Elsevier

Antiviral Research

Volume 143, July 2017, Pages 142-150
Antiviral Research

The role of epidermal growth factor receptor (EGFR) signaling in SARS coronavirus-induced pulmonary fibrosis

https://doi.org/10.1016/j.antiviral.2017.03.022Get rights and content

Highlights

  • Patients who survived SARS coronavirus infection often developed pulmonary fibrosis.

  • Mouse models of SARS-CoV infection recapitulate fibrotic lesions seen in humans.

  • Epidermal growth factor receptor (EGFR) may modulate the wound healing response to SARS-CoV.

  • The EGFR pathway is a prime target for therapeutic interventions to reduce fibrosis after respiratory virus infection.

Abstract

Many survivors of the 2003 outbreak of severe acute respiratory syndrome (SARS) developed residual pulmonary fibrosis with increased severity seen in older patients. Autopsies of patients that died from SARS also showed fibrosis to varying extents. Pulmonary fibrosis can be occasionally seen as a consequence to several respiratory viral infections but is much more common after a SARS coronavirus (SARS-CoV) infection. Given the threat of future outbreaks of severe coronavirus disease, including Middle East respiratory syndrome (MERS), it is important to understand the mechanisms responsible for pulmonary fibrosis, so as to support the development of therapeutic countermeasures and mitigate sequelae of infection. In this article, we summarize pulmonary fibrotic changes observed after a SARS-CoV infection, discuss the extent to which other respiratory viruses induce fibrosis, describe available animal models to study the development of SARS-CoV induced fibrosis and review evidence that pulmonary fibrosis is caused by a hyperactive host response to lung injury mediated by epidermal growth factor receptor (EGFR) signaling. We summarize work from our group and others indicating that inhibiting EGFR signaling may prevent an excessive fibrotic response to SARS-CoV and other respiratory viral infections and propose directions for future research.

Keywords

Wound healing
SARS-CoV
EGFR
Fibrosis

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