Immunogenicity Host Defense, Inflammation, and True Grit

Total Page:16

File Type:pdf, Size:1020Kb

Immunogenicity Host Defense, Inflammation, and True Grit True Grit: Programmed Necrosis in Antiviral Host Defense, Inflammation, and Immunogenicity This information is current as Edward S. Mocarski, William J. Kaiser, Devon of September 23, 2021. Livingston-Rosanoff, Jason W. Upton and Lisa P. Daley-Bauer J Immunol 2014; 192:2019-2026; ; doi: 10.4049/jimmunol.1302426 http://www.jimmunol.org/content/192/5/2019 Downloaded from References This article cites 119 articles, 33 of which you can access for free at: http://www.jimmunol.org/content/192/5/2019.full#ref-list-1 http://www.jimmunol.org/ Why The JI? Submit online. • Rapid Reviews! 30 days* from submission to initial decision • No Triage! Every submission reviewed by practicing scientists • Fast Publication! 4 weeks from acceptance to publication by guest on September 23, 2021 *average Subscription Information about subscribing to The Journal of Immunology is online at: http://jimmunol.org/subscription Permissions Submit copyright permission requests at: http://www.aai.org/About/Publications/JI/copyright.html Email Alerts Receive free email-alerts when new articles cite this article. Sign up at: http://jimmunol.org/alerts The Journal of Immunology is published twice each month by The American Association of Immunologists, Inc., 1451 Rockville Pike, Suite 650, Rockville, MD 20852 Copyright © 2014 by The American Association of Immunologists, Inc. All rights reserved. Print ISSN: 0022-1767 Online ISSN: 1550-6606. Th eJournal of Brief Reviews Immunology True Grit: Programmed Necrosis in Antiviral Host Defense, Inflammation, and Immunogenicity Edward S. Mocarski,*,† William J. Kaiser,*,† Devon Livingston-Rosanoff,*,† Jason W. Upton,‡ and Lisa P. Daley-Bauer*,† Programmed necrosis mediated by receptor interacting bris to promote Ag cross-presentation by dendritic cells (DCs), protein kinase (RIP)3 (also called RIPK3) has emerged thereby supporting a robust adaptive immune response that as an alternate death pathway triggered by TNF family ultimately controls infection. The study of virus-encoded cell death receptors, pathogen sensors, IFNRs, Ag-specific death suppressor mutants brought RIP3 necrosis to light, re- TCR activation, and genotoxic stress. Necrosis leads vealing interdependencies fostered by a pathogen–host arms to cell leakage and acts as a “trap door,” eliminating cells race centered on cell death measures and countermeasures (5). that cannot die by apoptosis because of the elaboration of Based on the variety of strategies that have been observed, cell Downloaded from pathogen-encoded caspase inhibitors. Necrotic signaling death suppressors are crucial to the pathogenesis of all large requires RIP3 binding to one of three partners—RIP1, DNA viruses (2, 3, 5, 8, 9). Because cell death is triggered by DAI, or TRIF—via a common RIP homotypic inter- pre-existing cellular machinery, dysregulation can inadvertently action motif. Once activated, RIP3 kinase targets the kill cells and cause inflammatory disease, even in the absence of infection (7). The distribution of these pathways in all somatic pseudokinase mixed lineage kinase domain-like to drive http://www.jimmunol.org/ cells opens possible routes to improve host resistance to natural cell lysis. Although necrotic and apoptotic death can pathogens, as well as to prevent infection of novel biothreat enhance T cell cross-priming during infection, mice agents. This review provides a perspective on recent advances in that lack these extrinsic programmed cell death path- RIP3 necrosis. The intention is to highlight triggers and al- ways are able to produce Ag-specific T cells and control ternate pathways of extrinsic cell death where therapeutic in- viral infection. The entwined relationship of apoptosis tervention might improve innate resistance to infection or drive and necrosis evolved in response to pathogen-encoded better cross-presentation during vaccination, without risking suppressors to support host defense and contribute to increased inflammatory disease (10). The derivation of viable, inflammation. The Journal of Immunology,2014,192: fertile, and immunocompetent mice with combined deficiency by guest on September 23, 2021 2019–2026. in Casp8 and RIP3 (11) dismisses any key role for Casp8- regulated pathways in development, but it certainly raises im- egulated cell death is a potent arm of host defense (1– portant questions as to how