1
|
Lu HZ, Xie YZ, Gao C, Wang Y, Liu TT, Wu XZ, Dai F, Wang DQ, Deng SQ. Diabetes mellitus as a risk factor for severe dengue fever and West Nile fever: A meta-analysis. PLoS Negl Trop Dis 2024; 18:e0012217. [PMID: 38820529 DOI: 10.1371/journal.pntd.0012217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Dengue fever (DF) and West Nile fever (WNF) have become endemic worldwide in the last two decades. Studies suggest that individuals with diabetes mellitus (DM) are at a higher risk of developing severe complications from these diseases. Identifying the factors associated with a severe clinical presentation is crucial, as prompt treatment is essential to prevent complications and fatalities. This article aims to summarize and assess the published evidence regarding the link between DM and the risk of severe clinical manifestations in cases of DF and WNF. METHODOLOGY/PRINCIPAL FINDINGS A systematic search was conducted using the PubMed and Web of Science databases. 27 studies (19 on DF, 8 on WNF) involving 342,873 laboratory-confirmed patients were included in the analysis. The analysis showed that a diagnosis of DM was associated with an increased risk for severe clinical presentations of both DF (OR 3.39; 95% CI: 2.46, 4.68) and WNF (OR 2.89; 95% CI: 1.89, 4.41). DM also significantly increased the risk of death from both diseases (DF: OR 1.95; 95% CI: 1.09, 3.52; WNF: OR 1.74; 95% CI: 1.40, 2.17). CONCLUSIONS/SIGNIFICANCE This study provides strong evidence supporting the association between DM and an increased risk of severe clinical manifestations in cases of DF and WNF. Diabetic individuals in DF or WNF endemic areas should be closely monitored when presenting with febrile symptoms due to their higher susceptibility to severe disease. Early detection and appropriate management strategies are crucial in reducing the morbidity and mortality rates associated with DF and WNF in diabetic patients. Tailored care and targeted public health interventions are needed to address this at-risk population. Further research is required to understand the underlying mechanisms and develop effective preventive and therapeutic approaches.
Collapse
Affiliation(s)
- Hong-Zheng Lu
- Department of Pathogen Biology, the Key Laboratory of Microbiology and Parasitology of Anhui Province, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui China
| | - Yu-Zhuang Xie
- Department of Pathogen Biology, the Key Laboratory of Microbiology and Parasitology of Anhui Province, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Chen Gao
- Department of Pathogen Biology, the Key Laboratory of Microbiology and Parasitology of Anhui Province, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui China
| | - Ying Wang
- Department of Tropical Medicine, College of Military Preventive Medicine, Army Medical University, Chongqing, China
| | - Ting-Ting Liu
- Department of Tropical Medicine, College of Military Preventive Medicine, Army Medical University, Chongqing, China
| | - Xing-Zhe Wu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fang Dai
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Duo-Quan Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology; WHO Collaborating Center for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Sheng-Qun Deng
- Department of Pathogen Biology, the Key Laboratory of Microbiology and Parasitology of Anhui Province, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| |
Collapse
|
2
|
Zambrana JV, Hasund CM, Aogo RA, Bos S, Arguello S, Gonzalez K, Collado D, Miranda T, Kuan G, Gordon A, Balmaseda A, Katzelnick LC, Harris E. Primary exposure to Zika virus is linked with increased risk of symptomatic dengue virus infection with serotypes 2, 3, and 4, but not 1. Sci Transl Med 2024; 16:eadn2199. [PMID: 38809964 DOI: 10.1126/scitranslmed.adn2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/23/2024] [Indexed: 05/31/2024]
Abstract
Infection with any of the four dengue virus serotypes (DENV1-4) can protect against or enhance subsequent dengue depending on preexisting antibodies and infecting serotype. Additionally, primary infection with the related flavivirus Zika virus (ZIKV) is associated with increased risk of DENV2 disease. Here, we measured how prior DENV and ZIKV immunity influenced risk of disease caused by DENV1-4 in a pediatric Nicaraguan cohort. Of 3412 participants in 2022, 10.6% experienced dengue cases caused by DENV1 (n = 139), DENV4 (n = 133), DENV3 (n = 54), DENV2 (n = 9), or an undetermined serotype (n = 39). Longitudinal clinical and serological data were used to define infection histories, and generalized linear and additive models adjusted for age, sex, time since last infection, and year, and repeat measurements were used to predict disease risk. Compared with flavivirus-naïve participants, primary ZIKV infection was associated with increased risk of disease caused by DENV4 (relative risk = 2.62, 95% confidence interval: 1.48 to 4.63) and DENV3 (2.90, 1.34 to 6.27), but not DENV1 infection. Primary DENV infection or DENV followed by ZIKV infection was also associated with increased risk of DENV4 disease. We reanalyzed 19 years of cohort data and demonstrated that prior flavivirus immunity and antibody titer had distinct associations with disease risk depending on incoming serotype. We thus find that prior ZIKV infection, like prior DENV infection, is associated with increased risk of disease with certain DENV serotypes. Cross-reactivity among flaviviruses should be considered when assessing vaccine safety and efficacy.
Collapse
Affiliation(s)
- José Victor Zambrana
- Sustainable Sciences Institute, Managua 14006, Nicaragua
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chloe M Hasund
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Rosemary A Aogo
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Sandra Bos
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-3370, USA
| | - Sonia Arguello
- Sustainable Sciences Institute, Managua 14006, Nicaragua
| | - Karla Gonzalez
- Sustainable Sciences Institute, Managua 14006, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua 14062, Nicaragua
| | | | | | - Guillermina Kuan
- Sustainable Sciences Institute, Managua 14006, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministerio de Salud, Managua 12037, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua 14006, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua 14062, Nicaragua
| | - Leah C Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-3370, USA
| |
Collapse
|
3
|
Cañari-Casaño JL, Paz-Soldan VA, Lescano AG, Morrison AC. Circulation of DENV-2 serotype associated with increased risk of cumulative incidence of severe dengue and dengue with warning signs: A 16-year retrospective study in Peru. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.02.24306735. [PMID: 38746174 PMCID: PMC11092699 DOI: 10.1101/2024.05.02.24306735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Dengue poses a significant public health challenge in Peru and other endemic countries worldwide. While severe dengue is known to be associated with secondary infection at the individual level, the factors that elevate the risk of severe dengue at the population level remain poorly understood. This study leverages over 16 years of secondary data from a Peruvian dengue surveillance system to assess which type of serotype-specific circulation is associated with an increased risk of cumulative incidence of severe dengue or dengue with warning signs (SD-DWS). Methodology This is a retrospective analysis of secondary data using the Peruvian Ministry of Health databases of dengue cases and serotyping. A mixed negative binomial regression model for repeated measures over time was employed to estimate the association between the cumulative incidence of reported SD-DWS cases per 100,000 inhabitants and serotype-specific circulation. Crude and adjusted incidence ratios (IRR) were estimated. Principal findings The study analyzed data from 2007 to 2022 across 19 regions of Peru, totaling 304 region-years. Data from nearly 58,000 serotype identification reports and 57,966 cases of SD-DWS were analyzed. The regions with most cumulative incidence of SD-DWS per 100,000 inhabitants during 2007 to 2022 were Madre de Dios (3859), Loreto (1518), Ucayali (1492), Tumbes (1335), and Piura (722). The adjusted model revealed a higher risk of cumulative incidence of SD-DWS when there was specific circulation of DENV-123 (aIRR 7.57 CI 4.00 - 14.31), DENV-12 (aIRR 4.66 CI 2.57 - 8.44), DENV-23 (aIRR 3.55 CI 1.75 - 7.21), or when there was circulation of DENV-2 alone or co-circulating with other serotypes (aIRR 27.7 CI 15.46 -49.63). Conclusions Circulation of DENV-2 was associated with higher average incidence rate ratios of SD-DWS. Author summary We investigated how the circulation of different dengue virus (DENV) serotypes are associated with the incidence of severe dengue and dengue with warning signs in Peru, a country where dengue is endemic. We analyzed 16 years of data from the dengue surveillance system, including nearly 58,000 serotype identification reports and 57,966 cases of severe dengue and dengue with warning signs. We found that regions with specific circulation of DENV-2, either alone or in combination with other serotypes, had higher incidence rates of severe dengue and dengue with warning signs. Our findings highlight the importance of monitoring DENV serotype circulation to manage and prevent severe dengue, especially in regions where DENV-2 is prevalent.
Collapse
|
4
|
Malavige GN, Ogg GS. Molecular mechanisms in the pathogenesis of dengue infections. Trends Mol Med 2024; 30:484-498. [PMID: 38582622 DOI: 10.1016/j.molmed.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/08/2024]
Abstract
Dengue is the most rapidly emerging climate-sensitive infection, and morbidity/mortality and disease incidence are rising markedly, leading to healthcare systems being overwhelmed. There are currently no specific treatments for dengue or prognostic markers to identify those who will progress to severe disease. Owing to an increase in the burden of illness and a change in epidemiology, many patients experience severe disease. Our limited understanding of the complex mechanisms of disease pathogenesis has significantly hampered the development of safe and effective treatments, vaccines, and biomarkers. We discuss the molecular mechanisms of dengue pathogenesis, the gaps in our knowledge, and recent advances, as well as the most crucial questions to be answered to enable the development of therapeutics, biomarkers, and vaccines.
Collapse
Affiliation(s)
- Gathsaurie Neelika Malavige
- Allergy Immunology and Cell Biology Unit, Department of Immunology and Molecular Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka; Medical Research Council (MRC) Translational Immune Discovery Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
| | - Graham S Ogg
- Allergy Immunology and Cell Biology Unit, Department of Immunology and Molecular Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka; Medical Research Council (MRC) Translational Immune Discovery Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
5
|
Waickman AT, Newell K, Lu JQ, Fang H, Waldran M, Gebo C, Currier JR, Friberg H, Jarman RG, Klick MD, Ware LA, Endy TP, Thomas SJ. Low-dose dengue virus 3 human challenge model: a phase 1 open-label study. Nat Microbiol 2024; 9:1356-1367. [PMID: 38561497 DOI: 10.1038/s41564-024-01668-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
Dengue human infection models present an opportunity to explore the potential of a vaccine, anti-viral or immuno-compound for clinical benefit in a controlled setting. Here we report the outcome of a phase 1 open-label assessment of a low-dose dengue virus 3 (DENV-3) challenge model (NCT04298138), in which nine participants received a subcutaneous inoculation with 0.5 ml of a 1.4 × 103 plaque-forming unit per ml suspension of the attenuated DENV-3 strain CH53489. The primary and secondary endpoints of the study were to assess the safety of this DENV-3 strain in healthy flavivirus-seronegative individuals. All participants developed RNAaemia within 7 days after inoculation with peak titre ranging from 3.13 × 104 to 7.02 × 108 genome equivalents per ml. Solicited symptoms such as fever and rash, clinical laboratory abnormalities such as lymphopenia and thrombocytopenia, and self-reported symptoms such as myalgia were consistent with mild-to-moderate dengue in all volunteers. DENV-3-specific seroconversion and memory T cell responses were observed within 14 days after inoculation as assessed by enzyme-linked immunosorbent assay and interferon-gamma-based enzyme-linked immunospot. RNA sequencing and serum cytokine analysis revealed anti-viral responses that overlapped with the period of viraemia. The magnitude and frequency of clinical and immunologic endpoints correlated with an individual's peak viral titre.
Collapse
Affiliation(s)
- Adam T Waickman
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA.
- Institute for Global Health and Translational Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA.
| | - Krista Newell
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Joseph Q Lu
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
- Institute for Global Health and Translational Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - HengSheng Fang
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Mitchell Waldran
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Chad Gebo
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Jeffrey R Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Heather Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Richard G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Michelle D Klick
- Institute for Global Health and Translational Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Lisa A Ware
- Institute for Global Health and Translational Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Timothy P Endy
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Stephen J Thomas
- Department of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY, USA.
