The correlation between Enterovirus -71 infection complicated with neurogenic pulmonary edema and nerve cell apoptosis

ZHONG Tao; ZHENG Wei-hua; OU Wei-lin; LI Yun-qian; PENG Juan; WANG Chang-ying; LI Xiong

Abstract：Objective To investigate the correlation between enterovirus -71 (EV71) infection complicated with neurogenic pulmonary edema and nerve cell apoptosis .Methods The clinical data were retrospectively collected in 9 children dead of EV71 infection complicated with neurogenic pulmonary edema and 7 EV71 uninfected children dead of pulmonary edema or pulmonary venous pleonaemia from Mar , 2010 to Jun, 2013.Autopsy was performed.Tissue samples of major organs, including brains, lungs and hearts were tested by TUNEL method , and the morphological change of apop -tosis under light microscopy was also observed .Results Local soften foci and satellite phenomenon in brain , and visible alveolar cavity collapse and alveolar lumen filled with edema fluid in lung were observed in infection group .However, no pathological change was observed in myocardial tissues in infection group .Meanwhile, no pathological change in brain or myocardial tissues, but pink edema fluid in alveolar lumen was observed in control group .Apoptotic cells were detected in each organ in infection group , with positive rate of 100%.Significantly more prominent apoptosis was observed in brain tissues of infection group when comparing with myocardial or alveolar tissues (P <0.01).Several apoptotic cells were re-vealed in myocardial and alveolar tissues in infection group , with low apoptosis index (AI), and there was no significant differences between them (P >0.05).Apoptotic cells in small count were observed in each organ in control group , with no significant difference among them .Significant difference was observed in only in apoptosis cell count between infection and control groups (P <0.05).Conclusion Severe EV71 infection complicated with pulmonary edema can cause cata -strophic nerve cell apoptosis.