Detection of Hemosiderin-Laden Macrophages in Bronchoalveolar Lavage Fluid of COVID-19 Patients: Is Perls Stain a Potential Indicator of Oxidative Alveolar Damage?

Alsibai, Kinan Drak

doi:10.1159/000508020

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…Large Prussian blue-stained cells (Figures 4(a) – 4(c) and 4(e) ) are in all probability hemosiderin-laden macrophages. Their presence is consistent with findings from analysis of bronchoalveolar lavages (BAL) from COVID-19 patients [ 63 ]. Together with the presence of hemosiderin granules in presumably NET-forming neutrophils (Figures 4(e) – 4(g) ) and other mobile cells ( Figure 4(i) ), and at various extracellular sites, this may prompt considerations about the scope of SARS-CoV-2-induced damage on erythrocyte hemoglobin.…”

Section: Discussionsupporting

confidence: 87%

“…Together with the presence of hemosiderin granules in presumably NET-forming neutrophils (Figures 4(e) – 4(g) ) and other mobile cells ( Figure 4(i) ), and at various extracellular sites, this may prompt considerations about the scope of SARS-CoV-2-induced damage on erythrocyte hemoglobin. Indeed, alveolar macrophages (and likely other phagocytes) collecting free iron ions derive from iron displacement from the heme porphyrin [ 63 – 65 ]. As a caveat, clustered large Prussian blue+ cells bear remarkable similarity to giant (pseudo-)syncytia also occurring in COVID-19 lungs.…”

Section: Discussionmentioning

confidence: 99%

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Neutrophil Extracellular Traps in Fatal COVID-19-Associated Lung Injury

et al. 2021

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An excess formation of neutrophil extracellular traps (NETs), previously shown to be strongly associated with cytokine storm and acute respiratory distress syndrome (ARDS) with prevalent endothelial dysfunction and thrombosis, has been postulated to be a central factor influencing the pathophysiology and clinical presentation of severe COVID-19. A growing number of serological and morphological evidence has added to this assumption, also in regard to potential treatment options. In this study, we used immunohistochemistry and histochemistry to trace NETs and their molecular markers in autopsy lung tissue from seven COVID-19 patients. Quantification of key immunomorphological features enabled comparison with non-COVID-19 diffuse alveolar damage. Our results strengthen and extend recent findings, confirming that NETs are abundantly present in seriously damaged COVID-19 lung tissue, especially in association with microthrombi of the alveolar capillaries. In addition, we provide evidence that low-density neutrophils (LDNs), which are especially prone to NETosis, contribute substantially to COVID-19-associated lung damage in general and vascular blockages in particular.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Neutrophil Extracellular Traps in Fatal COVID-19-Associated Lung Injury

et al. 2021

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“…Whilst the cytokine response associated with the single-cell landscape of COVID-19 patients was recently investigated, [ 2 ] the cytopathological pattern has not been compared to other infections nor has been used as an additional diagnostic tool in COVID-19 patients despite a timely reminder by K. Alsabi. [ 3 ] For this reason we analyzed the cellular components of COVID-19 patients in whom bronchoalveolar lavage (BAL) sampling was performed and compared their cellular profiles to the best possible matching patient groups in which mono-infections with other pathogens as the coronaviruses NL63, HKU1, OC43, and 229E, or Influenza virus type A and B, or Haemophilus influenzae, or Pneumocystis jirovecii have been detected.…”

Section: Introductionmentioning

confidence: 99%

Differential cytology profiles in bronchoalveolar lavage (BAL) in COVID-19 patients

et al. 2021

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Brochoalvelolar lavages (BALs) from patients suffering from hospitalized infections with SARS-CoV-2, other corona viruses (human coronavirus (HCoV)-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1), Influenza virus type A and B, Haemophilus influenzae and Pneumocystis jirovecii were compared cytopathologically. The aim of the study was to evaluate if the cellular profile detectable in BAL may be specific for the respective pathogens and could lead to diagnosis of COVID-19 even in the absence of PCR results. Differential cytology and flow cytometry datasets of 62 patients were observed and compared. We observed a significant association between individual cell pattern changes and the causing pathogen, but no general cell distribution pattern. The cytology pattern of the BAL fluid in COVID-19 is not specific enough to use it as a sole diagnostic criterion, although it may support clinical decision making

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“…BAL is also used to perform cell counting and to search for pathogens. Thus, BAL is an important tool in the diagnosis of inflammatory, autoimmune and infectious pulmonary diseases [16]. Hence, in patients with advanced HIV, it has been a major diagnostic procedure to identify infecting pathogens.…”

Section: Ethical Statementmentioning

confidence: 99%

Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana

Alsibai¹,

Aissaoui²,

Adenis³

et al. 2021

JoF

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Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of Histoplasma capsulatum is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to describe the cytology of histoplasmosis diagnosed by bronchoalveolar lavage (BAL) in relation to patient characteristics. BAL-diagnosed pulmonary histoplasmosis concerned 17 patients (14 HIV+). BAL cellularity ranged from 76,000 to 125,000 cells/mL in HIV patients, and 117,000 to 160,000 cells/mL in non-HIV patients. Macrophages predominated in all HIV patients (from 60% to 88%), lymphocytic infiltrates ranged from 5% to 15%, and neutrophils were very heterogeneous (from 2% to 32%). The number of H. capsulatum at hot spots seemed greater in HIV-infected than in immunocompetent patients (9 to 375 vs. 4 to 10) and were inversely proportional to the CD4 counts. Yeasts were both intracellular and extracellular in 85.7% of the HIV patients. This is the most comprehensive series detailing the cytological aspects of BAL in the diagnosis of H. capsulatum, focusing on the number of yeasts and their clustering pattern. The cytological examination of the Gomori-Grocott-stained BAL allows a reliable diagnosis of histoplasmosis.

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Detection of Hemosiderin-Laden Macrophages in Bronchoalveolar Lavage Fluid of COVID-19 Patients: Is Perls Stain a Potential Indicator of Oxidative Alveolar Damage?

Cited by 6 publications

References 17 publications

Neutrophil Extracellular Traps in Fatal COVID-19-Associated Lung Injury

Neutrophil Extracellular Traps in Fatal COVID-19-Associated Lung Injury

Differential cytology profiles in bronchoalveolar lavage (BAL) in COVID-19 patients

Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana

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