- Institute for Global Health and Translational Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA.
| |
Collapse
|
6
|
Frumence E, Wilkinson DA, Klitting R, Vincent M, Mnemosyme N, Grard G, Traversier N, Li-Pat-Yuen G, Heaugwane D, Souply L, Giry C, Paty MC, Collet L, Gérardin P, Thouillot F, De Lamballerie X, Jaffar-Bandjee MC. Dynamics of emergence and genetic diversity of dengue virus in Reunion Island from 2012 to 2022. PLoS Negl Trop Dis 2024; 18:e0012184. [PMID: 38768248 DOI: 10.1371/journal.pntd.0012184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/31/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Dengue is a major public health concern in Reunion Island, marked by recurrent epidemics, including successive outbreaks of dengue virus serotypes 1 and 2 (DENV1 and DENV2) with over 70,000 cases confirmed since 2017. METHODOLOGY/PRINCIPAL FINDINGS In this study, we used Oxford Nanopore NGS technology for sequencing virologically-confirmed samples and clinical isolates collected between 2012 and 2022 to investigate the molecular epidemiology and evolution of DENV in Reunion Island. Here, we generated and analyzed a total of 499 DENV1, 360 DENV2, and 18 DENV3 sequences. By phylogenetic analysis, we show that different genotypes and variants of DENV have circulated in the past decade that likely originated from Seychelles, Mayotte and Southeast Asia and highly affected areas in Asia and Africa. CONCLUSIONS/SIGNIFICANCE DENV sequences from Reunion Island exhibit a high genetic diversity which suggests regular introductions of new viral lineages from various Indian Ocean islands. The insights from our phylogenetic analysis may inform local health authorities about the endemicity of DENV variants circulating in Reunion Island and may improve dengue management and surveillance. This work emphasizes the importance of strong local coordination and collaboration to inform public health stakeholders in Reunion Island, neighboring areas, and mainland France.
Collapse
Affiliation(s)
- Etienne Frumence
- Centre National de Référence Arbovirus Associé, CHU de la Réunion Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - David A Wilkinson
- UMR ASTRE, CIRAD, INRAE, Université de Montpellier, Plateforme technologique CYROI, Sainte-Clotilde, Réunion, France
| | - Raphaelle Klitting
- Unité des Virus Émergents (UVE), Aix-Marseille Univ, IRD 190, INSERM 1207, Marseille, France
- CNR des Arbovirus, Marseille, France
| | | | - Nicolas Mnemosyme
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | | | - Nicolas Traversier
- Centre National de Référence Arbovirus Associé, CHU de la Réunion Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Ghislaine Li-Pat-Yuen
- Centre National de Référence Arbovirus Associé, CHU de la Réunion Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Diana Heaugwane
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Laurent Souply
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Claude Giry
- Centre National de Référence Arbovirus Associé, CHU de la Réunion Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | | | | | - Patrick Gérardin
- INSERM CIC 1410, CHU de la Réunion, Saint-Pierre, Réunion, France
| | | | - Xavier De Lamballerie
- Unité des Virus Émergents (UVE), Aix-Marseille Univ, IRD 190, INSERM 1207, Marseille, France
- CNR des Arbovirus, Marseille, France
| | - Marie-Christine Jaffar-Bandjee
- Centre National de Référence Arbovirus Associé, CHU de la Réunion Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| |
Collapse
|
7
|
Bos S, Zambrana JV, Duarte E, Graber AL, Huffaker J, Montenegro C, Premkumar L, Gordon A, Balmaseda A, Harris E. Inapparent primary dengue virus infections reveal hidden serotype-specific epidemiological patterns and spectrum of infection outcome: a cohort study in Nicaragua. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.05.24305281. [PMID: 38633800 PMCID: PMC11023678 DOI: 10.1101/2024.04.05.24305281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Dengue is the most prevalent mosquito-borne viral disease and a major public health problem worldwide. Most primary infections with the four dengue virus serotypes (DENV1-4) are inapparent; nevertheless, prior research has primarily focused on symptomatic infections, which has limited our understanding of the epidemiological burden and spectrum of disease of each DENV serotype. Our study addresses this bottleneck in dengue research by providing a new method and a detailed examination of primary inapparent infections. Methods Here we present (1) the evaluation of a multiplex DENV1-4 envelope domain III multiplex microsphere-based assay (EDIII-MMBA) to serotype inapparent primary infections and (2) its application leveraging 17 years of prospective sample collection from the Nicaraguan Pediatric Dengue Cohort Study. After evaluation, we analyzed 46% (N=574) of total inapparent primary DENV infections with the EDIII-MMBA. Remaining infections were inferred using stochastic imputation, taking year and neighborhood of infection into account. Findings The EDIII-MMBA demonstrated excellent diagnostic accuracy of symptomatic and inapparent primary DENV infections when evaluated against gold-standard serotyping methods. Significant within- and between-year variation in serotype distribution between symptomatic and inapparent infections and circulation of serotypes undetected in symptomatic cases were observed in multiple years. Our findings reveal that a significant majority of primary infections remained inapparent: 76.8% for DENV1, 79.9% for DENV2, and 63.9% for DENV3. DENV3 exhibited the highest likelihood of symptomatic and severe primary infections (Pooled OR compared to DENV1 = 2.13, 95% CI 1.28-3.56, and 6.75, 2.01-22.62, respectively), whereas DENV2 had similar likelihood to DENV1 in both analyses. Interpretation Our study indicates that case surveillance skews the perceived epidemiological footprint of DENV and reveals a more complex and intricate pattern of serotype distribution in inapparent infections. Further, the significant differences in infection outcomes by serotype emphasizes the need for serotype-informed public health strategies. Funding NIH/NIAID P01AI106695, U01AI153416. Research in context Evidence before this study: We conducted a search in PubMed for studies published up to February 2024. Keywords included "dengue virus" and "DENV" in combination with "inapparent infections", "asymptomatic infections", "primary infections by serotype", "FoI by serotype", "force of infection", "force of infection by serotype", and identified a significant gap in the current understanding of dengue epidemiology. Despite acknowledging the high prevalence of inapparent DENV infections in endemic regions, previous research has focused primarily on symptomatic infections, potentially biasing our understanding of the DENV epidemiological landscape and hindering our capacity to determine the complete disease spectrum of the different DENV serotypes. While cross-sectional studies have provided preliminary insights into this gap, there is a need for more comprehensive and detailed serotype-specific insights to evaluate the epidemiological impact of inapparent infections. The lack of comprehensive characterization of inapparent infections reflects methodological challenges, particularly the need for prospective cohort studies designed to capture and accurately serotype these infections. Moreover, the reliance on labor-intensive and low-throughput antibody neutralization assays for serotyping, despite their accuracy, has constrained high-throughput analysis required for large-scale epidemiological studies.Added value of this study: Our study, spanning 17 years of prospective cohort data in Nicaragua, addresses this bottleneck in dengue research by providing a detailed examination of primary inapparent infections. The introduction of a novel envelope domain III (EDIII) multiplex microsphere-based assay for DENV serotyping represents a significant methodological advance, offering an efficient, scalable alternative for large epidemiological studies. A key contribution of our study is the intricate pattern of serotype distribution among inapparent infections. In contrast to the serotype predominance observed in symptomatic infections, inapparent infections exhibit a complex landscape with co-circulation of multiple DENV serotypes, including serotypes undetected in symptomatic surveillance in multiple years. Our systematic documentation of the entire disease spectrum provides unprecedented insights into the serotype-specific disease burden in primary infection, including the proportion of symptomatic versus inapparent infection and its temporal variations, thus providing a more complete picture of DENV epidemiology than has been available to date. Notably, we demonstrate striking differences in disease severity by serotype, with DENV3 infections being significantly more symptomatic and more severe compared to DENV1 and DENV2, the latter displaying the highest rate of inapparent infection.Implications of all the available evidence: Our research challenges prior assumptions by demonstrating that inapparent and symptomatic primary DENV infections present distinct epidemiological profiles, revealing that the epidemiological footprint of DENV is broader and more nuanced than previously recognized through symptomatic cases alone. These findings underscore the utility for continuous and comprehensive surveillance systems that capture both symptomatic and inapparent infections to accurately assess the epidemiological burden of DENV and inform public health interventions. Additionally, they provide critical insight for enhancing the accuracy of predictive DENV transmission modeling. Furthermore, the marked differences in infection outcomes by serotype emphasize the need for serotype-informed public health strategies. This nuanced understanding is pivotal for the crafting of targeted interventions, vaccine development and vaccination strategies, and efficient resource allocation, ultimately contributing to the global effort to mitigate the impact of dengue.
Collapse
|
8
|
Mader K, Dustin LB. Beyond bNAbs: Uses, Risks, and Opportunities for Therapeutic Application of Non-Neutralising Antibodies in Viral Infection. Antibodies (Basel) 2024; 13:28. [PMID: 38651408 PMCID: PMC11036282 DOI: 10.3390/antib13020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
The vast majority of antibodies generated against a virus will be non-neutralising. However, this does not denote an absence of protective capacity. Yet, within the field, there is typically a large focus on antibodies capable of directly blocking infection (neutralising antibodies, NAbs) of either specific viral strains or multiple viral strains (broadly-neutralising antibodies, bNAbs). More recently, a focus on non-neutralising antibodies (nNAbs), or neutralisation-independent effects of NAbs, has emerged. These can have additive effects on protection or, in some cases, be a major correlate of protection. As their name suggests, nNAbs do not directly neutralise infection but instead, through their Fc domains, may mediate interaction with other immune effectors to induce clearance of viral particles or virally infected cells. nNAbs may also interrupt viral replication within infected cells. Developing technologies of antibody modification and functionalisation may lead to innovative biologics that harness the activities of nNAbs for antiviral prophylaxis and therapeutics. In this review, we discuss specific examples of nNAb actions in viral infections where they have known importance. We also discuss the potential detrimental effects of such responses. Finally, we explore new technologies for nNAb functionalisation to increase efficacy or introduce favourable characteristics for their therapeutic applications.
Collapse
Affiliation(s)
| | - Lynn B. Dustin
- Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, Oxford OX3 7FY, UK;
| |
Collapse
|
9
|
McBride A, Duyen HTL, Vuong NL, Tho PV, Tai LTH, Phong NT, Ngoc NT, Yen LM, Nhat PTH, Vi TT, Llewelyn MJ, Thwaites L, Hao NV, Yacoub S. Endothelial and inflammatory pathophysiology in dengue shock: New insights from a prospective cohort study in Vietnam. PLoS Negl Trop Dis 2024; 18:e0012071. [PMID: 38536887 PMCID: PMC11020502 DOI: 10.1371/journal.pntd.0012071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/16/2024] [Accepted: 03/14/2024] [Indexed: 04/18/2024] Open
Abstract
Dengue shock (DS) is the most severe complication of dengue infection; endothelial hyperpermeability leads to profound plasma leakage, hypovolaemia and extravascular fluid accumulation. At present, the only treatment is supportive with intravenous fluid, but targeted endothelial stabilising therapies and host immune modulators are needed. With the aim of prioritising potential therapeutics, we conducted a prospective observational study of adults (≥16 years) with DS in Vietnam from 2019-2022, comparing the pathophysiology underlying circulatory failure with patients with septic shock (SS), and investigating the association of biomarkers with clinical severity (SOFA score, ICU admission, mortality) and pulmonary vascular leak (daily lung ultrasound for interstitial and pleural fluid). Plasma was collected at enrolment, 48 hours later and hospital discharge. We measured biomarkers of inflammation (IL-6, ferritin), endothelial activation (Ang-1, Ang-2, sTie-2, VCAM-1) and endothelial glycocalyx breakdown (hyaluronan, heparan sulfate, endocan, syndecan-1). We enrolled 135 patients with DS (median age 26, median SOFA score 7, 34 required ICU admission, 5 deaths), together with 37 patients with SS and 25 healthy controls. Within the DS group, IL-6 and ferritin were associated with admission SOFA score (IL-6: βeta0.70, p<0.001 & ferritin: βeta0.45, p<0.001), ICU admission (IL-6: OR 2.6, p<0.001 & ferritin: OR 1.55, p<0.001) and mortality (IL-6: OR 4.49, p = 0.005 & ferritin: OR 13.8, p = 0.02); both biomarkers discriminated survivors and non-survivors at 48 hours and all patients who died from DS had pre-mortem ferritin ≥100,000ng/ml. IL-6 most strongly correlated with severity of pulmonary vascular leakage (R = 0.41, p<0.001). Ang-2 correlated with pulmonary vascular leak (R = 0.33, p<0.001) and associated with SOFA score (β 0.81, p<0.001) and mortality (OR 8.06, p = 0.002). Ang-1 was associated with ICU admission (OR 1.6, p = 0.005) and mortality (OR 3.62, p = 0.006). All 4 glycocalyx biomarkers were positively associated with SOFA score, but only syndecan-1 was associated with ICU admission (OR 2.02, p<0.001) and mortality (OR 6.51, p<0.001). This study highlights the central role of hyperinflammation in determining outcomes from DS; the data suggest that anti-IL-1 and anti-IL-6 immune modulators and Tie2 agonists may be considered as candidates for therapeutic trials in severe dengue.