apoptosis, as well as necrosis, con- 4), involving alternate strategies that evolved with tributes to the function of the immune system. animals to counteract pathogen-encoded cell death R Alternate Casp8-apoptosis and RIP3-necrosis pathways suppressors (3, 5). Intrinsic (mitochondrial) apoptosis is nec- essary for development (6), whereas extrinsic apoptosis and To set the stage for discussing the current understanding of programmed necrosis play out as alternate innate immune RIP3 kinase in host defense, it is important to consider the countermeasures to control infection (3, 5, 7). Although mech- crucial role that TNF-mediated signal transduction has played anistically distinct from Casp8-mediated extrinsic apoptosis, re- in the elaboration of alternate cytoprotective and cytotoxic ceptor interacting protein kinase (RIP)3 necrosis similarly pathways (1, 12). Three distinct outcomes of signal transduc- eliminates infected cells prior to release of viral progeny, tion via the TNF death receptor, TNFR1, are recognized: cyto- halting infection and triggering an inflammatory response (7). kine activation, extrinsic apoptosis, and programmed necrosis. Importantly, extrinsic apoptosis and necrotic cell death ma- These converge on death domain (DD) signaling that is or- chinery is distributed in all somatic cells. These pathways chestrated via the adaptor FADD in complex with Casp8 and reduce the burden of infection while also producing cell de- specific inhibitor, FLIP (12, 13) (Fig. 1). Pathogen sensors, *Department of Microbiology and Immunology, Emory University School of Medicine, Emory University School of Medicine, Atlanta, GA 30322. E-mail address: mocarski@ Atlanta, GA 30322; †Emory Vaccine Center, Emory University School of Medicine, emory.edu Atlanta, GA 30322; and ‡Department of Molecular Biosciences, Institute for Cellular Abbreviations used in this article: DAI, DNA-dependent activator of IRF; DC, dendritic and Molecular Biology, University of Texas at Austin, Austin, TX 78712 cell; DD, death domain; DED, death effector domain; HCMV, human CMV; MCMV, Received for publication October 2, 2013. Accepted for publication December 20, 2013. murine CMV; MLKL, mixed lineage kinase domain-like; RHIM, receptor interacting protein kinase homotypic interaction motif; RIP, receptor interacting protein kinase; This work was supported by National Institutes of Health Grants R01 AI030363 vFLIP, viral FLIP; vICA, viral inhibitor of Casp8 activation; vIRA, viral inhibitor of and AI020211 to E.S.M., National Institutes of Health Grant T32GM008169 and receptor interacting protein kinase activation; WT, wild-type. an Achievement Rewards for College Scientists Fellowship to D.L.-R., National Insti- tutes of Health Grant OD012198 to W.J.K., and start-up funds from the University of Ó Texas at Austin and the Cancer Prevention Research Institute of Texas to J.W.U. Copyright 2014 by The American Association of Immunologists, Inc. 0022-1767/14/$16.00 Address correspondence and reprint requests to Prof. Edward S. Mocarski, Department of Microbiology and Immunology, Emory Vaccine Center, 1462 Clifton Road NE, www.jimmunol.org/cgi/doi/10.4049/jimmunol.1302426 2020 BRIEF REVIEWS: IMMUNE IMPLICATIONS OF RIP3 NECROSIS IFNs, TCRs, and genotoxic stress all trigger analogous out- well as necroptosis, first emerged in studies of TNFR1 DD comes. Insights from TNFR DD signaling and identification signaling (22, 35, 36). Necroptosis is triggered when Casp8 of virus-encoded cell death suppressors using TNF-based becomes compromised during death signal transduction. In assays (14–16) has brought an appreciation of core cell these settings, RIP1 functions as both a RIP homotypic inter- death machinery operating as an integrated pathogen sensor action motif (RHIM)-dependent adaptor and a protein kinase system (5). In line with the view that extrinsic death came into to phosphorylate RIP3 (37–39), a partnership that results in existence to support host defense, both TNF antagonist im- formation of an amyloid-like complex (40). RIP3 kinase munotherapy (17) and genetic linkage studies (18) show that undergoes autophosphorylation and subsequently activates TNF signaling contributes as a redundant factor in host de- a target protein, mixed lineage kinase domain-like (MLKL), fense, like many other innate immune mechanisms. A goal of by phosphorylating key amino acids (7, 41, 42). The final steps this review is to highlight the growing evidence that TNF in this pathway involve the formation of an