The pathogenic role of epithelial and endothelial cells in early-phase COVID-19 pneumonia: victims and partners in crime.
Marco ChilosiVenerino PolettiClaudia RavagliaGiulio RossiAlessandra DubiniSara PiciucchiFederica PedicaVincenzo BronteGiovanni PizzoloGuido MartignoniClaudio DoglioniPublished in: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc (2021)
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.
Keyphrases
- respiratory failure
- sars cov
- endothelial cells
- coronavirus disease
- extracorporeal membrane oxygenation
- mechanical ventilation
- respiratory syndrome coronavirus
- single cell
- poor prognosis
- computed tomography
- patients undergoing
- oxidative stress
- community acquired pneumonia
- cell proliferation
- stem cells
- magnetic resonance
- cell therapy
- low grade
- intensive care unit
- ultrasound guided
- high glucose
- vascular endothelial growth factor
- image quality
- long non coding rna
- artificial intelligence