Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Ministry of Health and Sanitation, Sierra Leone.
Clin Infect Dis. 2022 May 30;74(10):1821-1830. doi: 10.1093/cid/ciab719.
Lassa fever is a zoonotic, acute viral illness first identified in Nigeria in 1969. An estimate shows that the "at risk" seronegative population (in Sierra Leone, Guinea, and Nigeria) may be as high as 59 million, with an annual incidence of all illnesses of 3 million, and fatalities up to 67 000, demonstrating the serious impact of the disease on the region and global health.
Histopathologic evaluation, immunohistochemical assay, and electron microscopic examination were performed on postmortem tissue samples from 12 confirmed Lassa fever cases.
Lassa fever virus antigens and viral particles were observed in multiple organ systems and cells, including cells in the mononuclear phagocytic system and other specialized cells where it had not been described previously.
The immunolocalization of Lassa fever virus antigens in fatal cases provides novel insightful information with clinical and pathogenetic implications. The extensive involvement of the mononuclear phagocytic system, including tissue macrophages and endothelial cells, suggests participation of inflammatory mediators from this lineage with the resulting vascular dilatation and increasing permeability. Other findings indicate the pathogenesis of Lassa fever is multifactorial and additional studies are needed.
拉沙热是一种人畜共患的急性病毒性疾病，于 1969 年在尼日利亚首次被发现。据估计，高危人群（塞拉利昂、几内亚和尼日利亚）的血清阴性人群可能高达 5900 万，每年有 300 万人患病，死亡人数多达 6.7 万，这表明该疾病对该地区和全球健康造成了严重影响。
对 12 例确诊拉沙热病例的尸检组织样本进行了组织病理学评估、免疫组织化学检测和电子显微镜检查。
在多个器官系统和细胞中观察到拉沙热病毒抗原和病毒颗粒，包括单核吞噬细胞系统和其他以前未描述过的专门细胞中的细胞。
在致死性病例中对拉沙热病毒抗原的免疫定位提供了具有临床和发病机制意义的新的有价值信息。单核吞噬细胞系统的广泛参与，包括组织巨噬细胞和内皮细胞，提示来自该谱系的炎症介质参与其中，导致血管扩张和通透性增加。其他发现表明拉沙热的发病机制是多因素的，需要进一步研究。
