Ho, Pl" uniqKey="Ho P">PL Ho</name></author><author><name sortKey="Lam, Wk" uniqKey="Lam W">WK Lam</name></author><author><name sortKey="Ng, Ck" uniqKey="Ng C">CK Ng</name></author><author><name sortKey="Ip, Ms" uniqKey="Ip M">MS Ip</name></author><author><name sortKey="Lai, Kn" uniqKey="Lai K">KN Lai</name></author><author><name sortKey="Chan Yeung, M" uniqKey="Chan Yeung M">M Chan-Yeung</name></author><author><name sortKey="Tsang, Kw" uniqKey="Tsang K">KW Tsang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Domachowske, Jb" uniqKey="Domachowske J">JB Domachowske</name></author><author><name sortKey="Bonville, Ca" uniqKey="Bonville C">CA Bonville</name></author><author><name sortKey="Ali Ahmad, D" uniqKey="Ali Ahmad D">D Ali-Ahmad</name></author><author><name sortKey="Rosenberg, Hf" uniqKey="Rosenberg H">HF 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