Skip to main content

20.10.2020 | COVID-19 | Short Communication | Ausgabe 1/2021 Zur Zeit gratis

Inflammation Research 1/2021

Inflammasome formation in the lungs of patients with fatal COVID-19

Inflammation Research > Ausgabe 1/2021
Stefano Toldo, Rossana Bussani, Vincenzo Nuzzi, Aldo Bonaventura, Adolfo G. Mauro, Antonio Cannatà, Raghavendra Pillappa, Gianfranco Sinagra, Patrick Nana-Sinkam, Patricia Sime, Antonio Abbate
Wichtige Hinweise
Responsible Editor: John Di Battista.

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00011-020-01413-2) contains supplementary material, which is available to authorized users.
Stefano Toldo and Rossana Bussani equally contributed to the realization of this manuscript.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.



The orf8b protein of the coronavirus SARS-CoV, analogous to SARS-CoV-2, triggers the NLRP3 inflammasome in macrophages in vitro. Deregulated inflammasome-mediated release of interleukin-1 family cytokines is important in hyper-inflammatory syndromes, like happens in SARS-CoV-2-mediated cytokine release syndrome. We propose that an intense inflammasome formation characterizes the lungs of patients with fatal COVID-19 disease due to pneumonia and acute respiratory distress syndrome (ARDS).


Samples from four patients with confirmed COVID-19 pneumonia who had been hospitalized at the Hospital of the University of Trieste (Italy) and died of ARDS and four lung samples from a historical repository from subjects who had died of cardiopulmonary arrest and had not been placed on mechanical ventilation and without evidence of pulmonary infection at postmortem examination were collected. Pathology samples had been fixed in formalin 10% at time of collection and subsequently embedded in paraffin. We conducted staining for ASC (Apoptosis-associated Speck-like protein containing a Caspase recruitment domain), NLRP3 (NACHT, LRR, and PYD domains-containing protein 3), and cleaved caspase-1.


Intense expression of the inflammasome was detected, mainly in leukocytes, within the lungs of all patients with fatal COVID-19 in the areas of lung injury. The number of ASC inflammasome specks per high power fields was significantly higher in the lungs of patients with fatal COVID-19 as compared with the lungs of control subjects (52 ± 22 vs 6 ± 3, P = 0.0064).


These findings identify the presence of NLRP3 inflammasome aggregates in the lungs of fatal COVID-19 pneumonia thus providing the potential molecular link between viral infection and cytokine release syndrome.

Nutzen Sie Ihre Chance: Dieser Inhalt ist zurzeit gratis verfügbar.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Unsere Produktempfehlungen

e.Med Interdisziplinär


Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

e.Med Dermatologie


Mit e.Med Dermatologie erhalten Sie Zugang zu CME-Fortbildungen des Fachgebietes Dermatologie, den Premium-Inhalten der dermatologischen Fachzeitschriften, inklusive einer gedruckten dermatologischen Zeitschrift Ihrer Wahl.

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Nur für berechtigte Nutzer zugänglich
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2021

Inflammation Research 1/2021 Zur Ausgabe

Coronavirus Corona-Update

Die aktuelle Entwicklung im Überblick: Nachrichten, Webinare, Übersichtsarbeiten.