Pathogenesis of influenza-induced acute respiratory distress syndrome

Short, Kirsty R., Kroeze, Edwin J. B. Veldhuis, Fouchier, Ron A. M. and Kuiken, Thijs (2014) Pathogenesis of influenza-induced acute respiratory distress syndrome. Lancet Infectious Diseases, 14 1: 57-69. doi:10.1016/S1473-3099(13)70286-X

Author Short, Kirsty R.
Kroeze, Edwin J. B. Veldhuis
Fouchier, Ron A. M.
Kuiken, Thijs
Title Pathogenesis of influenza-induced acute respiratory distress syndrome
Journal name Lancet Infectious Diseases   Check publisher's open access policy
ISSN 1473-3099
Publication date 2014-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/S1473-3099(13)70286-X
Open Access Status
Volume 14
Issue 1
Start page 57
End page 69
Total pages 13
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2015
Language eng
Abstract Acute respiratory distress syndrome (ARDS) is a fatal complication of influenza infection. In this Review we provide an integrated model for its pathogenesis. ARDS involves damage to the epithelial–endothelial barrier, fluid leakage into the alveolar lumen, and respiratory insufficiency. The most important part of the epithelial–endothelial barrier is the alveolar epithelium, strengthened by tight junctions. Influenza virus targets these epithelial cells, reducing sodium pump activity, damaging tight junctions, and killing infected cells. Infected epithelial cells produce cytokines that attract leucocytes—neutrophils and macrophages—and activate adjacent endothelial cells. Activated endothelial cells and infiltrated leucocytes stimulate further infiltration, and leucocytes induce production of reactive oxygen species and nitric oxide that damage the barrier. Activated macrophages also cause direct apoptosis of epithelial cells. This model for influenza-induced ARDS differs from the classic model, which is centred on endothelial damage, and provides a rationale for therapeutic intervention to moderate host response in influenza-induced ARDS.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Non HERDC
School of Biomedical Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 41 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 30 Dec 2014, 23:34:13 EST by Kirsty Short on behalf of School of Biomedical Sciences