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Review
. 2008 Apr;133(1):4-12.
doi: 10.1016/j.virusres.2007.01.022. Epub 2007 Sep 7.

Pathogenetic mechanisms of severe acute respiratory syndrome

Yong Guo  1 , Christine Korteweg, Michael A McNutt, Jiang Gu
Affiliations
Review

Pathogenetic mechanisms of severe acute respiratory syndrome

Yong Guo et al. Virus Res. 2008 Apr.

Abstract

Severe acute respiratory syndrome (SARS) is an acute respiratory disease with significant morbidity and mortality. While its clinical manifestations have been extensively studied, its pathogenesis is not yet fully understood. A limited number of autopsy studies have revealed that the lungs and the immune system are the organs that sustain the most severe damage. Other organs affected include the kidneys, brain, digestive tract, heart, liver, thyroid gland and urogenital tract. The primary target cells are pneumocytes and enterocytes, both cell types abundantly expressing angiotensin-converting enzyme 2 which is the main SARS-CoV receptor. Other cell types infected include the epithelial cells of renal tubules, cerebral neurons, and immune cells. The pathology of this disease results from both direct and indirect injury. Direct injury is caused by infection of the target cells by the virus. Indirect injury mainly results from immune responses, circulatory dysfunction, and hypoxia. In this review, we summarize the major pathological findings at the gross, cellular and molecular levels and discuss the various possible mechanisms that may contribute to the pathogenesis of SARS. The implications of the proposed pathogenesis for prevention, diagnosis and therapy of the disease are discussed.

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Figures

Fig. 1
Fig. 1
Diagram depicting the role of infected immune cells in the pathogenesis of SARS. Other etiological factors involved are not included in this diagram.
See this image and copyright information in PMC

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