title: [Pulmonary pathology in fatal human influenza A (H1N1) infection].
abstract: OBJECTIVE
  To study the pulmonary pathology in patients died of fatal human influenza A(H1N1) infection.
  
  
  METHODS
  Eight cases of fatal human influenza A (H1N1) infection, including 2 autopsy cases and 6 paramortem needle puncture biopsies, were enrolled into the study. Histologic examination, immunohistochemitry, flow cytometry and Western blotting were carried out.
  
  
  RESULTS
  The major pathologic changes included necrotizing bronchiolitis with surrounding inflammation, diffuse alveolar damage and pulmonary hemorrhage. Influenza viral antigen expression was detected in the lung tissue by Western blotting. Immunohistochemical study demonstrated the presence of nuclear protein and hemagglutinin virus antigens in parts of trachea, bronchial epithelium and glands, alveolar epithelium, macrophages and endothelium. Flow cytometry showed that the apoptotic rate of type II pneumocytes (32.15%, 78.15%) was significantly higher than that of the controls (1.93%, 3.77%).
  
  
  CONCLUSIONS
  Necrotizing bronchiolitis, diffuse alveolar damage and pulmonary hemorrhage followed by pulmonary fibrosis in late stage are the major pathologic changes in fatal human influenza A (H1N1) infection.
authors.affiliation: Department of Pathology, Capital Medical University, Beijing, China.
authors.forename: Xue-jing
authors.initials: XJ
authors.lastname: Duan
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: En-cong
authors.initials: EC
authors.lastname: Gong
authors.forename: Jue
authors.initials: J
authors.lastname: Wang
authors.forename: Fu-dong
authors.initials: FD
authors.lastname: Lü
authors.forename: He-qiu
authors.initials: HQ
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Sun
authors.forename: Zhu-jun
authors.initials: ZJ
authors.lastname: Yue
authors.forename: Chen-chao
authors.initials: CC
authors.lastname: Song
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Dai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D056809:Alveolar Epithelial Cells / Q000473:pathology; D000956:Antigens, Viral / Q000378:metabolism; D017209:Apoptosis; D001344:Autopsy; D001707:Biopsy, Needle; D001990:Bronchiolitis, Viral / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019267:Hemagglutinin Glycoproteins, Influenza Virus / Q000378:metabolism; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D007251:Influenza, Human / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000821:virology; D008168:Lung / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000378:metabolism; D011650:Pulmonary Alveoli / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000473:pathology; D055815:Young Adult
chemical_list: D000956:Antigens, Viral; D019267:Hemagglutinin Glycoproteins, Influenza Virus; D009687:Nuclear Proteins