Collapse
Affiliation(s)
- Angela McBride
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Brighton and Sussex Medical School, Brighton, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Nguyen Lam Vuong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Phan Vinh Tho
- Hospital for Tropical Disease, Ho Chi Minh City, Vietnam
| | | | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Tran Thuy Vi
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nguyen Van Hao
- Hospital for Tropical Disease, Ho Chi Minh City, Vietnam
| | - Sophie Yacoub
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
10
|
Roelofs B, Vos D, Halabi Y, Gerstenbluth I, Duits A, Grillet ME, Tami A, Vincenti-Gonzalez MF. Spatial and temporal trends of dengue infections in Curaçao: A 21-year analysis. Parasite Epidemiol Control 2024; 24:e00338. [PMID: 38323192 PMCID: PMC10844965 DOI: 10.1016/j.parepi.2024.e00338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/22/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Dengue viruses are a significant global health concern, causing millions of infections annually and putting approximately half of the world's population at risk, as reported by the World Health Organization (WHO). Understanding the spatial and temporal patterns of dengue virus spread is crucial for effective prevention of future outbreaks. By investigating these patterns, targeted dengue surveillance and control measures can be improved, aiding in the management of outbreaks in dengue-affected regions. Curaçao, where dengue is endemic, has experienced frequent outbreaks over the past 25 years. To examine the spatial and temporal trends of dengue outbreaks in Curaçao, this study employs an interdisciplinary and multi-method approach. Data on >6500 cases of dengue infections in Curaçao between the years 1995 and 2016 were used. Temporal and spatial statistics were applied. The Moran's I index identified the presence of spatial autocorrelation for incident locations, allowing us to reject the null hypothesis of spatial randomness. The majority of cases were recorded in highly populated areas and a relationship was observed between population density and dengue cases. Temporal analysis demonstrated that cases mostly occurred from October to January, during the rainy season. Lower average temperatures, higher precipitation and a lower sea surface temperature appear to be related to an increase in dengue cases. This effect has a direct link to La Niña episodes, which is the cooling phase of El Niño Southern Oscillation. The spatial and temporal analyses conducted in this study are fundamental to understanding the timing and locations of outbreaks, and ultimately improving dengue outbreak management.
Collapse
Affiliation(s)
- Bart Roelofs
- University of Groningen, Faculty of Spatial Sciences, Groningen, the Netherlands
| | - Daniella Vos
- University of Groningen, Faculty of Spatial Sciences, Groningen, the Netherlands
| | | | | | - Ashley Duits
- Red Cross Blood Bank Foundation Curaçao, Curaçao
| | - Maria E. Grillet
- Laboratorio de Biología de Vectores y Parásitos, Instituto de Zoología y Ecología Tropical, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | - Adriana Tami
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Groningen, the Netherlands
| | - Maria F. Vincenti-Gonzalez
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Groningen, the Netherlands
| |
Collapse
|
11
|
Castro-Trujillo S, Segura K, Bolívar-Marín S, Salgado DM, Bosch I, Vega R, Rojas MC, Narváez CF. NS1-Specific Antibody Response Facilitates the Identification of Children With Dengue and Zika in Hyperendemic Areas. Pediatr Infect Dis J 2024; 43:178-185. [PMID: 37963312 DOI: 10.1097/inf.0000000000004163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Infections by dengue virus (DENV) and Zika virus (ZIKV) have some similar symptoms and a cross-reactive immune response, although with different risk populations and outcomes. Here, we evaluated the virologic characteristics and the nonstructural protein 1 (NS1)-specific antibody responses to DENV and ZIKV in children suspected of dengue in different epidemiologic moments in Colombia. METHODS Viral RNA, circulating NS1 and IgM/IgG specific for DENV and ZIKV were performed by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA) in 301 children suspected of dengue enrolled in a hospital setting during the ZIKV epidemic and a primary healthcare setting during a DENV epidemic. For the detection of DENV and ZIKV-specific IgM, an NS1-based ELISA was validated using characterized pediatric samples. Clinical and laboratory parameters were also evaluated. RESULTS DENV RNA or NS1 antigen was detected in the plasma of 62% of children, and in none, the ZIKV RNA was found. NS1-based ELISA for DENV and ZIKV IgM showed a sensitivity/specificity of 90/84% and 73/98%, respectively. Of 114 children without detectable viremia or antigenemia, 30.7%, 17.5%, 22% and 30% were IgM-DENV + , IgM-ZIKV + , IgM-DENV + ZIKV + and IgM-DENV - ZIKV - , respectively. The ZIKV/DENV IgM-NS1 ratio allows the identification of the infecting orthoflavivirus in 88% of the children with IgM-DENV + ZIKV + , confirming a high predominance of DENV infections in the 2 pediatric settings. CONCLUSION Overall, 88% of the children with clinical suspicion of dengue had an identifiable orthoflaviviral infection, with 80% caused by DENV, 7% by ZIKV and 0.7% classified as recent infections or coinfection, demonstrating active viral cocirculation in the pediatric population of southern Colombia. The IgM-NS1 detection improved the identification of orthoflaviviral infections in children without viremia or antigenemia, suggesting it is a helpful complementary tool for medical personnel in tropical regions with high viral cocirculation and different clinical scenes.
Collapse
Affiliation(s)
- Sebastián Castro-Trujillo
- From the División de Inmunología, Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Katherine Segura
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Dirección Laboratorio de Salud Pública, Secretaría de Salud Departamental, Gobernación del Huila, Neiva, Huila, Colombia
| | - Sara Bolívar-Marín
- From the División de Inmunología, Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Doris M Salgado
- Área de Pediatría, Departamento de Ciencias Clínicas, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Irene Bosch
- Department of Microbiology, Harvard Medical School, Boston, Massachusetts
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts, USA
| | - Rocío Vega
- Área de Pediatría, Departamento de Ciencias Clínicas, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
- Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia
| | - María Clemencia Rojas
- Dirección Laboratorio de Salud Pública, Secretaría de Salud Departamental, Gobernación del Huila, Neiva, Huila, Colombia
| | - Carlos F Narváez
- Área de Pediatría, Departamento de Ciencias Clínicas, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
- Dirección Laboratorio de Salud Pública, Secretaría de Salud Departamental, Gobernación del Huila, Neiva, Huila, Colombia
| |
Collapse
|
12
|
Pinotti F, Giovanetti M, de Lima MM, de Cerqueira EM, Alcantara LCJ, Gupta S, Recker M, Lourenço J. Shifting patterns of dengue three years after Zika virus emergence in Brazil. Nat Commun 2024; 15:632. [PMID: 38245500 PMCID: PMC10799945 DOI: 10.1038/s41467-024-44799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
In 2015, the Zika virus (ZIKV) emerged in Brazil, leading to widespread outbreaks in Latin America. Following this, many countries in these regions reported a significant drop in the circulation of dengue virus (DENV), which resurged in 2018-2019. We examine age-specific incidence data to investigate changes in DENV epidemiology before and after the emergence of ZIKV. We observe that incidence of DENV was concentrated in younger individuals during resurgence compared to 2013-2015. This trend was more pronounced in Brazilian states that had experienced larger ZIKV outbreaks. Using a mathematical model, we show that ZIKV-induced cross-protection alone, often invoked to explain DENV decline across Latin America, cannot explain the observed age-shift without also assuming some form of disease enhancement. Our results suggest that a sudden accumulation of population-level immunity to ZIKV could suppress DENV and reduce the mean age of DENV incidence via both protective and disease-enhancing interactions.
Collapse
Affiliation(s)
- Francesco Pinotti
- Department of Biology, University of Oxford, Oxford, United Kingdom.
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Sciences and Technologies for Sustainable Development and One Health, University of Campus Bio-Medico di Roma, Rome, Italy
| | | | | | - Luiz C J Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Sunetra Gupta
- Department of Biology, University of Oxford, Oxford, United Kingdom
| | - Mario Recker
- Centre for Ecology and Conservation, University of Exeter, Penryn, United Kingdom
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - José Lourenço
- Católica Biomedical Research, Católica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| |
Collapse
|
13
|
Recker M, Fleischmann WA, Nghia TH, Truong NV, Nam LV, Duc Anh D, Song LH, The NT, Anh CX, Hoang NV, My Truong N, Toan NL, Kremsner PG, Velavan TP. Markers of prolonged hospitalisation in severe dengue. PLoS Negl Trop Dis 2024; 18:e0011922. [PMID: 38289968 PMCID: PMC10857710 DOI: 10.1371/journal.pntd.0011922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/09/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Dengue is one of the most common diseases in the tropics and subtropics. Whilst mortality is a rare event when adequate supportive care can be provided, a large number of patients get hospitalised with dengue every year that places a heavy burden on local health systems. A better understanding of the support required at the time of hospitalisation is therefore of critical importance for healthcare planning, especially when resources are limited during major outbreaks. METHODS Here we performed a retrospective analysis of clinical data from over 1500 individuals hospitalised with dengue in Vietnam between 2017 and 2019. Using a broad panel of potential biomarkers, we sought to evaluate robust predictors of prolonged hospitalisation periods. RESULTS Our analyses revealed a lead-time bias, whereby early admission to hospital correlates with longer hospital stays - irrespective of disease severity. Importantly, taking into account the symptom duration prior to hospitalisation significantly affects observed associations between hospitalisation length and previously reported risk markers of prolonged stays, which themselves showed marked inter-annual variations. Once corrected for symptom duration, age, temperature at admission and elevated neutrophil-to-lymphocyte ratio were found predictive of longer hospitalisation periods. CONCLUSION This study demonstrates that the time since dengue symptom onset is one of the most significant predictors for the length of hospital stays, independent of the assigned severity score. Pre-hospital symptom durations need to be accounted for to evaluate clinically relevant biomarkers of dengue hospitalisation trajectories.
Collapse
Affiliation(s)
- Mario Recker
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Wim A. Fleischmann
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Trinh Huu Nghia
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Truong
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Van Nam
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Duc Anh
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Le Huu Song
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Trong The
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | | | | | - Nhat My Truong
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Peter G. Kremsner
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon
| | - Thirumalaisamy P. Velavan
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| |
Collapse
|
14
|
Salazar Flórez JE, Segura Cardona ÁM, Restrepo Jaramillo BN, Arboleda Naranjo M, Giraldo Cardona LS, Echeverri Rendón ÁP. Immune system gene polymorphisms associated with severe dengue in Latin America: a systematic review. Rev Inst Med Trop Sao Paulo 2023; 65:e58. [PMID: 38055376 DOI: 10.1590/s1678-9946202365058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/25/2023] [Indexed: 12/08/2023] Open
Abstract
One of the main challenges in the clinical management of dengue is the early identification of cases that could progress to severe forms of the disease. A biomarker that may enable this identification is the presence of genetic polymorphisms in genes associated with immune responses. The objective of this study was to perform a systematic review of the Latin American literature on these genes. An electronic literature search was carried out in PubMed, Scopus, Lilacs, and the Virtual Health Library, and reference lists of systematic reviews in the area. Case-control studies conducted in Latin American countries examining at least one form of genetic polymorphism related to immune responses against severe dengue were included. In total, 424 articles were identified and 26 were included in this systematic review. Of the 26 selected articles, 16 reported polymorphisms associated with the risk of developing severe dengue (Risk); Similarly, 16 articles reported polymorphisms associated with a decreased risk of severe dengue (Protective). The final analysis revealed that multiple polymorphisms in immune system genes were early markers of the progression of dengue in Latin Americans and found that polymorphisms of the TNF-alpha gene may have a critical role in dengue pathogenesis.
