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DOI: 10.1055/s-0040-1714274
Pulmonary Megakaryocytes in Coronavirus Disease 2019 (COVID-19): Roles in Thrombi and Fibrosis
Coronavirus disease 2019 (COVID-19) has already claimed many lives and continues to do so in different parts of the world. Autopsy reports of patients who succumbed to this viral infection have been published despite concerns about health care professional safety. One of the unusual findings in COVID-19 lung autopsy reports is the increase in pulmonary megakaryocytes.[1] [2] Although the presence of megakaryocytes in the lungs is a well-established concept in the medical literature, it is still not widely accepted in the clinical fraternity. In this article, we discuss the role of lung megakaryocytes in relation to the clinicopathological findings in COVID-19 and discuss how this may impact on our understanding of acute respiratory distress syndrome (ARDS), pulmonary thrombi, and lung fibrosis, in general.
Publication History
Article published online:
03 September 2020
© 2020. Thieme. All rights reserved.
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References
- 1 Fox SE, Akmatbekov A, Harbert JL. et al. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med 2020; (e-pub ahead of print) DOI: 10.1016/S2213-2600(20)30243-5.
- 2 Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020; 99 (06) 1205-1208
- 3 Patel SR, Hartwig JH, Italiano Jr JE. The biogenesis of platelets from megakaryocyte proplatelets. J Clin Invest 2005; 115 (12) 3348-3354
- 4 Lefrançais E, Looney MR. Platelet biogenesis in the lung circulation. Physiology (Bethesda) 2019; 34 (06) 392-401
- 5 Kaufman RM, Airo R, Pollack S, Crosby WH, Doberneck R. Origin of pulmonary megakaryocytes. Blood 1965; 25: 767-775
- 6 Trowbridge EA, Martin JF, Slater DN. Evidence for a theory of physical fragmentation of megakaryocytes, implying that all platelets are produced in the pulmonary circulation. Thromb Res 1982; 28 (04) 461-475
- 7 Kallinikos-Maniatis A. Megakaryocytes and platelets in central venous and arterial blood. Acta Haematol 1969; 42 (06) 330-335
- 8 Lefrançais E, Ortiz-Muñoz G, Caudrillier A. et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors. Nature 2017; 544 (7648): 105-109
- 9 Beaulieu LM, Freedman JE. The role of inflammation in regulating platelet production and function: toll-like receptors in platelets and megakaryocytes. Thromb Res 2010; 125 (03) 205-209
- 10 Frydman GH, Ellett F, Jorgensen J. et al. Megakaryocytes display innate immune cell functions and respond during sepsis. bioRiv 2019; DOI: 10.1101/742676.
- 11 Zucker-Franklin D, Cao YZ. Megakaryocytes of human immunodeficiency virus-infected individuals express viral RNA. Proc Natl Acad Sci U S A 1989; 86 (14) 5595-5599
- 12 Ferry JA, Pettit CK, Rosenberg AE, Harris NL. Fungi in megakaryocytes. An unusual manifestation of fungal infection of the bone marrow. Am J Clin Pathol 1991; 96 (05) 577-581
- 13 Cunin P, Bouslama R, Machlus K. et al. Megakaryocyte emperipolesis mediates membrane transfer from intracytoplasmic neutrophils to platelets. bioRxiv 2018; 10: 504-555
- 14 Haas S, Hansson J, Klimmeck D. et al. Inflammation-induced emergency megakaryopoiesis driven by hematopoietic stem cell-like megakaryocyte progenitors. Cell Stem Cell 2015; 17 (04) 422-434
- 15 Chen N, Zhou M, Dong X. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395 (10223): 507-513
- 16 Hofstra JJ, Haitsma JJ, Juffermans NP, Levi M, Schultz MJ. The role of bronchoalveolar hemostasis in the pathogenesis of acute lung injury. Semin Thromb Hemost 2008; 34 (05) 475-484
- 17 Müller-Newen G, Stope MB, Kraus T, Ziegler P. Development of platelets during steady state and inflammation. J Leukoc Biol 2017; 101 (05) 1109-1117
- 18 Sharma GK, Talbot IC. Pulmonary megakaryocytes: “missing link” between cardiovascular and respiratory disease?. J Clin Pathol 1986; 39 (09) 969-976
- 19 Martin JF, Slater DN, Trowbridge EA. Abnormal intrapulmonary platelet production: a possible cause of vascular and lung disease. Lancet 1983; 1 (8328): 793-796
- 20 Wells S, Sissons M, Hasleton PS. Quantitation of pulmonary megakaryocytes and fibrin thrombi in patients dying from burns. Histopathology 1984; 8 (03) 517-527
- 21 Sulkowski S, Terlikowski S, Sulkowska M. Occlusion of pulmonary vessels by megakaryocytes after treatment with tumour necrosis factor-alpha (TNF-alpha). J Comp Pathol 1999; 120 (03) 235-245
- 22 Mandal RV, Mark EJ, Kradin RL. Megakaryocytes and platelet homeostasis in diffuse alveolar damage. Exp Mol Pathol 2007; 83 (03) 327-331
- 23 Yadav H, Kor DJ. Platelets in the pathogenesis of acute respiratory distress syndrome. Am J Physiol Lung Cell Mol Physiol 2015; 309 (09) L915-L923
- 24 Middleton EA, Rondina MT, Schwertz H, Zimmerman GA. Amicus or adversary revisited: platelets in acute lung injury and acute respiratory distress syndrome. Am J Respir Cell Mol Biol 2018; 59 (01) 18-35
- 25 Battinelli EM, Markens BA, Italiano Jr JE. Release of angiogenesis regulatory proteins from platelet alpha granules: modulation of physiologic and pathologic angiogenesis. Blood 2011; 118 (05) 1359-1369
- 26 Ackermann M, Verleden SE, Kuehnel M. et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med 2020; (e-pub ahead of print) DOI: 10.1056/NEJMoa2015432.
- 27 Arivazhagan S, Kadhiravan T, Basu D, Dutta TK. Validation of the megakaryocyte fragmentation theory of finger clubbing in patients with cardiopulmonary diseases. Platelets 2014; 25 (05) 317-321
- 28 Castro-Malaspina H, Rabellino EM, Yen A, Nachman RL, Moore MA. Human megakaryocyte stimulation of proliferation of bone marrow fibroblasts. Blood 1981; 57 (04) 781-787
- 29 Wynn TA. Cellular and molecular mechanisms of fibrosis. J Pathol 2008; 214 (02) 199-210
- 30 George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet 2020; (e-pub ahead of print) DOI: 10.1016/S2213-2600(20)30225-3.
- 31 Schuliga M, Grainge C, Westall G, Knight D. The fibrogenic actions of the coagulant and plasminogen activation systems in pulmonary fibrosis. Int J Biochem Cell Biol 2018; 97: 108-117
- 32 Bitto N, Liguori E, La Mura V. Coagulation, microenvironment and liver fibrosis. Cells 2018; 7 (08) 85