Статья

Pathomorphological and immunohistochemical features of lymph nodes in COVID-19 patients (Autopsy study)

A. Kovrigina, E. Shalamova, Y. Berezovskiy, D. Kalinin, E. Gretsov, T. Bagdasaryan, L. Semenova, D. Chebotarev, M. Samsonova, A. Chernyaev, L. Mikhaleva, O. Mishnev, E. Kurilina, O. Zayratyants,
2020

Introduction. The pathogenesis of the novel coronavirus infection COVID-19 is being actively studied. Nevertheless, our up-to-date knowledge of lymphoid tissue response in the secondary immune organs during severe COVID-19 remains extremely limited. The aim of the study was to evaluate patterns of immu-nomorphological alterations in lymph nodes in patients with severe COVID-19 and to assess lymphocytes functional activity in them. Materials and methods. Lymph node tissue (autopsy material) from 17 deceased patients with severe COVID-19 was examined by histological and immunohistochemical methods using antibodies to CD4, CD8, CD20, CD30, CD123, CD138, PD-1. Results. Examined lymph nodes demonstrated lymphoid follicles reduction and paracortex expansion with reactive plasmacytosis and extrafollicular B-cell activation as well as sinus histiocytosis, variable hemophago-cytic cells, and blood vessel congestion. Red thrombi were observed in some lymph nodes. Hemorrhages in the stroma were frequent, and massive hemorrhages were found in individual nodes. Immunohistochemical study revealed CD4 T-helpers predominance in the paracortex andcytotoxic CD8 lymphocytes depletion together with an increase in the expression of both the PD-1 suppressor protein and the CD30 activation anti-gen on the lymphocyte surface. CD123-positive plasmacytoid dendritic cells resided in sinuses in abundance. Conclusion. Demonstrated B-associated zone reduction and cytotoxic T-lymphocytes depletion with an up-regulation of PD-1 expression in the lymph nodes in patients with severe COVID-19 indicate immune response exhaustion. At the same time, observed significant reactive plasmacytosis with the presence of numerous T-helper cells constitutes a morphological substrate of the humoral immunity. These findings might indicate the ineffec-tiveness of the humoral response at late stages of COVID-19 infection in context of cytotoxic immunity failure. + +

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  • 1. Version of Record от 2020-01-01

Метаданные

Об авторах
  • A. Kovrigina
    National Research Center for Hematology
  • E. Shalamova
    National Research Center for Hematology
  • Y. Berezovskiy
    Central Institute of Tuberculosis, Russian Academy of Medical Sciences
  • D. Kalinin
    A.V. Vishnevsky National Medical Research Center of Surgery
  • E. Gretsov
    Central Institute of Tuberculosis, Russian Academy of Medical Sciences
  • T. Bagdasaryan
    Central Institute of Tuberculosis, Russian Academy of Medical Sciences
  • L. Semenova
    Central Institute of Tuberculosis, Russian Academy of Medical Sciences
  • D. Chebotarev
    National Research Center for Hematology
  • M. Samsonova
    Research Institute of Pulmonology, Loginov Moscow Clinical Scientific Center
  • A. Chernyaev
    Research Institute of Pulmonology, Research Institute of Human Morphology, Russian Academy of Medical Science, Pirogov Russian National Research Medical University (RNRMU)
  • L. Mikhaleva
    Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow Healthcare Department
  • O. Mishnev
    Pirogov Russian National Research Medical University (RNRMU)
  • E. Kurilina
    National Medical Research Center of Cardiology, Moscow
  • O. Zayratyants
    A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Название журнала
  • Clinical and Experimental Morphology
Том
  • 9
Выпуск
  • 4
Страницы
  • 12-23
Номер гранта
  • undefined
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus