Multiple organ infection and the pathogenesis of SARS

Gu, Jiang; Gong, Encong; Zhang, Bo; Zheng, Jie; Gao, Zifen; Zhong, Yanfeng; Zou, Wanzhong; Zhan, Jun; Wang, Shenglan; Xie, Zhigang; Zhuang, Hui; Wu, Bingquan; Zhong, Haohao; Shao, Hongquan; Fang, Weigang; Gao, Dongshia; Pei, Fei; Li, Xingwang; He, Zhongpin; Xu, Danzhen; Shi, Xeying; Anderson, Virginia M.; Leong, Anthony S.-Y.

This study unveils a hitherto unknown, but significant, aspect of the pathogenesis of SARS. Our proposed mechanism of infection and dissemination is capable of explaining all of the clinical symptoms and laboratory findings that have been reported for SARS. It provides a comprehensive theory of pathogenesis for this new disease. In a way, SARS infection is similar to HIV infection that causes AIDS. Although HIV attacks and destroys the target cells slowly, particularly lymphocytes (24) , SARS virus infects and destroys the immune cells in a much faster and more devastating fashion. Like many other infectious diseases, SARS infections show differing degrees of severity in different individuals. Only the most severe cases demonstrate the full range of pathologic changes that was described above. Our findings suggest that body fluid and fecal-respiratory tract transmission of the virus, although not reported, is possible because SARS viruses or its sequences are detectable in the blood, intestines, stool, and urine. A correct understanding of the pathogenesis is crucial for developing animal models to test effective vaccines and to establish techniques for early diagnosis. Further detailed studies of the immune damage will shed more light on the true nature of the pathogenesis of SARS.