MLKL homotrimer opened the awareness to a broadly distributed innate cell that translocates to the plasma membrane to mediate Ca2+ influx death system able to prevent infection. via a transient receptor potential melastatin related 7 channel TNF family death receptors. TNFR1, as well as the Fas/CD95 (43). A similar RIP3–MLKL axis (28) is apparently shared by and TRAIL death receptors, control NF-kB activation, extrinsic the three pathways leading to RIP3 necrosis, whether RIP1 apoptosis, and programmed necrosis by DD signal transduction, dependent or RIP1 independent (Fig. 2). functioning in collaboration with death effector domain (DED) Pathogen sensors. Pathogen recognition receptors trigger
Recommended publications
  • Wound Classification
    Wound Classification Presented by Dr. Karen Zulkowski, D.N.S., RN Montana State University Welcome! Thank you for joining this webinar about how to assess and measure a wound. 2 A Little About Myself… • Associate professor at Montana State University • Executive editor of the Journal of the World Council of Enterstomal Therapists (JWCET) and WCET International Ostomy Guidelines (2014) • Editorial board member of Ostomy Wound Management and Advances in Skin and Wound Care • Legal consultant • Former NPUAP board member 3 Today We Will Talk About • How to assess a wound • How to measure a wound Please make a note of your questions. Your Quality Improvement (QI) Specialists will follow up with you after this webinar to address them. 4 Assessing and Measuring Wounds • You completed a skin assessment and found a wound. • Now you need to determine what type of wound you found. • If it is a pressure ulcer, you need to determine the stage. 5 Assessing and Measuring Wounds This is important because— • Each type of wound has a different etiology. • Treatment may be very different. However— • Not all wounds are clear cut. • The cause may be multifactoral. 6 Types of Wounds • Vascular (arterial, venous, and mixed) • Neuropathic (diabetic) • Moisture-associated dermatitis • Skin tear • Pressure ulcer 7 Mixed Etiologies Many wounds have mixed etiologies. • There may be both venous and arterial insufficiency. • There may be diabetes and pressure characteristics. 8 Moisture-Associated Skin Damage • Also called perineal dermatitis, diaper rash, incontinence-associated dermatitis (often confused with pressure ulcers) • An inflammation of the skin in the perineal area, on and between the buttocks, into the skin folds, and down the inner thighs • Scaling of the skin with papule and vesicle formation: – These may open, with “weeping” of the skin, which exacerbates skin damage.
    [Show full text]
  • 797 Circulating Tumor DNA and Circulating Tumor Cells for Cancer
    Medical Policy Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy) Table of Contents • Policy: Commercial • Coding Information • Information Pertaining to All Policies • Policy: Medicare • Description • References • Authorization Information • Policy History • Endnotes Policy Number: 797 BCBSA Reference Number: 2.04.141 Related Policies Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer, #336 Policy1 Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Plasma-based comprehensive somatic genomic profiling testing (CGP) using Guardant360® for patients with Stage IIIB/IV non-small cell lung cancer (NSCLC) is considered MEDICALLY NECESSARY when the following criteria have been met: Diagnosis: • When tissue-based CGP is infeasible (i.e., quantity not sufficient for tissue-based CGP or invasive biopsy is medically contraindicated), AND • When prior results for ALL of the following tests are not available: o EGFR single nucleotide variants (SNVs) and insertions and deletions (indels) o ALK and ROS1 rearrangements o PDL1 expression. Progression: • Patients progressing on or after chemotherapy or immunotherapy who have never been tested for EGFR SNVs and indels, and ALK and ROS1 rearrangements, and for whom tissue-based CGP is infeasible (i.e., quantity not sufficient for tissue-based CGP), OR • For patients progressing on EGFR tyrosine kinase inhibitors (TKIs). If no genetic alteration is detected by Guardant360®, or if circulating tumor DNA (ctDNA) is insufficient/not detected, tissue-based genotyping should be considered. Other plasma-based CGP tests are considered INVESTIGATIONAL. CGP and the use of circulating tumor DNA is considered INVESTIGATIONAL for all other indications. 1 The use of circulating tumor cells is considered INVESTIGATIONAL for all indications.