Collapse
Affiliation(s)
- Jorge Emilio Salazar Flórez
- Universidad CES, Grupo de Epidemiología y Bioestadística, Medellín, Colombia
- Fundación Universitaria San Martín, Grupo GEINCRO, Sabaneta, Colombia
| | | | | | | | | | | |
Collapse
|
15
|
Zambrana JV, Hasund CM, Aogo RA, Bos S, Arguello S, Gonzalez K, Collado D, Miranda T, Kuan G, Gordon A, Balmaseda A, Katzelnick L, Harris E. Primary exposure to Zika virus increases risk of symptomatic dengue virus infection with serotypes 2, 3, and 4 but not serotype 1. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.29.23299187. [PMID: 38077039 PMCID: PMC10705633 DOI: 10.1101/2023.11.29.23299187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Infection with any of the four dengue virus serotypes (DENV1-4) can protect against or enhance subsequent dengue depending on pre-existing antibodies and the subsequent infecting serotype. Additionally, primary infection with the related flavivirus Zika virus (ZIKV) has been shown to increase DENV2 disease. Here, we measured how prior DENV and ZIKV immunity influenced risk of disease caused by all four serotypes in a pediatric Nicaraguan cohort. Of 3,412 participants in 2022, 10.6% experienced symptomatic DENV infections caused by DENV1 (n=139), DENV4 (n=133), DENV3 (n=54), DENV2 (n=9), or an undetermined serotype (n=39). Longitudinal clinical and serological data were used to define infection histories, and generalized linear and additive models adjusted for age, sex, time since the last infection, cohort year, and repeat measurements were used to predict disease risk. Compared to flavivirus-naïve participants, primary ZIKV infection increased disease risk of DENV4 (relative risk = 2.62, 95% confidence interval: 1.48-4.63) and DENV3 (2.90, 1.34-6.27) but not DENV1 (1.20, 0.72-1.99). Primary DENV infection or a DENV followed by ZIKV infection also increased DENV4 risk. We re-analyzed 19 years of cohort data and demonstrated that prior flavivirus-immunity and pre-existing antibody titer differentially affected disease risk for incoming serotypes, increasing risk of DENV2 and DENV4, protecting against DENV1, and protecting at high titers but enhancing at low titers against DENV3. We thus find that prior ZIKV infection, like prior DENV infection, increases risk of certain DENV serotypes. Cross-reactivity among flaviviruses should be carefully considered when assessing vaccine safety and efficacy.
Collapse
Affiliation(s)
- Jose Victor Zambrana
- Sustainable Sciences Institute; Managua, Nicaragua
- Department of Epidemiology, School of Public Health, University of Michigan; Ann Arbor, MI, USA
| | - Chloe M. Hasund
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda; MD, USA
| | - Rosemary A. Aogo
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda; MD, USA
| | - Sandra Bos
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley; Berkeley, CA, USA
| | | | - Karla Gonzalez
- Sustainable Sciences Institute; Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud; Managua, Nicaragua
| | | | | | - Guillermina Kuan
- Sustainable Sciences Institute; Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministerio de Salud; Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan; Ann Arbor, MI, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute; Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud; Managua, Nicaragua
| | - Leah Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda; MD, USA
| | - Eva Harris
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley; Berkeley, CA, USA
| |
Collapse
|
16
|
Kikawa C, Cartwright-Acar CH, Stuart JB, Contreras M, Levoir LM, Evans MJ, Bloom JD, Goo L. The effect of single mutations in Zika virus envelope on escape from broadly neutralizing antibodies. J Virol 2023; 97:e0141423. [PMID: 37943046 PMCID: PMC10688354 DOI: 10.1128/jvi.01414-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023] Open
Abstract
IMPORTANCE The wide endemic range of mosquito-vectored flaviviruses-such as Zika virus and dengue virus serotypes 1-4-places hundreds of millions of people at risk of infection every year. Despite this, there are no widely available vaccines, and treatment of severe cases is limited to supportive care. An avenue toward development of more widely applicable vaccines and targeted therapies is the characterization of monoclonal antibodies that broadly neutralize all these viruses. Here, we measure how single amino acid mutations in viral envelope protein affect neutralizing antibodies with both broad and narrow specificities. We find that broadly neutralizing antibodies with potential as vaccine prototypes or biological therapeutics are quantifiably more difficult to escape than narrow, virus-specific neutralizing antibodies.
Collapse
Affiliation(s)
- Caroline Kikawa
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
- Medical Scientist Training Program, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| | | | - Jackson B. Stuart
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| | - Maya Contreras
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| | - Lisa M. Levoir
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| | - Matthew J. Evans
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jesse D. Bloom
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
- Basic Sciences, Fred Hutch Cancer Center, Seattle, Washington, USA
- Computational Biology, Fred Hutch Cancer Center, Seattle, Washington, USA
- Howard Hughes Medical Institute, Seattle, Washington, USA
| | - Leslie Goo
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| |
Collapse
|
17
|
Pliego Zamora A, Kim J, Vajjhala PR, Thygesen SJ, Watterson D, Modhiran N, Bielefeldt-Ohmann H, Stacey KJ. Kinetics of severe dengue virus infection and development of gut pathology in mice. J Virol 2023; 97:e0125123. [PMID: 37850747 PMCID: PMC10688336 DOI: 10.1128/jvi.01251-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
IMPORTANCE Dengue virus, an arbovirus, causes an estimated 100 million symptomatic infections annually and is an increasing threat as the mosquito range expands with climate change. Dengue epidemics are a substantial strain on local economies and health infrastructure, and an understanding of what drives severe disease may enable treatments to help reduce hospitalizations. Factors exacerbating dengue disease are debated, but gut-related symptoms are much more frequent in severe than mild cases. Using mouse models of dengue infection, we have shown that inflammation and damage are earlier and more severe in the gut than in other tissues. Additionally, we observed impairment of the gut mucus layer and propose that breakdown of the barrier function exacerbates inflammation and promotes severe dengue disease. This idea is supported by recent data from human patients showing elevated bacteria-derived molecules in dengue patient serum. Therapies aiming to maintain gut integrity may help to abrogate severe dengue disease.
Collapse
Affiliation(s)
- Adriana Pliego Zamora
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jaehyeon Kim
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Parimala R. Vajjhala
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Sara J. Thygesen
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Daniel Watterson
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
| | - Naphak Modhiran
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Helle Bielefeldt-Ohmann
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
| | - Katryn J. Stacey
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
| |
Collapse
|
18
|
Aogo RA, Zambrana JV, Sanchez N, Ojeda S, Kuan G, Balmaseda A, Gordon A, Harris E, Katzelnick LC. Effects of boosting and waning in highly exposed populations on dengue epidemic dynamics. Sci Transl Med 2023; 15:eadi1734. [PMID: 37967199 PMCID: PMC11001200 DOI: 10.1126/scitranslmed.adi1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023]
Abstract
Sequential infection with multiple dengue virus (DENV) serotypes is thought to induce enduring protection against dengue disease. However, long-term antibody waning has been observed after repeated DENV infection. Here, we provide evidence that highly immune Nicaraguan children and adults (n = 4478) experience boosting and waning of antibodies during and after major Zika and dengue epidemics. We develop a susceptible-infected-recovered-susceptible (SIRS-type) model that tracks immunity by titer rather than number of infections to show that boosts in highly immune individuals can contribute to herd immunity, delaying their susceptibility to transmissible infection. In contrast, our model of lifelong immunity in highly immune individuals, as previously assumed, results in complete disease eradication after introduction. Periodic epidemics under this scenario can only be sustained with a constant influx of infected individuals into the population or a high basic reproductive number. We also find that Zika virus infection can boost DENV immunity and produce delays and then surges in dengue epidemics, as observed with real epidemiological data. This work provides insight into factors shaping periodicity in dengue incidence and may inform vaccine efforts to maintain population immunity.
Collapse
Affiliation(s)
- Rosemary A. Aogo
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Jose Victor Zambrana
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, 12014, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, 16064, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720-3370, USA
| | - Leah C. Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| |
Collapse
|
19
|
Tricou V, Winkle PJ, Tharenos LM, Rauscher M, Escudero I, Hoffman E, LeFevre I, Borkowski A, Wallace D. Consistency of immunogenicity in three consecutive lots of a tetravalent dengue vaccine candidate (TAK-003): A randomized placebo-controlled trial in US adults. Vaccine 2023; 41:6999-7006. [PMID: 37884415 DOI: 10.1016/j.vaccine.2023.09.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND We conducted a trial to demonstrate immunogenic equivalence of three consecutive manufacturing lots of Takeda's tetravalent dengue vaccine candidate, TAK-003, and further assessed its safety and reactogenicity. METHODS Healthy US adults (n = 923) randomized 2:2:2:1 to four groups received two doses of one of three TAK-003 lots or placebo on Days 0 and 90, with follow-up to Day 270. Primary endpoint evaluated lot-to-lot equivalence of geometric mean neutralizing titers at Day 120 against each of 4 dengue serotypes in baseline seronegative participants. Solicited local and systemic, and unsolicited adverse events (AEs) were assessed for 7, 14 and 28 days after each dose, respectively. Serious AEs (SAE) were monitored throughout the study. RESULTS Eight of 12 prespecified equivalence comparisons were met in the per-protocol set but failed marginally in the other 4 mainly due to loss of statistical power following higher than anticipated baseline seropositivity and drop-out rates. All three TAK-003 lots elicited high rates of tetravalent dengue seropositivity (96.7 %, 93.0 % and 97.5 % at Day 120; 91.0 %, 80.5 % and 85.7 % at Day 270) and had similar reactogenicity profiles with no vaccine-related SAEs. CONCLUSIONS The three lots of TAK-003 were immunogenic for all four dengue serotypes and well tolerated in healthy adults. Despite not meeting all equivalence comparisons, no major differences were observed between lots and the data support acceptable consistency of the manufacturing process. Trial registrationClinicalTrials.gov identifier: NCT03423173.
Collapse
Affiliation(s)
- Vianney Tricou
- Takeda Pharmaceuticals International, Zurich, Switzerland.
| | | | | | | | | | | | - Inge LeFevre
- Takeda Pharmaceuticals International, Zurich, Switzerland
| | | | | |
Collapse
|
20
|
Uno N, Ross TM. Putting the pieces together: Chimeric virus strategy decode Dengue virus 3 antibody responses. Cell Host Microbe 2023; 31:1772-1773. [PMID: 37944489 DOI: 10.1016/j.chom.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
In this issue of Cell Host & Microbe, Munt et al. shed light on variability in human immune responses after natural infection compared to vaccination by using a recombinant virus platform that expresses chimeric Dengue virus type 1 and type 3 envelope proteins to identify and characterize type-specific neutralizing antibodies.
Collapse
Affiliation(s)
- Naoko Uno
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Ted M Ross
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Florida Research and Innovation Center, Cleveland Clinic, Port Saint Lucie, FL, USA.
| |
Collapse
|
21
|
Tsai JJ, Chang K, Chen CH, Liao CL, Chen LJ, Tsai YY, Tsai CY, Lin PC, Hsu MC, Liu LT. Dengue virus serotype did not contribute to clinical severity or mortality in Taiwan's largest dengue outbreak in 2015. Eur J Med Res 2023; 28:482. [PMID: 37932817 PMCID: PMC10626727 DOI: 10.1186/s40001-023-01454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Dengue virus serotype 2 (DENV-2) was the major serotype in the 2015 dengue outbreak in Taiwan, while DENV-1 and DENV-3 were dominant between 2005 and 2014. We aimed to investigate whether DENV-2 contributed to disease severity and mortality in the outbreak in Kaohsiung city, Taiwan. METHODS We collected serum samples from dengue patients to detect the presence of DENV and determine the serotypes by using quantitative reverse transcription-polymerase chain reaction. Our cohorts comprised 105 DENV-1-infected cases and 1,550 DENV-2-infected cases. Demographic data, DENV serotype, and comorbidities were covariates for univariate and multivariate analyses to explore the association with severity and mortality. RESULTS The results suggested that DENV-1 persisted and circulated, while DENV-2 was dominant during the dengue outbreak that occurred between September and December 2015. However, DENV-2 did not directly contribute to either severity or mortality. Aged patients and patients with diabetes mellitus (DM) or moderate to severe chronic kidney disease (CKD) had a higher risk of developing severe dengue. The mortality of dengue patients was related to a higher Charlson comorbidity index score and severe dengue. Among DENV-2-infected patients and older patients, preexisting anti-dengue IgG, DM, and moderate to severe CKD were associated with severe dengue. Moreover, female sex and severe dengue were associated with a significantly higher risk of death. CONCLUSIONS Our findings highlight the importance of timely serological testing in elderly patients to identify potential secondary infections and focus on the meticulous management of elderly patients with DM or moderate to severe CKD to reduce dengue-related death.
