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Thromb Haemost 2003; 89(06): 967-972
DOI: 10.1055/s-0037-1613397
Review Article
Schattauer GmbH

Viral hemorrhagic fever – a vascular disease?

Hans J. Schnittler
1   Institute of Physiology, Medical Faculty Carl Gustav Carus of the Technical University Dresden, Dresden, Germany
,
Heinz Feldmann
2   Canadian Science Centre for Human and Animal Health, National Microbiology Laboratory, Special Pathogens Program, Winnipeg, Canada
3   Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
› Author AffiliationsFinancial support: The above review was based on data that were generated through projects financed by the Deutsche Forschungsgemeinschaft (SPP 1130 project SCHN 430/3-1, SCHN 430/1-2, Fe 286/4-1, SFB 286, SFB 535, SFB 355), the Kempkes-Stiftung (21/95), the Canadian Institutes of Health Research (MOP – 43921), the European Community (INCO-grant ERBIC 18 CT9803832) and “Med Drive Program” of the Medical faculty of Dresden.
Further Information

Publication History

Received 14 January 2003

Accepted after revision 07 March 2003

Publication Date:
08 December 2017 (online)

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Summary

The syndrome of “viral hemorrhagic fever” in man caused by certain viruses, such as Ebola, Lassa, Dengue, and Crimean-Congo hemorrhagic fever viruses, is often associated with a shock syndrome of undetermined pathogenesis. However, the vascular system, particularly the vascular endothelium, seems to be directly and indirectly targeted by all these viruses. Here we briefly summarize the current knowledge on Marburg and Ebola virus infections, the prototype viral hemorrhagic fever agents, and formulate a working hypothesis for the pathogenesis of viral hemorrhagic fever. Infections with filoviruses show lethality up to 89% and in severe cases lead to a shock syndrome associated with hypotension, coagulation disorders and an imbalance of fluid distribution between the intravascular and extravascular tissue space. The primary target cells for filovi-ruses are mononuclear phagocytotic cells which are activated upon infection and release certain cytokines and chemokines. These mediators indirectly target the endothelium and are thought to play a key role in the pathogenesis of filoviral hemorrhagic fever. In addition, direct infection and subsequent destruction of endothelial cells might contribute to the pathogenesis. Filoviruses, particularly Ebola virus, encode nonstructural glycoproteins which are released from infected host cells. Their function as potential determinants in pathogenicity remains to be investigated.

Keywords

Filoviruses - influenza virus - endothelium - cytokines
 

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