    [Show full text]
  • A 10 Year Cross Sectional Multicentre Study of Infected Pancreatic Necrosis
    JOP. J Pancreas (Online) 2021 Jan 30; 22(1): 11-20. ORIGINAL PAPER A 10 Year Cross Sectional Multicentre Study of Infected Pancreatic Necrosis. Trends in Management and an Analysis of Factors Predicting Mortality for Interventions in Infected Pancreatic Necrosis Johann Faizal Khan1, Suryati Mokhtar1, Krishnan Raman1, Harjit Singh1, Leow Voon Meng 2,3, Manisekar K Subramaniam1,2 1 2 Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Selayang Hospital, Selangor, Malaysia 3Department of General Surgery, Division of Hepatopancreatobiliary Surgery, Sultanah Bahiyah Hospital, Kedah, Malaysia Malaysia Advanced Medical and Dental Institute (AMDI), Science University of Malaysia (USM), Penang, ABSTRACT Objective To identify trends in management and analyse outcomes of patients undergoing interventions for infected pancreatic necrosis Method A cross sectional study of patients undergoing intervention for IPN with specific reference to factors predictive of mortality. between 2009-2018 were performed at two of the largest hepatopancreatobiliary centres in Malaysia. FinalResults outcome A measuretotal number of complete of 65 resolution was compared against mortality (D). Head to head comparison of percutaneous catheter drainage alone versus Videoscopic Assisted Retroperitoneal Debridement was performed based on final predictive factor on mortality. patients with IPN were identified. Data from 59/65 patients were analysed for final outcome of death (D) versus complete resolution. 6 patients were omitted due to incomplete data
    [Show full text]
  • WA Coding Rule 1215/07 Skin Ulcer Necrosis Versus Gangrene
    WA Coding Rules are a requirement of the Clinical Coding Policy MP0056/17 Western Australian Coding Rule 1215/07 Skin ulcer necrosis versus gangrene WA Coding Rule 0110/06 Skin ulcer necrosis versus gangrene is superseded by ACCD Coding Rule Skin necrosis (Ref No: Q2659) effective 1 January 2014; (log in to view on the ACCD CLIP portal). DECISION WA Coding Rule 0110/06 Skin ulcer necrosis versus gangrene is retired. [Effective 01 Jan 2014, ICD-10-AM/ACHI/ACS 8th Ed.] Page 1 of 3 © Department of Health WA 2018 WA Coding Rules are a requirement of the Clinical Coding Policy MP0056/17 Western Australian Coding Rule 0110/06 Skin ulcer necrosis versus gangrene Q. Often with traumatic wounds or infection there will be documentation of devitalized tissue or necrotic wound edges or just some mention of necrotic tissue, the extent of the necrosis usually not known. No mention of gangrene. The ICD 10 indexing for necrosis defaults to coding R02. For cases with documentation of necrosis irrespective of the extent of necrosis and definitely no mention of gangrene is the coder to assign the code R02 or if documentation suggests the amount of necrosis is small and confined to edges should this be considered part of the traumatic wound and the code not assigned? Necrosis is commonly documented in the patient records with traumatic wounds, burns, pressure sores etc. Necrosis due to lack of oxygen such as with a MI would be considered part of the MI code as would any necrosis with infection in pneumonia. Gangrene would seem to be a complication of necrotic tissue.