Collapse
Affiliation(s)
- Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ching-Len Liao
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Liang-Jen Chen
- Department of Family Medicine, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan.
| |
Collapse
|
22
|
Zeng Q, Liu J, Hao C, Zhang B, Zhang H. Making sense of flavivirus non-strctural protein 1 in innate immune evasion and inducing tissue-specific damage. Virus Res 2023; 336:199222. [PMID: 37716670 PMCID: PMC10518729 DOI: 10.1016/j.virusres.2023.199222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023]
Abstract
Flaviviruses include medically important mosquito-borne pathogens, such as Zika virus (ZIKV), Japanese encephalitis virus (JEV), dengue virus (DENV) and West Nile virus (WNV), that cause hundreds of millions of infections each year. Currently, there are no approved effect therapies against mosquito-borne flaviviruses. The flaviviruses encoded nonstructural protein 1 (NS1) is a secreted glycoprotein widely involved in viral replication, immune evasion, and directly causing tissue-specific damage during flaviviruses infection. Upon viral infection of host cell, NS1 can be found in multiple oligomeric forms and include a dimer on the cell surface, and a soluble secreted hexameric lipoparticle. In the recent decade, the detailed crystal structure of several flaviviruses NS1 have been determined and unraveled its broader and deeper functions. Consistent with the potential immune function revealed by its structure, NS1 is involved in the escaping of host signal immune pathway mediated by pattern recognition receptors (PRRs), including RIG-I-like receptors (RLRS) and Toll-like receptors (TLRs). Moreover, the flavivirus NS1 is efficiently secreted by infected cells and circulates in the blood of the host to directly induce specific tissues damage. The NS1 of ZIKV, JEV and WNV changes the permeability of brain microvascular endothelial cell to cause endothelial cell dysfunction and promote virus pathogenesis. DENV NS1 can induce systemic tissues damage in humans through multiple strategies. Mutations of several key amino acids in NS1 can reduce the neurovirulence of the flavivirus. In this article, we provide an overview of the latest research on this fascinating protein in these disparate areas.
Collapse
Affiliation(s)
- Quan Zeng
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450002, China
| | - Jiaqi Liu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450002, China
| | - Chenlin Hao
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450002, China
| | - Bo Zhang
- Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Honglei Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450002, China.
| |
Collapse
|
23
|
Limthongkul J, Akkarasereenon K, Yodweerapong T, Songthammawat P, Tong-Ngam P, Tubsuwan A, Kunkaew N, Kanjanasirirat P, Khumpanied T, Wannalo W, Ubol S, Borwornpinyo S, Ploypradith P, Ponpuak M. Novel Potent Autophagy Inhibitor Ka-003 Inhibits Dengue Virus Replication. Viruses 2023; 15:2012. [PMID: 37896789 PMCID: PMC10611120 DOI: 10.3390/v15102012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Every year, dengue virus (DENV) affects millions of people. Currently, there are no approved drugs for the treatment of DENV infection. Autophagy is a conserved degradation process that was shown to be induced by DENV infection and required for optimal DENV replication. The modulation of autophagy is, therefore, considered an attractive target to treat DENV infection. This study carried out a high-content image screen analysis using Crispr-Cas9 GFP-LC3 knocked-in HeLa cells of a compound library synthesized from or inspired by natural products and their biocongener precursors to discover novel autophagy inhibitors. The screen identified Ka-003 as the most effective compound for decreasing the number of autophagic vacuoles inside cells upon autophagy induction. Ka-003 could inhibit autophagy in a dose-dependent manner at low micromolar concentrations. More importantly, Ka-003 demonstrated the concentration-dependent inhibition of DENV production in Crispr-Cas9 GFP-LC3 knocked-in THP-1 monocytes. The core structure of Ka-003, which is a methyl cyclohexene derivative, resembles those found in mulberry plants, and could be synthetically prepared in a bioinspired fashion. Taken together, data indicate that Ka-003 hampered autophagy and limited DENV replication. The low cytotoxicity of Ka-003 suggests its therapeutic potential, which warrants further studies for the lead optimization of the compound for dengue treatment.
Collapse
Affiliation(s)
- Jitra Limthongkul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand (S.U.)
| | - Kornkamon Akkarasereenon
- Laboratory of Medicinal Chemistry, Chulabhorn Research Institute, Bangkok 10210, Thailand (P.P.)
| | - Tanpitcha Yodweerapong
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand (S.U.)
| | - Poramate Songthammawat
- Laboratory of Medicinal Chemistry, Chulabhorn Research Institute, Bangkok 10210, Thailand (P.P.)
| | - Pirut Tong-Ngam
- Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom 73170, Thailand (A.T.)
| | - Alisa Tubsuwan
- Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom 73170, Thailand (A.T.)
| | - Nawapol Kunkaew
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Phongthon Kanjanasirirat
- Excellent Center for Drug Discovery, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Tanawadee Khumpanied
- Excellent Center for Drug Discovery, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Warawuth Wannalo
- Excellent Center for Drug Discovery, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Sukathida Ubol
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand (S.U.)
| | - Suparerk Borwornpinyo
- Excellent Center for Drug Discovery, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Department of Biotechnology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Poonsakdi Ploypradith
- Laboratory of Medicinal Chemistry, Chulabhorn Research Institute, Bangkok 10210, Thailand (P.P.)
| | - Marisa Ponpuak
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand (S.U.)
| |
Collapse
|
24
|
Kikawa C, Cartwright-Acar CH, Stuart JB, Contreras M, Levoir LM, Evans MJ, Bloom JD, Goo L. The effect of single mutations in Zika virus envelope on escape from broadly neutralizing antibodies. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.13.557606. [PMID: 37808848 PMCID: PMC10557620 DOI: 10.1101/2023.09.13.557606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Zika virus and dengue virus are co-circulating flaviviruses with a widespread endemic range. Eliciting broad and potent neutralizing antibodies is an attractive goal for developing a vaccine to simultaneously protect against these viruses. However, the capacity of viral mutations to confer escape from broadly neutralizing antibodies remains undescribed, due in part to limited throughput and scope of traditional approaches. Here, we use deep mutational scanning to map how all possible single amino acid mutations in Zika virus envelope protein affect neutralization by antibodies of varying breadth and potency. While all antibodies selected viral escape mutations, the mutations selected by broadly neutralizing antibodies conferred less escape relative to those selected by narrow, virus-specific antibodies. Surprisingly, even for broadly neutralizing antibodies with similar binding footprints, different single mutations led to escape, indicating distinct functional requirements for neutralization not captured by existing structures. Additionally, the antigenic effects of mutations selected by broadly neutralizing antibodies were conserved across divergent, albeit related, flaviviruses. Our approach identifies residues critical for antibody neutralization, thus comprehensively defining the as-yet-unknown functional epitopes of antibodies with clinical potential.
Collapse
Affiliation(s)
- Caroline Kikawa
- Department of Genome Sciences, University of Washington, Seattle, Washington, 98109, USA
- Medical Scientist Training Program, University of Washington, Seattle, Washington, 98109, USA
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, 98109, USA
| | | | - Jackson B. Stuart
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, 98109, USA
| | - Maya Contreras
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, 98109, USA
| | - Lisa M. Levoir
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, 98109, USA
| | - Matthew J. Evans
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, 10029, USA
| | - Jesse D. Bloom
- Department of Genome Sciences, University of Washington, Seattle, Washington, 98109, USA
- Basic Sciences and Computational Biology, Fred Hutch Cancer Center, Seattle Washington, 98109, USA
- Howard Hughes Medical Institute, Seattle, WA, 98109, USA
| | - Leslie Goo
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, 98109, USA
| |
Collapse
|
25
|
Annan E, Treviño J, Zhao B, Rodriguez-Morales AJ, Haque U. Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. PLoS Negl Trop Dis 2023; 17:e0011537. [PMID: 37556473 PMCID: PMC10441797 DOI: 10.1371/journal.pntd.0011537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 08/21/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and region. Further, we assessed the spatial clustering of dengue severity for individuals with primary and secondary infection across Mexican municipalities. Health data from 2012 to 2017 was retrieved from Mexico's Ministry of Health. A mediation analysis was performed using multiple logistic regression models based on a directed acyclic graph. The models were explored for the direct effect of age on dengue severity and its indirect impact through secondary infection. In addition, severe dengue clusters were determined in some Northeastern and Southeastern municipalities through spatial analysis. We observed a nonlinear trend between age and severe dengue. There was a downward trend of severe dengue for individuals between 0 and 10 years and an upward trend above 10 years. The effect of age on dengue severity was no longer significant for individuals between 10 and 60 years after introducing infectivity status into the model. The mediating role of infectivity status in the causal model was 17%. Clustering of severe dengue among individuals with primary infection in the Northeastern region may point to the high prevalence of DENV-3 in the region. Public health efforts may prevent secondary infection among infants and the aged. In addition, there should be a further investigation into the effect of DENV-3 in individuals with primary disease.
Collapse
Affiliation(s)
- Esther Annan
- Center for Health and Wellbeing, School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America
| | - Jesús Treviño
- Department of Urban Affairs at the School of Architecture, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo Léon, México
| | - Bingxin Zhao
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
| | - Ubydul Haque
- Rutgers Global Health Institute, New Brunswick, New Jersey, United States of America
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| |
Collapse
|
26
|
Ye G, Xu Z, Yang M, Wang J, Liang J, Yin J, Yang Y, Xia H, Liu Y. Clinical features and transmission risk analysis of dengue virus infections in Shenzhen, During 2014-2019. Comput Struct Biotechnol J 2023; 21:3728-3735. [PMID: 37560123 PMCID: PMC10407296 DOI: 10.1016/j.csbj.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 08/11/2023] Open
Abstract
UNLABELLED Dengue fever (DF) and dengue hemorrhagic fever (DHF) are among the most common tropical diseases affecting humans. To analyze the risk of clinical and transmission of DF/DHF in Shenzhen, the surveillance on patients of all-age patients with dengue virus (DENV) infections was conducted. Our findings revealed that the majority of DENV-infected patients are young to middle-aged males, and the development of the disease is accompanied by abnormal changes in the percentages of neutrophils, lymphocytes, and basophils. Demographic analysis revealed that these patients is concentrated in areas such as Futian District, which may be due to the higher mosquito density and temperature than that in other area. Subsequent, mosquito infection experiments confirmed that the effect of temperature shift on DENV proliferation and transmission. Not only that, constant temperatures can enhance the spread of DENV, even increase the risk of epidemic. Thus, the role of innate immune response should be highlighted in the prediction of severe severity of DENV-infected patients, and temperature should be taken into account in the prevention and control of DENV. INTRODUCTION Dengue fever (DF) and dengue hemorrhagic fever (DHF) are among the most common tropical diseases affecting humans, and which caused by the four dengue virus serotypes (DENV 1-4). OBJECTIVES To analyze the risk of clinical and transmission of DF/DHF in Shenzhen. METHODS The surveillance on patients of all-age patients with dengue virus (DENV) infections was conducted. RESULTS Our findings revealed that the majority of DENV-infected patients are young to middle-aged males, and the development of the disease is accompanied by abnormal changes in the percentages of neutrophils, lymphocytes, and basophils. Demographic analysis revealed that these patients is concentrated in areas such as Futian District, which may be due to the higher mosquito density and temperature than that in other area. Subsequent, mosquito infection experiments confirmed that the effect of temperature shift on DENV proliferation and transmission. Not only that, constant temperatures can enhance the spread of DENV, even increase the risk of epidemic. CONCLUSION 1. Elevated levels of neutrophils, lymphocytes, basophils, and temperature are all significant risk factors for dengue transmission and pathogenesis; 2. Temperature increasing is associated with a higher risk of dengue transmission; 3. Fluctuations in temperature around 28 °C (28 ± 5 °C) would increase dengue transmission.
