1. Novel insight from the first lung transplant of a COVID-19 patient
- Author
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Wen E. Zhao, Yue Shuai Guo, Chang Xing Luan, Xiaofei Liu, Yanfang Yu, Jing Xin Li, Yuan Lin He, Kai Li, Zhong Ming Tan, Feng Chen, Chuan Su, Lei Xu, Jing Yu Chen, Jie Wang, Xiaojun Chen, Zhi Bin Hu, Dong Wei, Ding Li, Jing Jing Ding, Zhi Hong Zhang, Bo Wu, Xuejiang Guo, Li Hu, and You Jia Yu
- Subjects
Male ,Proteomics ,Pathology ,medicine.medical_specialty ,Neutrophils ,T cell ,medicine.medical_treatment ,Pulmonary Fibrosis ,T-Lymphocytes ,Clinical Biochemistry ,Interleukin-1beta ,Nitric Oxide Synthase Type II ,Hemorrhage ,030204 cardiovascular system & hematology ,Biochemistry ,Severity of Illness Index ,Monocytes ,Proinflammatory cytokine ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Fibrosis ,Tandem Mass Spectrometry ,Pulmonary fibrosis ,Macrophages, Alveolar ,Medicine ,Lung transplantation ,Humans ,030212 general & internal medicine ,RNA-Seq ,Lung ,B-Lymphocytes ,business.industry ,Interleukin-6 ,SARS-CoV-2 ,Gene Expression Profiling ,COVID-19 ,General Medicine ,Middle Aged ,medicine.disease ,Flow Cytometry ,Killer Cells, Natural ,medicine.anatomical_structure ,Lymph Nodes ,business ,Cytokine storm ,Chromatography, Liquid ,Lung Transplantation - Abstract
BACKGROUND: To reveal detailed histopathological changes, virus distributions, immunologic properties and multi-omic features caused by SARS-CoV-2 in the explanted lungs from the world's first successful lung transplantation of a COVID-19 patient. MATERIALS AND METHODS: A total of 36 samples were collected from the lungs. Histopathological features and virus distribution were observed by optical microscope and transmission electron microscope (TEM). Immune cells were detected by flow cytometry and immunohistochemistry. Transcriptome and proteome approaches were used to investigate main biological processes involved in COVID-19-associated pulmonary fibrosis. RESULTS: The histopathological changes of the lung tissues were characterized by extensive pulmonary interstitial fibrosis and haemorrhage. Viral particles were observed in the cytoplasm of macrophages. CD3+ CD4- T cells, neutrophils, NK cells, I³/I´ T cells and monocytes, but not B cells, were abundant in the lungs. Higher levels of proinflammatory cytokines iNOS, IL-1s and IL-6 were in the area of mild fibrosis. Multi-omics analyses revealed a total of 126 out of 20,356 significant different transcription and 114 out of 8,493 protein expression in lung samples with mild and severe fibrosis, most of which were related to fibrosis and inflammation. CONCLUSIONS: Our results provide novel insight that the significant neutrophil/ CD3+ CD4- T cell/ macrophage activation leads to cytokine storm and severe fibrosis in the lungs of COVID-19 patient and may contribute to a better understanding of COVID-19 pathogenesis.
- Published
- 2020