Acute alveolar injury and repair

Corrin, B.; Nicholson, Andrew G.

doi:10.1016/b978-0-7020-3369-8.00004-5

Cited by 7 publications

(7 citation statements)

References 148 publications

(131 reference statements)

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“…Reported cases of pre‐mortem pathology are rare, and this case is a snapshot of what appears to be the disease in the earliest microscopically visible phase of DAD/acute lung injury. Although no hyaline membranes are seen there are oedematous exudates, one of the earliest features of DAD, identifiable on microscopy 10 . Typically, hyaline membranes take hours to develop.…”

Section: Figurementioning

confidence: 99%

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COVID‐19 related lung pathology: old patterns in new clothing?

et al. 2020

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Section: Figurementioning

confidence: 99%

“…Although no hyaline membranes are seen there are oedematous exudates, one of the earliest features of DAD, identifiable on microscopy. 10 Typically, hyaline membranes take hours to develop. Similar features have been reported in lung cancer resections of patients later shown to have COVID-19 infections.…”

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confidence: 99%

COVID‐19 related lung pathology: old patterns in new clothing?

et al. 2020

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“…MKs are usually not mentioned as a characteristic histopathologic finding associated to acute pulmonary injury [4][5][6][7]. However, a few studies and textbooks point out that their number is increased in the lungs of patients with diffuse alveolar damage (DAD), burns, shock, or sepsis [8][9][10][11]. Inflammatory injury to alveolar epithelium and endothelial cells, resulting in intra-alveolar edema, deposition of fibrin, and formation of microthrombi are important pathogenic mechanisms of DAD.…”

Section: Introductionmentioning

confidence: 99%

Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage: an autopsy study with clinical correlation and review of the literature

et al. 2020

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Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their number is increased in diffuse alveolar damage (DAD). In this autopsy study, we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute lung injury (7.61 ± 5.59 megakaryocytes per 25 high-power fields vs. 1.14 ± 0.86 for the control group, p < 0.05). We analyzed samples of 18 patients, most of whom died after prolonged disease and use of mechanical ventilation. Most patients showed advanced DAD and abnormal coagulation parameters with high levels of fibrinogen, D-dimers, and variable thrombocytopenia. For comparison, pulmonary samples from a group of 14 non-COVID-19 patients dying with DAD were reviewed. They showed similar pulmonary histopathologic findings and an increase in the number of megakaryocytes (4 ± 4.17 vs. 1.14 ± 0.86 for the control group, p < 0.05). Megakaryocyte count in the COVID-19 group was greater but did not reach statistical significance (7.61 ± 5.59 vs. 4 ± 4.17, p = 0.063). Regardless of the cause, pulmonary megakaryocytes are increased in patients with DAD. Their high number seen in COVID-19 patients suggests a relation with the thrombotic events so often seen these patients. Since the lung is considered an active site of megakaryopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response.

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“…Microscopic examination showed DAD in bilateral lungs. DAD can be divided into 3 phases: acute (exudate), proliferative, and repair (scarring) phase 15. Of 18 patients, 14 reached the repair (scarring) phase and 4 were at proliferative phase.…”

Section: Resultsmentioning

confidence: 99%

“…DAD can be divided into 3 phases: acute (exudate), proliferative, and repair (scarring) phase. 15 Of 18 patients, 14 reached the repair (scarring) phase and 4 were at proliferative phase. Different phases may coexist in the same patient.…”

Section: Inflammatory Cell Infiltrate and Pathologic Findings In Pati...mentioning

confidence: 99%

Patterns of Inflammatory Cell Infiltration and Expression of STAT6 in the Lungs of Patients With COVID-19: An Autopsy Study

Cao

Birkenbach²,

Chen³

2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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Background: Severe acute respiratory syndrome coronavirus 2 causes diffuse alveolar damage (DAD), lymphocyte infiltration in the lungs and a cytokine storm. In this study we examined inflammatory cell infiltrates and the expression of signal transducer and activator of transcription (STAT) 6 in the lungs of patients with coronavirus disease 2019 (COVID-19).Methods: Eighteen COVID-19 autopsy cases, 9 non-COVID cases with DAD, and 11 controls without lung diseases were included. Immunostainings for STAT6, CD3, CD4, CD8, CD68, and broad-spectrum keratins were performed. Results:The average age of COVID-19 patients was 64.4 ± 2.1 years. The disease duration was 7 to 53 days. The number of pneumocytes, macrophages or CD3 + T cells was significantly increased in the lungs of patients with COVID-19. Patients' age above 67 years, blood troponin levels > 0.2 ng/mL, platelet count > 100×10 9 /L, lung macrophages > 130/high-power field (HPF), CD3 + T cells > 145/HPF, CD8 + T cells <30/HPF, and CD8/CD4 ratio <1 were associated with shorter survival duration after onset of symptoms. In addition, STAT6 staining was much stronger in pneumocytes and lymphocytes in the lungs of patients with COVID-19 than non-COVID DAD patients or controls. Conclusion:Older age, high blood troponin level and platelet count, more macrophages and fewer CD8 + T cells in the lungs of COVID-19 were associated with poorer outcome. STAT6 expression was increased in pneumocytes and lymphocytes in the lungs of patients with COVID-19, implying a role of STAT6 in cytokine storms.

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Acute alveolar injury and repair

Cited by 7 publications

References 148 publications

COVID‐19 related lung pathology: old patterns in new clothing?

COVID‐19 related lung pathology: old patterns in new clothing?

Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage: an autopsy study with clinical correlation and review of the literature

Patterns of Inflammatory Cell Infiltration and Expression of STAT6 in the Lungs of Patients With COVID-19: An Autopsy Study

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