Collapse
Affiliation(s)
- Guoguo Ye
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Zhixiang Xu
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Minghui Yang
- Key Laboratory of Medical Molecule Science and Pharmaceutics Engineering, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Molecular Medicine and Biotherapy, Beijing 100081, China
- Advanced Research Institute of Multidisciplinary Sciences, Beijing Institute of Technology, Beijing 100081, China
| | - Jun Wang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Jinhu Liang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Juzhen Yin
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Yang Yang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Han Xia
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Yingxia Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, Division of Infectious Disease,The Third People's Hospital of Shenzhen, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| |
Collapse
|
27
|
Angelin M, Sjölin J, Kahn F, Ljunghill Hedberg A, Rosdahl A, Skorup P, Werner S, Woxenius S, Askling HH. Qdenga® - A promising dengue fever vaccine; can it be recommended to non-immune travelers? Travel Med Infect Dis 2023; 54:102598. [PMID: 37271201 DOI: 10.1016/j.tmaid.2023.102598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Qdenga® has been approved by the European Medicines Agency (EMA) for individuals > 4 years of age and for use according to national recommendations. The vaccine shows high efficacy against virologically confirmed dengue and severe dengue in clinical studies on 4-16-year old's living in endemic areas. For individuals 16-60 years old only serological data exists and there is no data for individuals > 60 years. Its use as a travel vaccine is still unclear. We present the studies behind the approval and the recommendations for travelers as issued by the Swedish Society for Infectious Diseases Physicians.
Collapse
Affiliation(s)
- Martin Angelin
- Department of Clinical Microbiology, Infectious Diseases, Umeå University, Sweden
| | - Jan Sjölin
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Fredrik Kahn
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Sweden
| | - Anna Ljunghill Hedberg
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Anja Rosdahl
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden
| | - Paul Skorup
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Simon Werner
- Department of Infectious Diseases, Skåne University Hospital, Malmö, Region Skåne, Sweden
| | - Susanne Woxenius
- Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena H Askling
- Department of Medicine, Solna, Division of Infectious Diseases, Karolinska Institutet, Sweden; Academic Specialist Centre, Stockholm County Health Care Services, Region Stockholm, Sweden.
| |
Collapse
|
28
|
Maduranga S, Valencia BM, Sigera C, Adikari T, Weeratunga P, Fernando D, Rajapakse S, Lloyd AR, Bull RA, Rodrigo C. Genomic Surveillance of Recent Dengue Outbreaks in Colombo, Sri Lanka. Viruses 2023; 15:1408. [PMID: 37515097 PMCID: PMC10384240 DOI: 10.3390/v15071408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
All four serotypes of the dengue virus (DENV1-4) cause a phenotypically similar illness, but serial infections from different serotypes increase the risk of severe disease. Thus, genomic surveillance of circulating viruses is important to detect serotype switches that precede community outbreaks of disproportionate magnitude. A phylogenetic analysis was conducted on near full length DENV genomes sequenced from serum collected from a prospective cohort study from the Colombo district, Sri Lanka during a 28-month period using Oxford nanopore technology, and the consensus sequences were analyzed using maximum likelihood and Bayesian evolutionary analysis. From 523 patients, 328 DENV sequences were successfully generated (DENV1: 43, DENV2: 219, DENV3:66). Most circulating sequences originated from a common ancestor that was estimated to have existed from around 2010 for DENV2 and around 2015/2016 for DENV1 and DENV3. Four distinct outbreaks coinciding with monsoon rain seasons were identified during the observation period mostly driven by DENV2 cosmopolitan genotype, except for a large outbreak in 2019 contributed by DENV3 genotype I. This serotype switch did not result in a more clinically severe illness. Phylogeographic analyses showed that all outbreaks started within Colombo city and then spread to the rest of the district. In 2019, DENV3 genotype I, previously, rarely reported in Sri Lanka, is likely to have contributed to a disease outbreak. However, this did not result in more severe disease in those infected, probably due to pre-existing DENV3 immunity in the community. Targeted vector control within Colombo city before anticipated seasonal outbreaks may help to limit the geographic spread of outbreaks.
Collapse
Affiliation(s)
- Sachith Maduranga
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW 2052, Australia
- Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | | | - Chathurani Sigera
- Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - Thiruni Adikari
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW 2052, Australia
| | | | - Deepika Fernando
- Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - Senaka Rajapakse
- Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - Andrew R Lloyd
- Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Rowena A Bull
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW 2052, Australia
- Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Chaturaka Rodrigo
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW 2052, Australia
- Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| |
Collapse
|
29
|
Malnero CM, Azevedo RC, Bergmann IE, de Meneses MDF, Cavalcanti AC, Ibáñez LI, Malirat V. Expression of recombinant dengue virus type 1 non-structural protein 1 in mammalian cells and preliminary assessment of its suitability to detect human IgG antibodies elicited by viral infection. J Immunol Methods 2023; 518:113503. [PMID: 37263391 DOI: 10.1016/j.jim.2023.113503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/18/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
In recent years dengue has become a rapidly growing public health problem worldwide, however, the availability of accurate and affordable diagnostic immunoassays is limited, partly due to the difficulty of producing large quantities of purified antigen. Non-structural protein 1 (NS1) has shown to be a good candidate for inclusion in diagnostic assays and for serosurveys, particularly in endemic countries as a prerequisite for vaccination. In this work the NS1 antigen derived from dengue virus type-1 (DENV1) was expressed in HEK293-T cells and purified by affinity chromatography. The recombinant protein was recovered properly folded as dimers, highly purified and with good yield (1.5 mg/L). It was applied as a serological probe in an indirect ELISA developed in this work to detect human IgG antibodies. Preliminary comparative performance values of 81.1% sensitivity and 83.0% specificity of the developed and preliminary validated iELISA, relative to a commercial kit were obtained, suggesting that the purified recombinant DENV1 NS1 antigen is suitable to detect IgG antibodies, indicative of past DENV infection.
Collapse
Affiliation(s)
- Cristian Miguel Malnero
- Centro de Virología Humana y Animal (CEVHAN), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Abierta Interamericana (UAI), Buenos Aires C1287, Argentina
| | - Renata Campos Azevedo
- Department of Virology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ingrid Evelyn Bergmann
- Centro de Virología Humana y Animal (CEVHAN), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Abierta Interamericana (UAI), Buenos Aires C1287, Argentina
| | | | - Andrea Cony Cavalcanti
- Department of Virology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Central Laboratory of Public Health Noel Nutels (LACEN-RJ), Rio de Janeiro, Brazil
| | - Lorena Itatí Ibáñez
- Instituto de Química Física de los Materiales, Medio Ambiente y Energía (INQUIMAE), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires (UBA), Buenos Aires C1428EGA, Argentina
| | - Viviana Malirat
- Centro de Virología Humana y Animal (CEVHAN), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Abierta Interamericana (UAI), Buenos Aires C1287, Argentina.
| |
Collapse
|
30
|
Rahman MM, Tanni KN, Roy T, Islam MR, Al Raji Rumi MA, Sadman Sakib M, Abdul Quader M, Bhuiyan NUI, Shobuj IA, Sayara Rahman A, Haque MI, Faruk F, Tahsan F, Rahman F, Alam E, Md. Towfiqul Islam AR. Knowledge, Attitude and Practices Towards Dengue Fever Among Slum Dwellers: A Case Study in Dhaka City, Bangladesh. Int J Public Health 2023; 68:1605364. [PMID: 37284509 PMCID: PMC10239854 DOI: 10.3389/ijph.2023.1605364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/09/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives: This study intends to evaluate Dhaka city slum dwellers' responses to Dengue fever (DF). Methods: 745 individuals participated in a KAP survey that was pre-tested. Face-to-face interviews were performed to obtain data. Python with RStudio was used for data management and analysis. The multiple regression models were applied when applicable. Results: 50% of respondents were aware of the deadly effects of DF, its common symptoms, and its infectious nature. However, many were unaware that DF could be asymptomatic, a previously infected person could have DF again, and the virus could be passed to a fetus. Individuals agreed that their families, communities, and authorities should monitor and maintain their environment to prevent Aedes mosquito breeding. However, overall 60% of the study group had inadequate preventative measures. Many participants lacked necessary practices such as taking additional measures (cleaning and covering the water storage) and monitoring potential breeding places. Education and types of media for DF information were shown to promote DF prevention practices. Conclusion: Slum dwellers lack awareness and preventative activities that put them at risk for DF. Authorities must improve dengue surveillance. The findings suggest efficient knowledge distribution, community stimulation, and ongoing monitoring of preventative efforts to reduce DF. A multidisciplinary approach is needed to alter dwellers' behavior since DF control can be done by raising the population's level of life. People and communities must perform competently to eliminate vector breeding sites.
Collapse
Affiliation(s)
- Md. Mostafizur Rahman
- Department of Disaster Management and Resilience, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Kamrun Nahar Tanni
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Tuly Roy
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Md. Rakibul Islam
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Md. Alim Al Raji Rumi
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Mohammed Sadman Sakib
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Masrur Abdul Quader
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Nafee-Ul-Islam Bhuiyan
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Ifta Alam Shobuj
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Afra Sayara Rahman
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Md. Iftekharul Haque
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Fariha Faruk
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Fahim Tahsan
- Department of Disaster and Human Security Management, Faculty of Arts and Social Sciences, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Farzana Rahman
- Department of Computer Science and Engineering, Independent University, Bangladesh, Dhaka, Bangladesh
| | - Edris Alam
- Faculty of Resilience, Rabdan Academy, Abu Dhabi, United Arab Emirates
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh
| | | |
Collapse
|
31
|
Sampei Z, Koo CX, Teo FJ, Toh YX, Fukuzawa T, Gan SW, Nambu T, Ho A, Honda K, Igawa T, Ahmed F, Wang CI, Fink K, Nezu J. Complement Activation by an Anti-Dengue/Zika Antibody with Impaired Fcγ Receptor Binding Provides Strong Efficacy and Abrogates Risk of Antibody-Dependent Enhancement. Antibodies (Basel) 2023; 12:antib12020036. [PMID: 37218902 DOI: 10.3390/antib12020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/12/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
To combat infectious diseases, vaccines are considered the best prophylactic strategy for a wide range of the population, but even when vaccines are effective, the administration of therapeutic antibodies against viruses could provide further treatment options, particularly for vulnerable groups whose immunity against the viruses is compromised. Therapeutic antibodies against dengue are ideally engineered to abrogate binding to Fcγ receptors (FcγRs), which can induce antibody-dependent enhancement (ADE). However, the Fc effector functions of neutralizing antibodies against SARS-CoV-2 have recently been reported to improve post-exposure therapy, while they are dispensable when administered as prophylaxis. Hence, in this report, we investigated the influence of Fc engineering on anti-virus efficacy using the anti-dengue/Zika human antibody SIgN-3C and found it affected the viremia clearance efficacy against dengue in a mouse model. Furthermore, we demonstrated that complement activation through antibody binding to C1q could play a role in anti-dengue efficacy. We also generated a novel Fc variant, which displayed the ability for complement activation but showed very low FcγR binding and an undetectable level of the risk of ADE in a cell-based assay. This Fc engineering approach could make effective and safe anti-virus antibodies against dengue, Zika and other viruses.