    [Show full text]
  • Molecular Pathological Epidemiology in Diabetes Mellitus and Risk of Hepatocellular Carcinoma
    Submit a Manuscript: http://www.wjgnet.com/esps/ World J Hepatol 2016 September 28; 8(27): 1119-1127 Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx ISSN 1948-5182 (online) DOI: 10.4254/wjh.v8.i27.1119 © 2016 Baishideng Publishing Group Inc. All rights reserved. REVIEW Molecular pathological epidemiology in diabetes mellitus and risk of hepatocellular carcinoma Chun Gao Chun Gao, Department of Gastroenterology, China-Japan logy and epidemiology, and investigates the relationship Friendship Hospital, Ministry of Health, Beijing 100029, China between exogenous and endogenous exposure factors, tumor molecular signatures, and tumor initiation, progres- Author contributions: Gao C conceived the topic, performed sion, and response to treatment. Molecular epidemiology research, retrieved concerned literatures and wrote the paper. broadly encompasses MPE and conventional-type mole- cular epidemiology. Hepatocellular carcinoma (HCC) Supported by Beijing NOVA Programme of Beijing Municipal is the third most common cause of cancer-associated Science and Technology Commission, No. Z13110.7000413067. death worldwide and remains as a major public health Conflict-of-interest statement: No conflict of interest. challenge. Over the past few decades, a number of epidemiological studies have demonstrated that diabetes Open-Access: This article is an open-access article which was mellitus (DM) is an established independent risk factor selected by an in-house editor and fully peer-reviewed by external for HCC. However, how DM affects the occurrence and
    [Show full text]
  • Salivary Gland – Necrosis
    Salivary Gland – Necrosis Figure Legend: Figure 1 Salivary gland - Necrosis in a male F344/N rat from a subchronic study. There is necrosis of the acinar cells (arrow) with inflammation. Figure 2 Salivary gland - Necrosis in a male F344/N rat from a subchronic study. There is necrosis of the acinar cells (arrow) with chronic active inflammation. Figure 3 Salivary gland - Necrosis in a female F344/N rat from a subchronic study. There is necrosis of an entire lobe of the salivary gland (arrow), consistent with an infarct. Figure 4 Salivary gland - Necrosis in a female F344/N rat from a subchronic study. There is necrosis of all the components of the salivary gland (consistent with an infarct), with inflammatory cells, mostly neutrophils. Comment: Necrosis may be characterized either by scattered single-cell necrosis or by locally extensive areas of necrosis involving contiguous cells or structures. Single-cell necrosis can present as cell shrinkage, condensation of nuclear chromatin and cytoplasm, convolution of the cell, and the presence of apoptotic bodies. Acinar necrosis can present as focal to multifocal areas characterized by 1 Salivary Gland – Necrosis tissue that is paler than the surrounding viable tissue, consisting of swollen cells with variable degrees of eosinophilia, hyalinized cytoplasm, vacuolated cytoplasm, nuclear pyknosis, karyolysis, and/or karyorrhexis with associated cellular debris (Figure 1 and Figure 2). Secondary inflammation is common. Infarction (Figure 3 and Figure 4) is characterized by a focal to focally extensive area of salivary gland necrosis. One cause of necrosis, inflammation, and atrophy of the salivary gland in the rat is an active sialodacryoadenitis virus infection, but this virus does not affect the mouse salivary gland.
    [Show full text]
  • Characterization and Epidemiology of Soybean Vein Necrosis Associated Virus Jing Zhou University of Arkansas, Fayetteville
    University of Arkansas, Fayetteville ScholarWorks@UARK Theses and Dissertations 12-2012 Characterization and Epidemiology of Soybean Vein Necrosis Associated Virus Jing Zhou University of Arkansas, Fayetteville Follow this and additional works at: http://scholarworks.uark.edu/etd Part of the Botany Commons, Molecular Biology Commons, and the Plant Pathology Commons Recommended Citation Zhou, Jing, "Characterization and Epidemiology of Soybean Vein Necrosis Associated Virus" (2012). Theses and Dissertations. 643. http://scholarworks.uark.edu/etd/643 This Thesis is brought to you for free and open access by ScholarWorks@UARK. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of ScholarWorks@UARK. For more information, please contact [email protected], [email protected]. CHARACTERIZATION AND EPIDEMIOLOGY OF SOYBEAN VEIN NECROSIS ASSOCIATED VIRUS CHARACTERIZATION AND EPIDEMIOLOGY OF SOYBEAN VEIN NECROSIS ASSOCIATED VIRUS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Cell and Molecular Biology By Jing Zhou Qingdao Agriculture University, College of Life Sciences Bachelor of Science in Biotechnology, 2008 December 2012 University of Arkansas ABSTRACT Soybean vein necrosis disease (SVND) is widespread in major soybean-producing areas in the U.S. The typical disease symptoms exhibit as vein clearing along the main vein, which turn into chlorosis or necrosis as season progresses. Double-stranded RNA isolation and shot gun cloning of symptomatic tissues revealed the presence of a new tospovirus, provisionally named as Soybean vein necrosis associated virus (SVNaV). The presence of the virus has been confirmed in 12 states: Arkansas, Illinois, Missouri, Kansas, Tennessee, Kentucky, Mississippi, Maryland, Delaware, Virginia and New York.
