The pathogenic role of epithelial and endothelial cells in early-phase COVID-19 pneumonia: victims and partners in crime

被引:39
作者
Chilosi, Marco [1 ]
Poletti, Venerino [2 ,3 ]
Ravaglia, Claudia [3 ]
Rossi, Giulio [4 ]
Dubini, Alessandra [5 ]
Piciucchi, Sara [6 ]
Pedica, Federica [7 ]
Bronte, Vincenzo [8 ]
Pizzolo, Giovanni [9 ]
Martignoni, Guido [1 ,10 ]
Doglioni, Claudio [7 ]
机构
[1] Pederzoli Hosp, Dept Pathol, Peschiera Del Garda, Italy
[2] Aarhus Univ Hosp, Dept Resp Dis & Allergy, Aarhus, Denmark
[3] GB Morgagni L Pierantoni Hosp, Dept Dis Thorax, Forli, Italy
[4] Ravenna Hosp, Dept Pathol, Ravenna, Italy
[5] GB Morgagni L Pierantoni Hosp, Dept Pathol, Forli, Italy
[6] GB Morgagni L Pierantoni Hosp, Dept Radiol, Forli, Italy
[7] Ist Sci San Raffaele, Dept Pathol, Milan, Italy
[8] Univ Verona, Immunol Sect, Dept Med, Verona, Italy
[9] Univ Verona, Sect Hematol, Dept Med, Verona, Italy
[10] Univ Verona, Dept Pathol & Diagnost, Verona, Italy
关键词
D O I
10.1038/s41379-021-00808-8
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Current understanding of the complex pathogenesis of COVID-19 interstitial pneumonia pathogenesis in the light of biopsies carried out in early/moderate phase and histology data obtained at postmortem analysis is discussed. In autopsies the most observed pattern is diffuse alveolar damage with alveolar-epithelial type-II cell hyperplasia, hyaline membranes, and frequent thromboembolic disease. However, these observations cannot explain some clinical, radiological and physiopathological features observed in SARS-CoV-2 interstitial pneumonia, including the occurrence of vascular enlargement on CT and preserved lung compliance in subjects even presenting with or developing respiratory failure. Histological investigation on early-phase pneumonia on perioperative samples and lung biopsies revealed peculiar morphological and morpho-phenotypical changes including hyper-expression of phosphorylated STAT3 and immune checkpoint molecules (PD-L1 and IDO) in alveolar-epithelial and endothelial cells. These features might explain in part these discrepancies.
引用
收藏
页码:1444 / 1455
页数:12
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