Collapse
Affiliation(s)
- Zenjiro Sampei
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | | | - Frannie Jiuyi Teo
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Ying Xiu Toh
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Taku Fukuzawa
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Siok Wan Gan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Takeru Nambu
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Adrian Ho
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Kiyofumi Honda
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Tomoyuki Igawa
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Fariyal Ahmed
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Cheng-I Wang
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Katja Fink
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Junichi Nezu
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| |
Collapse
|
32
|
Phadungsombat J, Vu HTT, Nguyen QT, Nguyen HTV, Nguyen HTN, Dang BT, Nakayama EE, Ishizaki A, Ichimura H, Shioda T, Pham TN. Molecular Characterization of Dengue Virus Strains from the 2019-2020 Epidemic in Hanoi, Vietnam. Microorganisms 2023; 11:1267. [PMID: 37317240 DOI: 10.3390/microorganisms11051267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/16/2023] Open
Abstract
Dengue virus (DENV), which has circulated in Vietnam for several decades, has multiple serotypes and genotypes. A 2019 dengue outbreak resulted in a larger number of cases than any other outbreak. We conducted a molecular characterization using samples collected in 2019-2020 from dengue patients in Hanoi and nearby cities located in northern Vietnam. The circulating serotypes were DENV-1 (25%, n = 22) and DENV-2 (73%, n = 64). Phylogenetic analyses revealed that all DENV-1 (n = 13) were genotype I and clustered to local strains circulating during the previous outbreak in the 2017, whereas DENV-2 consisted of two genotypes: Asian-I (n = 5), related to local strains from 2006-2022, and cosmopolitan (n = 18), the predominant genotype in this epidemic. The current cosmopolitan virus was identified as having an Asian-Pacific lineage. The virus was closely related to strains in other recent outbreaks in Southeast Asian countries and China. Multiple introductions occurred in 2016-2017, which were possibly from maritime Southeast Asia (Indonesia, Singapore, and Malaysia), mainland Southeast Asia (Cambodia and Thailand), or China, rather than from an expansion of localized Vietnamese cosmopolitan strains that were previously detected in the 2000s. We also analyzed the genetic relationship between Vietnam's cosmopolitan strain and recent global strains reported from Asia, Oceania, Africa, and South America. This analysis revealed that viruses of Asian-Pacific lineage are not restricted to Asia but have spread to Peru and Brazil in South America.
Collapse
Affiliation(s)
- Juthamas Phadungsombat
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan
| | | | - Quynh Thi Nguyen
- Department of Viral infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan
| | | | | | - Bich Thi Dang
- National Hospital for Tropical Disease, Hanoi 100000, Vietnam
| | - Emi E Nakayama
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan
| | - Azumi Ishizaki
- Department of Viral infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan
| | - Hiroshi Ichimura
- Department of Viral infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan
| | - Tatsuo Shioda
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan
| | - Thach Ngoc Pham
- National Hospital for Tropical Disease, Hanoi 100000, Vietnam
| |
Collapse
|
33
|
Zuzic L, Marzinek JK, Anand GS, Warwicker J, Bond PJ. A pH-dependent cluster of charges in a conserved cryptic pocket on flaviviral envelopes. eLife 2023; 12:82447. [PMID: 37144875 PMCID: PMC10162804 DOI: 10.7554/elife.82447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/18/2023] [Indexed: 05/06/2023] Open
Abstract
Flaviviruses are enveloped viruses which include human pathogens that are predominantly transmitted by mosquitoes and ticks. Some, such as dengue virus, exhibit the phenomenon of antibody-dependent enhancement (ADE) of disease, making vaccine-based routes of fighting infections problematic. The pH-dependent conformational change of the envelope (E) protein required for fusion between the viral and endosomal membranes is an attractive point of inhibition by antivirals as it has the potential to diminish the effects of ADE. We examined six flaviviruses by employing large-scale molecular dynamics (MD) simulations of raft systems that represent a substantial portion of the flaviviral envelope. We utilised a benzene-mapping approach that led to a discovery of shared hotspots and conserved cryptic sites. A cryptic pocket previously shown to bind a detergent molecule exhibited strain-specific characteristics. An alternative conserved cryptic site at the E protein domain interfaces showed a consistent dynamic behaviour across flaviviruses and contained a conserved cluster of ionisable residues. Constant-pH simulations revealed cluster and domain-interface disruption under low pH conditions. Based on this, we propose a cluster-dependent mechanism that addresses inconsistencies in the histidine-switch hypothesis and highlights the role of cluster protonation in orchestrating the domain dissociation pivotal for the formation of the fusogenic trimer.
Collapse
Affiliation(s)
- Lorena Zuzic
- Bioinformatics Institute (A*STAR), Singapore, Singapore
- Department of Chemistry, Manchester Institute of Biotechnology, The University of Manchester, Manchester, United Kingdom
| | | | - Ganesh S Anand
- Department of Biological Sciences, 16 Science Drive 4, National University of Singapore, Singapore, Singapore
- Department of Chemistry, The Pennsylvania State University, University Park, United States
| | - Jim Warwicker
- School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Institute of Biotechnology, The University of Manchester, Manchester, United Kingdom
| | - Peter J Bond
- Bioinformatics Institute (A*STAR), Singapore, Singapore
- Department of Biological Sciences, 16 Science Drive 4, National University of Singapore, Singapore, Singapore
| |
Collapse
|
34
|
Thomas SJ. Is new dengue vaccine efficacy data a relief or cause for concern? NPJ Vaccines 2023; 8:55. [PMID: 37061527 PMCID: PMC10105158 DOI: 10.1038/s41541-023-00658-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/29/2023] [Indexed: 04/17/2023] Open
Abstract
Dengue is a major global public health problem requiring a safe and efficacious vaccine as the foundation of a comprehensive countermeasure strategy. Despite decades of attempts, the world has a single dengue vaccine licensed in numerous countries, but restrictions and conditions of its use have deterred uptake. Recently, clinical efficacy data has been revealed for two additional dengue vaccine candidates and the data appears encouraging. In this perspective I discuss dengue, the complexities of dengue vaccine development, early development setbacks, and how the latest data from the field may be cause for measured optimism. Finally, I provide some perspectives on evaluating dengue vaccine performance and how the pursuit of the perfect dengue vaccine may prevent advancement of vaccines which are good enough.
Collapse
Affiliation(s)
- Stephen J Thomas
- SUNY Upstate Medical University, Institute for Global Health and Translational Sciences, Syracuse, NY, USA.
| |
Collapse
|
35
|
Ioannidis LJ, Studniberg SI, Eriksson EM, Suwarto S, Denis D, Liao Y, Shi W, Garnham AL, Sasmono RT, Hansen DS. Integrated systems immunology approach identifies impaired effector T cell memory responses as a feature of progression to severe dengue fever. J Biomed Sci 2023; 30:24. [PMID: 37055751 PMCID: PMC10103532 DOI: 10.1186/s12929-023-00916-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Typical symptoms of uncomplicated dengue fever (DF) include headache, muscle pains, rash, cough, and vomiting. A proportion of cases progress to severe dengue hemorrhagic fever (DHF), associated with increased vascular permeability, thrombocytopenia, and hemorrhages. Progression to severe dengue is difficult to diagnose at the onset of fever, which complicates patient triage, posing a socio-economic burden on health systems. METHODS To identify parameters associated with protection and susceptibility to DHF, we pursued a systems immunology approach integrating plasma chemokine profiling, high-dimensional mass cytometry and peripheral blood mononuclear cell (PBMC) transcriptomic analysis at the onset of fever in a prospective study conducted in Indonesia. RESULTS After a secondary infection, progression to uncomplicated dengue featured transcriptional profiles associated with increased cell proliferation and metabolism, and an expansion of ICOS+CD4+ and CD8+ effector memory T cells. These responses were virtually absent in cases progressing to severe DHF, that instead mounted an innate-like response, characterised by inflammatory transcriptional profiles, high circulating levels of inflammatory chemokines and with high frequencies of CD4low non-classical monocytes predicting increased odds of severe disease. CONCLUSIONS Our results suggests that effector memory T cell activation might play an important role ameliorating severe disease symptoms during a secondary dengue infection, and in the absence of that response, a strong innate inflammatory response is required to control viral replication. Our research also identified discrete cell populations predicting increased odds of severe disease, with potential diagnostic value.
Collapse
Affiliation(s)
- Lisa J Ioannidis
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Stephanie I Studniberg
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Emily M Eriksson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Suhendro Suwarto
- Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital (RSCM), Jakarta, Indonesia
| | - Dionisius Denis
- Eijkman Research Center for Molecular Biology, Jakarta, Indonesia
| | - Yang Liao
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Wei Shi
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Alexandra L Garnham
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- School of Mathematics and Statistics, The University of Melbourne, Parkville, VIC, Australia
| | - R Tedjo Sasmono
- Eijkman Research Center for Molecular Biology, Jakarta, Indonesia
| | - Diana S Hansen
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia.
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.
| |
Collapse
|
36
|
Ndiaye O, Woolston K, Gaye A, Loucoubar C, Cocozza M, Fall C, Dia F, Adams ER, Samb M, Camara D, Sadio BD, Diagne CT, Weidmann M, Faye O, Fitchett JRA, Sall AA, Diagne CT. Laboratory Evaluation and Field Testing of Dengue NS1 and IgM/IgG Rapid Diagnostic Tests in an Epidemic Context in Senegal. Viruses 2023; 15:v15040904. [PMID: 37112887 PMCID: PMC10143717 DOI: 10.3390/v15040904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
In Senegal, the burden of dengue is increasing and expanding. As case management and traditional diagnostic techniques can be difficult to implement, rapid diagnostic tests (RDTs) deployed at point of care are ideal for investigating active outbreaks. The aim of this study was to evaluate the diagnostic performance of the Dengue NS1 and Dengue IgM/IgG RDTs on the serum/plasma samples in a laboratory setting and in the field. During laboratory evaluation, performance of the NS1 RDT was assessed using NS1 ELISA as the gold standard. Sensitivity and specificity were 88% [75–95%] and 100% [97–100%], respectively. Performance of the IgM/IG RDT was assessed using the IgM Antibody Capture (MAC) ELISA, indirect IgG, and PRNT as gold standards. The IgM and IgG test lines respectively displayed sensitivities of 94% [83–99%] and 70% [59–79%] and specificities of 91% [84–95%] and 91% [79–98%]. In the field, the Dengue NS1 RDT sensitivity and specificity was 82% [60–95%] and 75% [53–90%], respectively. The IgM and IgG test lines displayed sensitivities of 86% [42–100%] and 78% [64–88%], specificities of 85% [76–92%] and 55% [36–73%], respectively. These results demonstrate that RDTs are ideal for use in a context of high prevalence or outbreak setting and can be implemented in the absence of a confirmatory test for acute and convalescent patients.
Collapse
Affiliation(s)
- Oumar Ndiaye
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Kevin Woolston
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Aboubacry Gaye
- Epidemiology Clinical Research and Data Science Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Cheikh Loucoubar
- Epidemiology Clinical Research and Data Science Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Michael Cocozza
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Cheikh Fall
- Microbiology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Fatou Dia
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Emily R. Adams
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Marième Samb
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Diogop Camara
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | | | - Cheikh T. Diagne
- Mivegec Infectious Diseases and Vector: Ecology, Genetics, Evolution and Control, Université Montpellier, IRD, CNRS, 34394 Montpellier, France
| | - Manfred Weidmann
- Institute of Microbiology and Virology, Medical School Brandenburg Theodor Fontane, D-01968 Senftenberg, Germany
| | - Oumar Faye
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | | | - Amadou Alpha Sall
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Cheikh Tidiane Diagne
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| |
Collapse
|
37
|
Zerfu B, Kassa T, Legesse M. Epidemiology, biology, pathogenesis, clinical manifestations, and diagnosis of dengue virus infection, and its trend in Ethiopia: a comprehensive literature review. Trop Med Health 2023; 51:11. [PMID: 36829222 PMCID: PMC9950709 DOI: 10.1186/s41182-023-00504-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
Dengue fever is a dengue virus infection, emerging rapidly and posing public health threat worldwide, primarily in tropical and subtropical countries. Nearly half of the world's population is now at risk of contracting the dengue virus, including new countries with no previous history-like Ethiopia. However, little is known about the epidemiology and impact of the disease in different countries. This is especially true in countries, where cases have recently begun to be reported. This review aims to summarize epidemiology, biology, pathogenesis, clinical manifestations, and diagnosis of dengue virus infection and its trend in Ethiopia. It may help countries, where dengue fever is not yet on the public health list-like Ethiopia to alert healthcare workers to consider the disease for diagnosis and treatment. The review retrieved and incorporated 139 published and organizational reports showing approximately 390 million new infections. About 100 million of these infections develop the clinical features of dengue, and thousands of people die annually from severe dengue fever in 129 countries. It is caused by being bitten by a dengue virus-infected female mosquito, primarily Aedes aegypti and, lesser, Ae. albopictus. Dengue virus is a member of the Flavivirus genus of the Flaviviridae family and has four independent but antigen-related single-stranded positive-sense RNA virus serotypes. The infection is usually asymptomatic but causes illnesses ranging from mild febrile illness to fatal dengue hemorrhagic fever or shock syndrome. Diagnosis can be by detecting the virus genome using nucleic acids amplification tests or testing NS1 antigen and/or anti-dengue antibodies from serum, plasma, circulating blood cells, or other tissues. Dengue cases and outbreaks have increased in recent decades, with a significant public health impact. Ethiopia has had nearly annual outbreaks since 2013, devastating an already fragmented health system and economy. Standardization of medication, population-level screening for early diagnosis and prompt treatment, and minimization of mosquito bites reduce overall infection and mortality rates.
