Viral Pathogens and Acute Lung Injury: Investigations Inspired by the SARS Epidemic and the 2009 H1N1 Influenza Pandemic
Identifieur interne : 002727 ( Ncbi/Checkpoint ); précédent : 002726; suivant : 002728Viral Pathogens and Acute Lung Injury: Investigations Inspired by the SARS Epidemic and the 2009 H1N1 Influenza Pandemic
Auteurs : Carolyn M. Hendrickson [États-Unis] ; Michael A. Matthay [États-Unis]Source :
- Seminars in respiratory and critical care medicine [ 1069-3424 ] ; 2013.
Descripteurs français
- KwdFr :
- Animaux, Flambées de maladies, Grippe humaine (épidémiologie), Humains, Lésion pulmonaire aigüe (diagnostic), Lésion pulmonaire aigüe (virologie), Lésion pulmonaire aigüe (épidémiologie), Pneumopathie virale (), Réaction de polymérisation en chaîne (), Sous-type H1N1 du virus de la grippe A (isolement et purification), Syndrome respiratoire aigu sévère (épidémiologie), Technique d'immunofluorescence directe, Virus du SRAS (isolement et purification).
- MESH :
- diagnostic : Lésion pulmonaire aigüe.
- isolement et purification : Sous-type H1N1 du virus de la grippe A, Virus du SRAS.
- virologie : Lésion pulmonaire aigüe.
- épidémiologie : Grippe humaine, Lésion pulmonaire aigüe, Syndrome respiratoire aigu sévère.
- Animaux, Flambées de maladies, Humains, Pneumopathie virale, Réaction de polymérisation en chaîne, Technique d'immunofluorescence directe.
English descriptors
- KwdEn :
- Acute Lung Injury (diagnosis), Acute Lung Injury (epidemiology), Acute Lung Injury (virology), Animals, Disease Outbreaks, Fluorescent Antibody Technique, Direct, Humans, Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (epidemiology), Pneumonia, Viral (complications), Polymerase Chain Reaction (methods), SARS Virus (isolation & purification), Severe Acute Respiratory Syndrome (epidemiology).
- MESH :
- complications : Pneumonia, Viral.
- diagnosis : Acute Lung Injury.
- epidemiology : Acute Lung Injury, Influenza, Human, Severe Acute Respiratory Syndrome.
- isolation & purification : Influenza A Virus, H1N1 Subtype, SARS Virus.
- methods : Polymerase Chain Reaction.
- virology : Acute Lung Injury.
- Animals, Disease Outbreaks, Fluorescent Antibody Technique, Direct, Humans.
Abstract
Acute viral pneumonia is an important cause of acute lung injury (ALI), although not enough is known about the exact incidence of viral infection in ALI. Polymerase chain reaction-based assays, direct fluorescent antigen (DFA) assays, and viral cultures can detect viruses in samples from the human respiratory tract, but the presence of the virus does not prove it to be a pathogen, nor does it give information regarding the interaction of viruses with the host immune response and bacterial flora of the respiratory tract. The severe acute respiratory syndrome (SARS) epidemic and the 2009 H1N1 influenza pandemic provided a better understanding of how viral pathogens mediate lung injury. Although the viruses initially infect the respiratory epithelium, the relative role of epithelial damage and endothelial dysfunction has not been well defined. The inflammatory host immune response to H1N1 infection is a major contributor to lung injury. The SARS coronavirus causes lung injury and inflammation in part through actions on the nonclassical renin angiotensin pathway. The lessons learned from the pandemic outbreaks of SARS coronavirus and H1N1 capture key principles of virally mediated ALI. There are pathogen-specific pathways underlying virally mediated ALI that converge onto a common end pathway resulting in diffuse alveolar damage. In terms of therapy, lung protective ventilation is the cornerstone of supportive care. There is little evidence that corticosteroids are beneficial, and they might be harmful. Future therapeutic strategies may be targeted to specific pathogens, the pathogenetic pathways in the host immune response, or enhancing repair and regeneration of tissue damage.
Url:
DOI: 10.1055/s-0033-1351122
PubMed: 23934716
PubMed Central: 4045622
Affiliations:
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PMC:4045622Le document en format XML
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<term>Animals</term>
<term>Disease Outbreaks</term>
<term>Fluorescent Antibody Technique, Direct</term>
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<term>Influenza A Virus, H1N1 Subtype (isolation & purification)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Pneumonia, Viral (complications)</term>
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<term>Lésion pulmonaire aigüe (virologie)</term>
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<front><div type="abstract" xml:lang="en"><p id="P1">Acute viral pneumonia is an important cause of acute lung injury (ALI), although not enough is known about the exact incidence of viral infection in ALI. Polymerase chain reaction-based assays, direct fluorescent antigen (DFA) assays, and viral cultures can detect viruses in samples from the human respiratory tract, but the presence of the virus does not prove it to be a pathogen, nor does it give information regarding the interaction of viruses with the host immune response and bacterial flora of the respiratory tract. The severe acute respiratory syndrome (SARS) epidemic and the 2009 H1N1 influenza pandemic provided a better understanding of how viral pathogens mediate lung injury. Although the viruses initially infect the respiratory epithelium, the relative role of epithelial damage and endothelial dysfunction has not been well defined. The inflammatory host immune response to H1N1 infection is a major contributor to lung injury. The SARS coronavirus causes lung injury and inflammation in part through actions on the nonclassical renin angiotensin pathway. The lessons learned from the pandemic outbreaks of SARS coronavirus and H1N1 capture key principles of virally mediated ALI. There are pathogen-specific pathways underlying virally mediated ALI that converge onto a common end pathway resulting in diffuse alveolar damage. In terms of therapy, lung protective ventilation is the cornerstone of supportive care. There is little evidence that corticosteroids are beneficial, and they might be harmful. Future therapeutic strategies may be targeted to specific pathogens, the pathogenetic pathways in the host immune response, or enhancing repair and regeneration of tissue damage.</p>
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