After >8,000 infections and >700 deaths worldwide, the pathogenesis of the new infectious disease, severe acute respiratory syndrome (SARS), remains poorly understood. We investigated 18 autopsies of patients who had suspected SARS; 8 cases were confirmed as SARS. We evaluated white blood cells from 22 confirmed SARS patients at various stages of the disease. T lymphocyte counts in 65 confirmed and 35 misdiagnosed SARS cases also were analyzed retrospectively. SARS viral particles and genomic sequence were detected in a large number of circulating lymphocytes, monocytes, and lymphoid tissues, as well as in the epithelial cells of the respiratory tract, the mucosa of the intestine, the epithelium of the renal distal tubules, the neurons of the brain, and macrophages in different organs. SARS virus seemed to be capable of infecting multiple cell types in several organs; immune cells and pulmonary epithelium were identified as the main sites of injury. A comprehensive theory of pathogenesis is proposed for SARS with immune and lung damage as key features.
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1 August 2005
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July 25 2005
Multiple organ infection and the pathogenesis of SARS
Jiang Gu,
Jiang Gu
1Department of Pathology, Peking University, Beijing, China 100083
4State University of New York Health Science Center at Brooklyn, Brooklyn, NY 11203
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Encong Gong,
Encong Gong
1Department of Pathology, Peking University, Beijing, China 100083
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Bo Zhang,
Bo Zhang
1Department of Pathology, Peking University, Beijing, China 100083
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Jie Zheng,
Jie Zheng
1Department of Pathology, Peking University, Beijing, China 100083
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Zifen Gao,
Zifen Gao
1Department of Pathology, Peking University, Beijing, China 100083
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Yanfeng Zhong,
Yanfeng Zhong
1Department of Pathology, Peking University, Beijing, China 100083
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Wanzhong Zou,
Wanzhong Zou
1Department of Pathology, Peking University, Beijing, China 100083
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Jun Zhan,
Jun Zhan
1Department of Pathology, Peking University, Beijing, China 100083
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Shenglan Wang,
Shenglan Wang
1Department of Pathology, Peking University, Beijing, China 100083
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Zhigang Xie,
Zhigang Xie
1Department of Pathology, Peking University, Beijing, China 100083
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Hui Zhuang,
Hui Zhuang
2Department of Microbiology, Peking University, Beijing, China 100083
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Bingquan Wu,
Bingquan Wu
1Department of Pathology, Peking University, Beijing, China 100083
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Haohao Zhong,
Haohao Zhong
1Department of Pathology, Peking University, Beijing, China 100083
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Hongquan Shao,
Hongquan Shao
1Department of Pathology, Peking University, Beijing, China 100083
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Weigang Fang,
Weigang Fang
1Department of Pathology, Peking University, Beijing, China 100083
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Dongshia Gao,
Dongshia Gao
1Department of Pathology, Peking University, Beijing, China 100083
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Fei Pei,
Fei Pei
1Department of Pathology, Peking University, Beijing, China 100083
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Xingwang Li,
Xingwang Li
3Beijing Ditan Hospital, Beijing, China 100011
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Zhongpin He,
Zhongpin He
3Beijing Ditan Hospital, Beijing, China 100011
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Danzhen Xu,
Danzhen Xu
3Beijing Ditan Hospital, Beijing, China 100011
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Xeying Shi,
Xeying Shi
1Department of Pathology, Peking University, Beijing, China 100083
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Virginia M. Anderson,
Virginia M. Anderson
4State University of New York Health Science Center at Brooklyn, Brooklyn, NY 11203
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Anthony S.-Y. Leong
Anthony S.-Y. Leong
5Hunter Area Pathology Services and Discipline of Anatomical Pathology, University of Newcastle, Newcastle, Australia 2310
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Jiang Gu
1Department of Pathology, Peking University, Beijing, China 100083
4State University of New York Health Science Center at Brooklyn, Brooklyn, NY 11203
Encong Gong
1Department of Pathology, Peking University, Beijing, China 100083
Bo Zhang
1Department of Pathology, Peking University, Beijing, China 100083
Jie Zheng
1Department of Pathology, Peking University, Beijing, China 100083
Zifen Gao
1Department of Pathology, Peking University, Beijing, China 100083
Yanfeng Zhong
1Department of Pathology, Peking University, Beijing, China 100083
Wanzhong Zou
1Department of Pathology, Peking University, Beijing, China 100083
Jun Zhan
1Department of Pathology, Peking University, Beijing, China 100083
Shenglan Wang
1Department of Pathology, Peking University, Beijing, China 100083
Zhigang Xie
1Department of Pathology, Peking University, Beijing, China 100083
Hui Zhuang
2Department of Microbiology, Peking University, Beijing, China 100083
Bingquan Wu
1Department of Pathology, Peking University, Beijing, China 100083
Haohao Zhong
1Department of Pathology, Peking University, Beijing, China 100083
Hongquan Shao
1Department of Pathology, Peking University, Beijing, China 100083
Weigang Fang
1Department of Pathology, Peking University, Beijing, China 100083
Dongshia Gao
1Department of Pathology, Peking University, Beijing, China 100083
Fei Pei
1Department of Pathology, Peking University, Beijing, China 100083
Xingwang Li
3Beijing Ditan Hospital, Beijing, China 100011
Zhongpin He
3Beijing Ditan Hospital, Beijing, China 100011
Danzhen Xu
3Beijing Ditan Hospital, Beijing, China 100011
Xeying Shi
1Department of Pathology, Peking University, Beijing, China 100083
Virginia M. Anderson
4State University of New York Health Science Center at Brooklyn, Brooklyn, NY 11203
Anthony S.-Y. Leong
5Hunter Area Pathology Services and Discipline of Anatomical Pathology, University of Newcastle, Newcastle, Australia 2310
CORRESPONDENCE Jiang Gu: [email protected]
Abbreviations used: CoV, coronavirus; EM, electron microscopy; LM, light microscopy; SARS, severe acute respiratory syndrome.
Received:
April 25 2005
Accepted:
June 16 2005
Online ISSN: 1540-9538
Print ISSN: 0022-1007
The Rockefeller University Press
2005
J Exp Med (2005) 202 (3): 415–424.
Article history
Received:
April 25 2005
Accepted:
June 16 2005
Citation
Jiang Gu, Encong Gong, Bo Zhang, Jie Zheng, Zifen Gao, Yanfeng Zhong, Wanzhong Zou, Jun Zhan, Shenglan Wang, Zhigang Xie, Hui Zhuang, Bingquan Wu, Haohao Zhong, Hongquan Shao, Weigang Fang, Dongshia Gao, Fei Pei, Xingwang Li, Zhongpin He, Danzhen Xu, Xeying Shi, Virginia M. Anderson, Anthony S.-Y. Leong; Multiple organ infection and the pathogenesis of SARS . J Exp Med 1 August 2005; 202 (3): 415–424. doi: https://doi.org/10.1084/jem.20050828
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