PubMed Journals: PLoS Med

  Source:		PMID: 16379499
  Download:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324951/pdf/pmed.0030027.pdf

    		PLoS Med. 2006 Feb;3(2):e27. Epub 2006 Jan

			Time course and cellular localization of
			SARS-CoV nucleoprotein and RNA in lungs from
			fatal cases of SARS.

			Nicholls JM(1), Butany J, Poon LL, Chan
			KH, Beh SL, Poutanen S, Peiris JS, Wong

			Author Information
			(1) Department of Pathology,
			The University of Hong Kong, Pok Fu Lam,
			Hong Kong SAR, China. nicholls@pathology.hku.hk

			BACKGROUND: Cellular localization of
			severe acute respiratory syndrome coronavirus
			(SARS-CoV) in the lungs of patients with SARS
			is important in confirming the etiological
			association of the virus with disease as well as
			in understanding the pathogenesis of the
			disease. To our knowledge, there have been no
			comprehensive studies investigating viral infection at
			the cellular level in humans. METHODS AND FINDINGS:
			We collected the largest series of fatal
			cases of SARS with autopsy material to date
			by merging the pathological material from
			two regions involved in the 2003 worldwide
			SARS outbreak in Hong Kong, China, and Toronto,
			Canada. We developed a monoclonal antibody
			against the SARS-CoV nucleoprotein and used
			it together with in situ hybridization (ISH)
			to analyze the autopsy lung tissues of 32
			patients with SARS from Hong Kong and Toronto.
			We compared the results of these assays
			with the pulmonary pathologies and the clinical
			course of illness for each patient. SARS-CoV
			nucleoprotein and RNA were detected by
			immunohistochemistry and ISH, respectively,
			primarily in alveolar pneumocytes and, less
			frequently, in macrophages. Such localization
			was detected in four of the seven patients
			who died within two weeks of illness onset,
			and in none of the 25 patients who died
			later than two weeks after symptom onset.
			CONCLUSIONS: The pulmonary alveolar epithelium is
			the chief target of SARS-CoV, with macrophages
			infected subsequently. Viral replication
			appears to be limited to the first two weeks
			after symptom onset, with little evidence
			of continued widespread replication after
			this period. If antiviral therapy is considered
			for future treatment, it should be focused
			on this two-week period of acute clinical

			DOI: 10.1371/journal.pmed.0030027
			PMCID: PMC1324951 PMID: 16379499 [Indexed
			for MEDLINE]

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