title: Apoptosis and pathogenesis of avian influenza A (H5N1) virus in humans.
abstract: The pathogenesis of avian influenza A (H5N1) virus in humans has not been clearly elucidated. Apoptosis may also play an important role. We studied autopsy specimens from 2 patients who died of infection with this virus. Apoptosis was observed in alveolar epithelial cells, which is the major target cell type for the viral replication. Numerous apoptotic leukocytes were observed in the lung of a patient who died on day 6 of illness. Our data suggest that apoptosis may play a major role in the pathogenesis of influenza (H5N1) virus in humans by destroying alveolar epithelial cells. This pathogenesis causes pneumonia and destroys leukocytes, leading to leukopenia, which is a prominent clinical feature of influenza (H5N1) virus in humans. Whether observed apoptotic cells were a direct result of the viral replication or a consequence of an overactivation of the immune system requires further studies.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Mongkol
authors.initials: M
authors.lastname: Uiprasertkul
authors.forename: Rungrueng
authors.initials: R
authors.lastname: Kitphati
authors.forename: Pilaipan
authors.initials: P
authors.lastname: Puthavathana
authors.forename: Romchat
authors.initials: R
authors.lastname: Kriwong
authors.forename: Alita
authors.initials: A
authors.lastname: Kongchanagul
authors.forename: Kumnuan
authors.initials: K
authors.lastname: Ungchusak
authors.forename: Suwimon
authors.initials: S
authors.lastname: Angkasekwinai
authors.forename: Kulkanya
authors.initials: K
authors.lastname: Chokephaibulkit
authors.forename: Kanittar
authors.initials: K
authors.lastname: Srisook
authors.forename: Nirun
authors.initials: N
authors.lastname: Vanprapar
authors.forename: Prasert
authors.initials: P
authors.lastname: Auewarakul
mesh_terms: D017209:Apoptosis; D001344:Autopsy; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000473:pathology / Q000821:virology; D012367:RNA, Viral / Q000032:analysis; D020545:Respiratory Mucosa / Q000473:pathology / Q000821:virology; D013785:Thailand
chemical_list: D012367:RNA, Viral