Immune responses and severe dengue: what have we learned?

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2024-10-01 Epub Date: 2024-07-24 DOI:10.1097/QCO.0000000000001040
Gathsaurie Neelika Malavige, Graham S Ogg
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Abstract

Purpose of review: With the marked rise in dengue globally, developing well tolerated and effective vaccines and therapeutics is becoming more important. Here we discuss the recent developments in the understanding of immune mechanisms that lead to severe dengue and the learnings from the past, that can help us to find therapeutic targets, prognostic markers, and vaccines to prevent development of severe disease.

Recent findings: The extent and duration of viraemia often appears to be associated with clinical disease severity but with some variability. However, there also appear to be significant differences in the kinetics of viraemia and nonstructural protein 1 (NS1) antigenemia and pathogenicity between different serotypes and genotypes of the DENV. These differences may have significant implications for development of treatments and in inducing robust immunity through dengue vaccines. Although generally higher levels of neutralizing antibodies are thought to protect against infection and severe disease, there have been exceptions and the specificity, breadth and functionality of the antibody responses are likely to be important.

Summary: Although there have been many advances in our understanding of dengue pathogenesis, viral and host factors associated with occurrence of severe dengue, vascular leak and the immune correlates of protection remain poorly understood.

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免疫反应与严重登革热:我们学到了什么?
综述的目的:随着全球登革热发病率的显著上升,开发耐受性好且有效的疫苗和疗法变得越来越重要。在此,我们将讨论在了解导致严重登革热的免疫机制方面的最新进展,以及从过去的研究中汲取的经验教训,这将有助于我们找到治疗目标、预后标志物和疫苗,以预防严重疾病的发生:病毒血症的程度和持续时间似乎常常与临床疾病的严重程度有关,但存在一定的变异性。然而,在不同血清型和基因型的 DENV 之间,病毒血症和非结构蛋白 1(NS1)抗原血症和致病性的动力学似乎也存在显著差异。这些差异可能会对开发治疗方法和通过登革热疫苗诱导强大的免疫力产生重大影响。总结:尽管我们对登革热发病机制的认识取得了许多进展,但对与严重登革热的发生、血管渗漏和免疫保护相关的病毒和宿主因素仍然知之甚少。
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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