    [Show full text]
  • Avascular Necrosis (AVN)
    Avascular Necrosis (AVN) Avascular necrosis is an injury to Treatment bones. It is caused when blood cannot flow AVN pain can become chronic, meaning pain that to the bone. Without blood, the bone tissue doesn’t go away completely. However, people can live dies. This may cause the bone to break down. and function with chronic pain by limiting activities and AVN can involve the bones of a joint. If this using pain medicine carefully. happens, the joint can break down or have • Physical Therapy exercises for building strength trouble moving normally. AVN most often and increasing range of motion. affects the hips and shoulders. Other joints • Decrease weight bearing by using crutches, a can be affected. walker, or a wheelchair. • Anti-inflammatory medicines such as ibuprofen or Causes naproxen work well for AVN pain. Please talk to AVN is caused when the blood supply is your medical provider if these medicines are not blocked and cannot get to the bone. Blood working. Opioid medications (oxycodone, gets to the bone through blood vessels. morphine) should only be used rarely. Sickle cells can block the blood vessels • Consultation with a Pain Management specialist leading to the hip joint, shoulder joint, or may be helpful. other bones. Some medicines, such as prednisone, can cause AVN or make it worse. Treatment with Surgery The most common surgery for AVN is hip replacement Symptoms surgery. Surgery is done when pain is severe, a person has • People in the early stages of AVN may limited ability to do normal things, and none of the other not have any symptoms.
    [Show full text]
  • Swine Inflammation and Necrosis Syndrome Is Associated
    animals Article Swine Inflammation and Necrosis Syndrome Is Associated with Plasma Metabolites and Liver Transcriptome in Affected Piglets Robert Ringseis 1,† , Denise K. Gessner 1,† , Frederik Loewenstein 2, Josef Kuehling 2, Sabrina Becker 2, Hermann Willems 2, Mirjam Lechner 3, Klaus Eder 1 and Gerald Reiner 2,* 1 Institute of Animal Nutrition and Nutrition Physiology, Justus Liebig University Giessen, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany; [email protected] (R.R.); [email protected] (D.K.G.); [email protected] (K.E.) 2 Department of Veterinary Clinical Sciences, Clinic for Swine, Justus Liebig University Giessen, Frankfurter Strasse 112, 35392 Giessen, Germany; [email protected] (F.L.); [email protected] (J.K.); [email protected] (S.B.); [email protected] (H.W.) 3 UEG Hohenlohe, Am Wasen 20, 91567 Herrieden, Germany; [email protected] * Correspondence: [email protected] † Authors contributed equally. Simple Summary: Swine inflammation and necrosis syndrome (SINS) is a newly identified syndrome associated with inflammatory and necrotic signs in different body parts of suckling piglets, weaners, and fatteners. While the proven inflammatory basis of the disease and the development of signs in even newborns indicate a primarily endogenous etiology, the mechanisms underlying SINS development are largely unknown. In this study, the hypothesis was tested that SINS is indirectly Citation: Ringseis, R.; Gessner, D.K.; triggered by the translocation of gut-derived microbial components into the liver, thereby causing Loewenstein, F.; Kuehling, J.; Becker, derangements of liver metabolism, by comparing the hepatic transcriptome and plasma metabolome S.; Willems, H.; Lechner, M.; Eder, K.; of SINS-affected and unaffected piglets.
    [Show full text]
  • Lung, Epithelium – Necrosis
    Lung, Epithelium – Necrosis Figure Legend: Figure 1 Lung, Bronchiole, Epithelium, Bronchiole - Necrosis in a female B6C3F1/N mouse from a subchronic study. The epithelial cells are fragmented, with pyknotic and karyorrhectic nuclei. Figure 2 Lung, Epithelium - Necrosis in a male Wistar Han rat from a chronic study. There is a large area of coagulative necrosis surrounded by suppurative inflammation. Figure 3 Lung, Epithelium, Alveolus - Necrosis in a female F344/N rat from a subchronic study. There is loss of epithelial cells, and many of the interstitial cells have pyknotic nuclei. Figure 4 Lung, Epithelium, Alveolus - Necrosis in a female F344/N rat from a subchronic study. In this focal lesion, there is loss of epithelial and interstitial cells. Comment: Necrosis (Figure 1, Figure 2, Figure 3, and Figure 4) and degeneration are considered to be parts of the continuum of cell damage, with necrosis representing irreversible cell damage and 1 Lung, Epithelium – Necrosis degeneration representing reversible cell damage. The light microscopic features of necrosis include nuclear pyknosis, karyorrhexis, or karyolysis, cell swelling, loss of cellular detail, cell fragmentation, and cytoplasmic hypereosinophilia (in which the cytoplasm often has a homogeneous appearance). Large areas of necrosis (Figure 2, Figure 3, and Figure 4) may also have disrupted tissue architecture, large areas of necrotic debris, loss of staining intensity, and inflammatory cells. Necrosis of the epithelial cells lining the airways as a result of toxic injury is often characterized by sloughing of necrotic cells or cellular debris into the lumen. The light microscopic hallmarks of reversible cell damage include cellular swelling, cytoplasmic vacuolation, perinuclear clear spaces, formation of cytoplasmic blebs, loss of normal apical blebs from Clara cells, and loss of cilia.
