Editorial Response: The Importance of the Autopsy in Emerging and Reemerging Infectious Diseases

Schwartz, David A.; Herman, Chester J.

doi:10.1093/clinids/23.2.248

Cited by 56 publications

(40 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2,3,7 Pathology studies have been shown to be an important component of the public health investigation of emerging infections, contributing to the understanding of the mechanisms of tissue injury, for example, human immunodeficiency virus, Ebola virus, hantavirus, West Nile virus, and many others. [10][11][12][13] In those situations in which infections may be transmitted from pregnant women to their fetuses, placental pathology can provide important information on the mechanism(s) of maternal-fetal (vertical) transmission, the nature of the inflammatory response of the mother and fetus to the infection, and the effects of the organisms on the placenta, such as necrosis, hemorrhage, or vascular disease.…”

mentioning

confidence: 99%

Placental Pathology of Zika Virus: Viral Infection of the Placenta Induces Villous Stromal Macrophage (Hofbauer Cell) Proliferation and Hyperplasia

Rosenberg¹,

Yu²,

Hill³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

161

151

View full text Add to dashboard Cite

Context.-The placenta is an important component in understanding the fetal response to intrauterine Zika virus infection, but the pathologic changes in this organ remain largely unknown. Hofbauer cells are fetal-derived macrophages normally present in the chorionic villous stroma. They have been implicated in a variety of physiological and pathologic processes, in particular involving infectious agents.Objectives.-To characterize the fetal and maternal responses and viral localization in the placenta following Zika virus transmission to an 11 weeks' gestation fetus. The clinical course was notable for prolonged viremia in the mother and extensive neuronal necrosis in the fetus. The fetus was delivered at 21 weeks' gestation after pregnancy termination.Design.-The placenta was evaluated by using immunohistochemistry for inflammatory cells (macrophages/ monocytes [Hofbauer cells], B and T lymphocytes) and proliferating cells, and an RNA probe to Zika virus. The fetal brain and the placenta were previously found to be positive for Zika virus RNA by reverse transcriptionpolymerase chain reaction.Results.-The placenta demonstrated prominently enlarged, hydropic chorionic villi with hyperplasia and focal proliferation of Hofbauer cells. The degree of Hofbauer cell hyperplasia gave an exaggerated immature appearance to the villi. No acute or chronic villitis, villous necrosis, remote necroinflammatory abnormalities, chorioamnionitis, funisitis, or hemorrhages were present. An RNA probe to Zika virus was positive in villous stromal cells, presumably Hofbauer cells.Conclusions.-Zika virus placental infection induces proliferation and prominent hyperplasia of Hofbauer cells in the chorionic villi but does not elicit villous necrosis or a maternal or fetal lymphoplasmacellular or acute inflammatory cell reaction.

show abstract

mentioning

confidence: 99%

Placental Pathology of Zika Virus: Viral Infection of the Placenta Induces Villous Stromal Macrophage (Hofbauer Cell) Proliferation and Hyperplasia

Rosenberg¹,

Yu²,

Hill³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

161

151

View full text Add to dashboard Cite

show abstract

“…[2][3][4] This has been especially true in past occurrences of emerging and reemerging infectious diseases. [3][4][5][6] In cases where there is an autopsy, microscopic examination of cells and tissues from infected individuals can potentially reveal several important findings: the tissue distribution of the organism in the body; anatomic localization of the organism to an extracellular or intracellular environment; identification of specific cell type(s) that the organisms may infect (tropism); the approximate quantity (load or burden) of the organisms in tissue; the type and intensity of the host inflammatory response to the organism; the effect(s) of the agent on the host cells and tissues; aspects of the reproduction of the agent in tissues; and whether the organism infects specific body fluids, cells, or tissues that can reach the external environment and permit person-toperson transmission. 7 In situations where vertical (mother-to-infant) infection occurs, pathology has been an important factor in understanding the pathophysiology of transmission; these include viruses (human immunodeficiency virus, cytomegalovirus, parvovirus), bacteria (Listeria, syphilis), and even parasites (Toxoplasma, Trypanosoma cruzi).…”

mentioning

confidence: 99%

Autopsy and Postmortem Studies Are Concordant: Pathology of Zika Virus Infection Is Neurotropic in Fetuses and Infants With Microcephaly Following Transplacental Transmission

Schwartz

2016

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context.-Pathology studies have been important in concluding that Zika virus infection occurring in pregnant women can result in vertical transmission of the agent from mother to fetus. Fetal and infant autopsies have provided crucial direct evidence that Zika virus can infect an unborn child, resulting in microcephaly, other malformations, and, in some cases, death.Objective.-To better understand the etiologic role and mechanism(s) of Zika virus in causing birth defects such as microcephaly, this communication analyzes the spectrum of clinical and autopsy studies reported from fetuses and infants who developed intrauterine Zika virus infection, and compares these findings with experimental data related to Zika virus infection.Design.-Retrospective analysis of reported clinical, autopsy, pathology, and related postmortem studies from 9 fetuses and infants with intrauterine Zika virus infection and microcephaly.Results.-All fetuses and infants examined demonstrated an overlapping spectrum of gross and microscopic neuropathologic abnormalities. Direct cytopathic effects of infection by the Zika virus were confined to the brain; in cases where other organs were evaluated, no direct viral effects were identified.Conclusions.-There is concordance of the spectrum of brain damage, reinforcing previous data indicating that the Zika virus has a strong predilection for cells of the fetal central nervous system following vertical transmission. The occurrence of additional congenital abnormalities suggests that intrauterine brain damage from Zika virus interferes with normal fetal development, resulting in fetal akinesia. Experimental in vitro and in vivo studies of Zika virus infection corroborate the human autopsy findings of neural specificity.

show abstract

“…16 Autopsy material may be an extremely useful tool to address this topic. 28 Better understanding of TB/HIV immunopathology may contribute to the development of novel disease biomarkers and preventive/therapeutic approaches.…”

Section: B Conclusionmentioning

confidence: 99%

Immunophenotype of lung granulomas in HIV and non-HIV associated tuberculosis

Silva¹,

Mauad²,

Saldiva³

et al. 2014

Medical Express

View full text Add to dashboard Cite

OBJECTIVE:To describe the immunophenotype of pulmonary TB granulomas from autopsied patients with tuberculosis (TB group) and from HIV patients with tuberculosis (TB/HIV group), and to identify the Mycobacterium species using polymerase chain reaction (PCR) technique. METHODS: Lung samples of 15 TB group patients and 23 TB/HIV group patients were selected. Histopathologic analyses and immunohistochemistry tests were performed to describe the granulomas and to detect the infectious agent (anti-BCG). CD4, CD8, CD20 and CD68 were evaluated to characterize the immnophenotype of the granulomas. Polymerase Chain Reaction was performed to identify the mycobacterium species. RESULTS: CD4 þ T lymphocytes were the cells with highest density in the TB group, whereas CD68 cells exhibited the highest density in the TB/HIV group. Comparison between groups showed that the CD4 þ T density was significantly higher in the TB patients; whereas, CD68 density was significantly higher in the TB/HIV patients. M. tuberculosis was identified in 8 cases of each group; M. avium was only found in one case of the TB/HIV group. CONCLUSION: With the advent of AIDS, the immunological profile of TB has changed. This may be associated with the depletion of CD4 þ T lymphocytes in lung granulomas. M. tuberculosis was the major etiological agent of TB in both groups.

show abstract

Editorial Response: The Importance of the Autopsy in Emerging and Reemerging Infectious Diseases

Cited by 56 publications

References 23 publications

Placental Pathology of Zika Virus: Viral Infection of the Placenta Induces Villous Stromal Macrophage (Hofbauer Cell) Proliferation and Hyperplasia

Placental Pathology of Zika Virus: Viral Infection of the Placenta Induces Villous Stromal Macrophage (Hofbauer Cell) Proliferation and Hyperplasia

Autopsy and Postmortem Studies Are Concordant: Pathology of Zika Virus Infection Is Neurotropic in Fetuses and Infants With Microcephaly Following Transplacental Transmission

Immunophenotype of lung granulomas in HIV and non-HIV associated tuberculosis

Contact Info

Product

Resources

About