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      Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS‐CoV) in SARS patients: implications for pathogenesis and virus transmission pathways

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          Abstract

          We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS‐associated coronavirus (SARS‐CoV). In the present study, we used a murine monoclonal antibody specific for SARS‐CoV nucleoprotein, and probes specific for a SARS‐CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS‐CoV systematically in tissues from patients who died of SARS. SARS‐CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS‐CoV may also be targets of SARS‐CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS‐CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS‐CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS‐CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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          Most cited references 12

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          Fatal aspergillosis in a patient with SARS who was treated with corticosteroids.

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            The Secret Life of ACE2 as a Receptor for the SARS Virus

            The membrane-associated carboxypeptidase angiotensin-converting enzyme 2 (ACE2) is an essential regulator of heart function. Now, Li at al. identify and characterize an unexpected second function of ACE2 as a partner of the SARS-CoV spike glycoprotein in mediating virus entry and cell fusion.
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              Identification of an epitope of SARS-coronavirus nucleocapsid protein

               Ying Lin,  Xu Shen,  Rui Yang (2003)
              The nucleocapsid (N) protein of severe acute respiratory syndrome-coronavirus (SARS-CoV) is a major virion structural protein. In this study, two epitopes (N1 and N2) of the N protein of SARS-CoV were predicted by bioinformatics analysis. After immunization with two peptides, the peptides-specific antibodies were isolated from the immunized rabbits. The further experiments demonstrated that N1 peptide-induced polyclonal antibodies had a high affinity to bind to E. coli expressed N protein of SARS-CoV. Furthermore, it was confirmed that N1 peptide-specific IgG antibodies were detectable in the sera of severe acute respiratory syndrome (SARS) patients. The results indicated that an epitope of the N protein has been identified and N protein specific Abs were produced by peptide immunization, which will be useful for the study of SARS-CoV.
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                Author and article information

                Contributors
                dyq@fimmu.com
                sjiang@nybloodcenter.org
                Journal
                J Pathol
                J. Pathol
                10.1002/(ISSN)1096-9896
                PATH
                The Journal of Pathology
                John Wiley & Sons, Ltd. (Chichester, UK )
                0022-3417
                1096-9896
                07 May 2004
                June 2004
                : 203
                : 2 ( doiID: 10.1002/path.v203:2 )
                : 622-630
                Affiliations
                [ 1 ]Department of Pathology, Nan Fang Hospital, First Military Medical University, Guangzhou, China
                [ 2 ]Department of Infectious Diseases, Nan Fang Hospital, First Military Medical University, Guangzhou, China
                [ 3 ]Centre Laboratory, Zhujiang Hospital, First Military Medical University, Guangzhou, China
                [ 4 ]Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, New York, USA
                Author notes
                [* ] Yanqing Ding, Department of Pathology, First Military Medical University, Guangzhou 5101515, China.

                Shibo Jiang, Laboratory of Viral Immunology, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.

                Article
                PATH1560
                10.1002/path.1560
                7167761
                15141376
                Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                Page count
                Figures: 3, Tables: 1, References: 31, Pages: 9
                Product
                Funding
                Funded by: Chinese National Foundation of Natural Sciences
                Award ID: 30340015
                Funded by: Military Foundation of Medical Science
                Award ID: 03F016‐2
                Funded by: Foundation of Natural Sciences of Guangdong Province
                Award ID: GD2003‐80
                Categories
                Rapid Communication
                Rapid Communications
                Custom metadata
                2.0
                June 2004
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.0 mode:remove_FC converted:15.04.2020

                Pathology

                transmission, pathogenesis, detection, distribution, sars‐cov, sars

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