    [Show full text]
  • Cytomegalic Inclusion Virus Encephalitis in Patients with AIDS: CT, Clinical, and Pathologic Correlation
    275 CytomegaliC Inclusion Virus Encephalitis in Patients with AIDS: CT, Clinical, and Pathologic Correlation M. Judith Donovan Post1 The computed tomographic (CT) scans of 10 patients with acquired immunodeficiency George T. Henslel syndrome who had central nervous system (CNS) involvement by cytomegalovirus (CMV) Lee B. Moskowitz3 were retrospectively reviewed and correlated with clinical data and pathologic findings. Margaret Fischl4 Diagnosis was established in all 10 patients by autopsy, which showed the pathogno­ monic "owl's eye" intracellular inclusions of CMV. In six patients CMV caused an initial CNS infection that was directly responsible for the patient's progressive encephalopathy and death. In four patients CMV caused a superimposed nondominant CNS infection that had no clinical expression in two. Cortical atrophy and mild hydrocephalus ex vacuo were seen on CT in all 10 patients. Positive findings on CT that could be attributed to infection with CMV were present in only three of the 10 patients, and in these three symptomatic cases autopsy correlation revealed that CT underestimated the degree of CNS involvement. In the other three symptomatic patients, CT showed no parenchymal abnormalities, while autopsy demonstrated diffuse cerebral involvement. In the four patients whose CNS was secondarily involved by CMV, CT showed changes proven at autopsy to be related only to the dominant infection with Toxoplasma gondii and to postoperative hematomas. CT did not demonstrate any abnormalities at the sites of CMV involvement, which were found at autopsy in this latter group. It was concluded that CT is not very sensitive for the detection of CMV encephalitis. Cytomegalovirus (CMV), a member of the herpesvirus family , exists in a latent form in a large percentage of the general adult population [1, 2].
    [Show full text]
  • Snake-Eye Myelopathy and Surgical Prognosis: Case Series and Systematic Literature Review
    Journal of Clinical Medicine Review Snake-Eye Myelopathy and Surgical Prognosis: Case Series and Systematic Literature Review Marco Maria Fontanella 1,*, Luca Zanin 1 , Riccardo Bergomi 1, Marco Fazio 2, Costanza Maria Zattra 1, Edoardo Agosti 3, Giorgio Saraceno 1, Silvia Schembari 3, Lucio De Maria 1 , Luisa Quartini 4, Ugo Leggio 5, Massimiliano Filosto 6 , Roberto Gasparotti 7 and Davide Locatelli 3 1 Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; [email protected] (L.Z.); [email protected] (R.B.); [email protected] (C.M.Z.); [email protected] (G.S.); [email protected] (L.D.M.) 2 Neurosurgery Unit, Poliambulanza Foundation, 24124 Brescia, Italy; [email protected] 3 Neurosurgery Unit, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; [email protected] (E.A.); [email protected] (S.S.); [email protected] (D.L.) 4 Intensive Care Unit, Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili di Brecia, 25123 Brescia, Italy; [email protected] 5 Neurophysiopathology Unit, Department of Neurological Sciences and Vision, ASST Spedali Civili di Brecia, 25123 Brescia, Italy; [email protected] 6 Center for Neuromuscular Diseases, Unit of Neurology, ASST “Spedali Civili”, 25123 Brescia, Italy; massimiliano.fi[email protected] 7 Neuroradiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-030-3995-587 Received: 9 May 2020; Accepted: 9 July 2020; Published: 12 July 2020 Abstract: The prognostic value of “snake-eyes” sign in spinal cord magnetic resonance imaging (MRI) is unclear and the correlation with different pathological conditions has not been completely elucidated.
    [Show full text]