TY - JOUR
T1 - Autoimmunity in dengue pathogenesis
AU - Wan, Shu Wen
AU - Lin, Chiou Feng
AU - Yeh, Trai Ming
AU - Liu, Ching Chuan
AU - Liu, Hsiao Sheng
AU - Wang, Shuying
AU - Ling, Pin
AU - Anderson, Robert
AU - Lei, Huan Yao
AU - Lin, Yee Shin
N1 - Funding Information:
This work was supported by grants NSC100-2321-B006-004 and NSC100-2325-B006-007 from the National Science Council, Taiwan ; NHRI-100A1-PDCO-0209115 from the National Health Research Institutes, Taiwan ; and DOH101-TD-B-111-002 from the Multidisciplinary Center of Excellence for Clinical Trial and Research, Department of Health, Taiwan .
PY - 2013/1
Y1 - 2013/1
N2 - Dengue is one of the most important vector-borne viral diseases. With climate change and the convenience of travel, dengue is spreading beyond its usual tropical and subtropical boundaries. Infection with dengue virus (DENV) causes diseases ranging widely in severity, from self-limited dengue fever to life-threatening dengue hemorrhagic fever and dengue shock syndrome. Vascular leakage, thrombocytopenia, and hemorrhage are the major clinical manifestations associated with severe DENV infection, yet the mechanisms remain unclear. Besides the direct effects of the virus, immunopathogenesis is also involved in the development of dengue disease. Antibody-dependent enhancement increases the efficiency of virus infection and may suppress type I interferon-mediated antiviral responses. Aberrant activation of T cells and overproduction of soluble factors cause an increase in vascular permeability. DENV-induced autoantibodies against endothelial cells, platelets, and coagulatory molecules lead to their abnormal activation or dysfunction. Molecular mimicry between DENV proteins and host proteins may explain the cross-reactivity of DENV-induced autoantibodies. Although no licensed dengue vaccine is yet available, several vaccine candidates are under development. For the development of a safe and effective dengue vaccine, the immunopathogenic complications of dengue disease need to be considered.
AB - Dengue is one of the most important vector-borne viral diseases. With climate change and the convenience of travel, dengue is spreading beyond its usual tropical and subtropical boundaries. Infection with dengue virus (DENV) causes diseases ranging widely in severity, from self-limited dengue fever to life-threatening dengue hemorrhagic fever and dengue shock syndrome. Vascular leakage, thrombocytopenia, and hemorrhage are the major clinical manifestations associated with severe DENV infection, yet the mechanisms remain unclear. Besides the direct effects of the virus, immunopathogenesis is also involved in the development of dengue disease. Antibody-dependent enhancement increases the efficiency of virus infection and may suppress type I interferon-mediated antiviral responses. Aberrant activation of T cells and overproduction of soluble factors cause an increase in vascular permeability. DENV-induced autoantibodies against endothelial cells, platelets, and coagulatory molecules lead to their abnormal activation or dysfunction. Molecular mimicry between DENV proteins and host proteins may explain the cross-reactivity of DENV-induced autoantibodies. Although no licensed dengue vaccine is yet available, several vaccine candidates are under development. For the development of a safe and effective dengue vaccine, the immunopathogenic complications of dengue disease need to be considered.
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U2 - 10.1016/j.jfma.2012.11.006
DO - 10.1016/j.jfma.2012.11.006
M3 - Review article
C2 - 23332423
AN - SCOPUS:84872372074
SN - 0929-6646
VL - 112
SP - 3
EP - 11
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 1
ER -