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The UNC School of Medicine laboratory of Camille Ehre, PhD, assistant professor of pediatrics, produced striking images in respiratory tract cultures of the infectious form of the SARS-CoV-2 virus produced by infected respiratory epithelial cells. the New England Journal of Medicine presented this work in his section “Images in Medicine”.
Ehre, a member of the UNC Marsico Lung Institute and the UNC Children’s Research Institute, captured these images to illustrate how severe SARS-CoV-2 infection of the airways can be in highly graphic, easy-to-understand images. Her laboratory carried out this research in collaboration with the laboratories of Ralph Baric, PhD, William R. Kenan Distinguished Professor of Epidemiology at the UNC Gillings School of Public Health, who has a joint appointment as a professor in the Department of Microbiology and Immunology. from UNC, and Richard Boucher, MD, James C. Moeser Eminent Distinguished Professor of Medicine and Director of the Marsico Lung Institute of the UNC School of Medicine.
In a laboratory setting, the researchers inoculated the SARS-Co-V-2 virus into human bronchial epithelial cells, which were then examined 96 hours later using scanning electron microscopy.
The images, recolored by UNC medical student Cameron Morrison, show infected hair cells with strands of mucus (yellow) attached to the tips of the cilia (blue). Cilia are hair-like structures on the surface of airway epithelial cells that carry mucus (and trapped viruses) from the lung. A higher power magnification image shows the structure and density of the SARS-CoV-2 virions (red) produced by the human airway epithelia. Virions are the complete infectious form of the virus released to respiratory surfaces by infected host cells.
This imaging research helps illustrate the incredibly high number of virions produced and released per cell within the human respiratory system. The large viral load is a source of spread of infection to multiple organs of an infected individual and probably mediates the high frequency of transmission of COVID-19 to others. These images make a strong case for the use of masks by infected and uninfected people to limit the transmission of SARS-CoV-2.
The images can be viewed here:
https://www.nejm.org/doi/full/10.1056/NEJMicm2023328
The National Institutes of Health and the Cystic Fibrosis Foundation funded this research.
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