Collapse
Affiliation(s)
- Biruk Zerfu
- Department of Medical Laboratory Science, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia. .,Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Tesfu Kassa
- grid.7123.70000 0001 1250 5688Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mengistu Legesse
- grid.7123.70000 0001 1250 5688Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
38
|
Marín-López A, Raduwan H, Chen TY, Utrilla-Trigo S, Wolfhard DP, Fikrig E. Mosquito Salivary Proteins and Arbovirus Infection: From Viral Enhancers to Potential Targets for Vaccines. Pathogens 2023; 12:371. [PMID: 36986293 PMCID: PMC10054260 DOI: 10.3390/pathogens12030371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 03/03/2023] Open
Abstract
Arthropod-borne viruses present important public health challenges worldwide. Viruses such as DENV, ZIKV, and WNV are of current concern due to an increasing incidence and an expanding geographic range, generating explosive outbreaks even in non-endemic areas. The clinical signs associated with infection from these arboviruses are often inapparent, mild, or nonspecific, but occasionally develop into serious complications marked by rapid onset, tremors, paralysis, hemorrhagic fever, neurological alterations, or death. They are predominately transmitted to humans through mosquito bite, during which saliva is inoculated into the skin to facilitate blood feeding. A new approach to prevent arboviral diseases has been proposed by the observation that arthropod saliva facilitates transmission of pathogens. Viruses released within mosquito saliva may more easily initiate host invasion by taking advantage of the host's innate and adaptive immune responses to saliva. This provides a rationale for creating vaccines against mosquito salivary proteins, especially because of the lack of licensed vaccines against most of these viruses. This review aims to provide an overview of the effects on the host immune response by the mosquito salivary proteins and how these phenomena alter the infection outcome for different arboviruses, recent attempts to generate mosquito salivary-based vaccines against flavivirus including DENV, ZIKV, and WNV, and the potential benefits and pitfalls that this strategy involves.
Collapse
Affiliation(s)
- Alejandro Marín-López
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Hamidah Raduwan
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Tse-Yu Chen
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Sergio Utrilla-Trigo
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
- Center for Animal Health Research (CISA-INIA/CSIC), 28130 Madrid, Spain
| | - David P. Wolfhard
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
- Faculty of Engineering Sciences, Institute of Pharmacy and Molecular Biotechnology, 69120 Heidelberg, Germany
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
| |
Collapse
|
39
|
Santos LL, de Aquino EC, Fernandes SM, Ternes YMF, Feres VCDR. Dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica 2023; 47:e34. [PMID: 36788963 PMCID: PMC9910557 DOI: 10.26633/rpsp.2023.34] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/03/2022] [Indexed: 02/11/2023] Open
Abstract
Objectives To characterize the distribution profile of dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean and to identify possible factors associated with the risk of dissemination and severity of these arboviruses. Methods The protocol of this review was registered on the PROSPERO platform. Searches were carried out in the following databases: Virtual Health Library, MEDLINE/PubMed, and Embase. The search terms were: Zika virus, Zika virus infection, dengue, dengue virus, chikungunya virus, chikungunya fever, epidemiology, observational study, Latin America, and Caribbean region. Studies that addressed the distribution of these arboviruses and the risk factors associated with dengue, Zika virus disease, and chikungunya, published between January 2000 and August 2020 in English, Portuguese, and Spanish, were included. Results Of 95 studies included, 70 identified risk factors, clinical manifestations, and outcomes for arbovirus infections and 25 described complications and/or deaths. The highest frequency of confirmed cases was for dengue. Brazil reported most cases of the three arboviruses in the period analyzed. Environmental and socioeconomic factors facilitated the proliferation and adaptation of vectors, and host-related factors were reported to aggravate dengue. Most deaths were due to chikungunya, Zika virus disease caused most neurological alterations, and dengue resulted in greater morbidity leading to more frequent hospitalization. Conclusions The review provides a broad view of the three arboviruses and the intrinsic aspects of infections, and highlights the factors that influence the spread of these viruses in the populations studied.
Collapse
Affiliation(s)
- Letícia L.M. Santos
- Molecular Biology Laboratory and Technologies Applied to Laboratory DiagnosisFaculty of PharmacyFederal University of GoiasGoiâniaBrazilMolecular Biology Laboratory and Technologies Applied to Laboratory Diagnosis, Faculty of Pharmacy, Federal University of Goias, Goiânia, Brazil.
| | - Erika Carvalho de Aquino
- Public Health DepartmentInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilPublic Health Department, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Suleimy Marinho Fernandes
- Laboratory of Virology and Cell CultureInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilLaboratory of Virology and Cell Culture, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Yves Mauro F. Ternes
- Public Health DepartmentInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilPublic Health Department, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Valéria C. de R. Feres
- Molecular Biology Laboratory and Technologies Applied to Laboratory DiagnosisFaculty of PharmacyFederal University of GoiasGoiâniaBrazilMolecular Biology Laboratory and Technologies Applied to Laboratory Diagnosis, Faculty of Pharmacy, Federal University of Goias, Goiânia, Brazil.
| |
Collapse
|
40
|
Tricou V, Eyre S, Ramjee M, Collini P, Mojares Z, Loeliger E, Mandaric S, Rauscher M, Brose M, Lefevre I, Folschweiller N, Wallace D. A randomized phase 3 trial of the immunogenicity and safety of coadministration of a live-attenuated tetravalent dengue vaccine (TAK-003) and an inactivated hepatitis a (HAV) virus vaccine in a dengue non-endemic country. Vaccine 2023; 41:1398-1407. [PMID: 36681529 DOI: 10.1016/j.vaccine.2023.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Vaccination against hepatitis A virus (HAV) is largely recommended for travelers worldwide. Concurrent dengue and HAV vaccination may be desired in parallel for travelers to countries where both diseases are endemic. This randomized, observer-blind, phase 3 trial evaluated coadministration of HAV vaccine with tetravalent dengue vaccine (TAK-003) in healthy adults aged 18-60 years living in the UK. METHODS Participants were randomized (1:1:1) to receive HAV vaccine and placebo on Day 1, and placebo on Day 90 (Group 1), TAK-003 and placebo on Day 1, and TAK-003 on Day 90 (Group 2), or TAK-003 and HAV vaccine on Day 1, and TAK-003 on Day 90 (Group 3). The primary objective was non-inferiority of HAV seroprotection rate (anti-HAV ≥ 12.5 mIU/mL) in Group 3 versus Group 1, one month post-first vaccination (Day 30) in HAV-naïve and dengue-naïve participants. Sensitivity analyses were performed on combinations of baseline HAV and dengue serostatus. Secondary objectives included dengue seropositivity one month post-second vaccination (Day 120), HAV geometric mean concentrations (GMCs), and safety. RESULTS 900 participants were randomized. On Day 30, HAV seroprotection rates were non-inferior following coadministration of HAV and TAK-003 (Group 3: 98.7 %) to HAV administration alone (Group 1: 97.1 %; difference: -1.68, 95 % CI: -8.91 to 4.28). Sensitivity analyses including participants who were neither HAV-naïve nor DENV-naïve at baseline supported this finding. Anti-HAV GMCs on Day 30 were 82.1 (95 % CI: 62.9-107.1) mIU/mL in Group 1 and 93.0 (76.1-113.6) mIU/mL in Group 3. By Day 120, 90.9-96.8 % of TAK-003 recipients were seropositive (neutralizing antibody titer > 10) to all four dengue serotypes. Coadministration of HAV vaccine and TAK-003 was well tolerated, with no important safety risks identified. CONCLUSION Immune responses following coadministration of HAV vaccine and TAK-003 were non-inferior to administration of HAV vaccine alone. The results support the coadministration of HAV vaccine and TAK-003 with no adverse impact on immunogenicity, safety, and reactogenicity of either vaccine. CLINICALTRIALS gov registration: NCT03525119.
Collapse
Affiliation(s)
- Vianney Tricou
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland.
| | - Susannah Eyre
- Medical Operations, Synexus Merseyside Clinical Research Centre, Liverpool, L22 0LG Merseyside, UK
| | - Mahadev Ramjee
- Synexus Lancashire Clinical Research Centre, Chorley, PR7 7NA Lancashire, UK
| | - Paul Collini
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, S10 2RX Sheffield, UK
| | - Zenaida Mojares
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Edde Loeliger
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Sanja Mandaric
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Martina Rauscher
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Manja Brose
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Inge Lefevre
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Nicolas Folschweiller
- Takeda Pharmaceuticals International AG, 8152 Glattpark-Opfikon (Zurich), Switzerland
| | - Derek Wallace
- Global Dengue Program, Takeda Vaccines, Inc., Boston, 02139 MA, USA
| |
Collapse
|
41
|
Phumesin P, Panaampon J, Kariya R, Limjindaporn T, Yenchitsomanus PT, Okada S. Cepharanthine inhibits dengue virus production and cytokine secretion. Virus Res 2023; 325:199030. [PMID: 36587870 DOI: 10.1016/j.virusres.2022.199030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022]
Abstract
Dengue virus (DENV) infection is a public health problem in tropical and subtropical regions. It can cause a spectrum of clinical manifestations ranging from mild dengue fever (DF) to severe dengue haemorrhagic fever (DHF) and potentially life-threatening disease including dengue shock syndrome (DSS). Severe DENV infection is caused by high viral load and cytokine storm in dengue-infected patients. Currently, there is no specific antiviral drug for DENV infection. An anti-DENV agent that demonstrates inhibitory effects on both DENV replication and cytokine secretion is urgently needed. In this study, cepharanthine (CEP), which is an anti-inflammatory, anti-HIV, and anti-tumor compound isolated from Stephania cepharantha Hayata, was tested for inhibition of DENV infection. We investigated the efficacy of CEP to inhibit DENV infection, replication, and cytokine production. The inhibitory effect of CEP treatment was studied in DENV-infected human chronic myeloid leukemia (K562) cells. The levels of DENV E protein and DENV production were determined by flow cytometry and FFU assay, respectively. CEP treatment significantly reduced viral E protein and viral production in all DENV-1, 2, 3, 4 serotypes. In addition, CEP treatment reduced the IL-6 proinflammatory cytokine production in DENV-infected A549 cells. Taken together, CEP has inhibitory effects on DENV infection specifically at the initial viral replication states and proinflammatory cytokine secretion, and is a promising candidate for further development as an anti-DENV treatment.
Collapse
Affiliation(s)
- Patta Phumesin
- Graduate Program in Immunology, Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Molecular Medicine, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Jutatip Panaampon
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Ryusho Kariya
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Thawornchai Limjindaporn
- Division of Molecular Medicine, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pa-Thai Yenchitsomanus
- Division of Molecular Medicine, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Seiji Okada
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan.
| |
Collapse
|
42
|
Serum biomarkers and anti-flavivirus antibodies at presentation as indicators of severe dengue. PLoS Negl Trop Dis 2023; 17:e0010750. [PMID: 36848385 PMCID: PMC9997924 DOI: 10.1371/journal.pntd.0010750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 03/09/2023] [Accepted: 02/10/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Dengue is the most common vector-borne viral disease worldwide. Most cases are mild, but some evolve into severe dengue (SD), with high lethality. Therefore, it is important to identify biomarkers of severe disease to improve outcomes and judiciously utilize resources. METHODS/PRINCIPAL FINDINGS One hundred forty-five confirmed dengue cases (median age, 42; range <1-91 years), enrolled from February 2018 to March 2020, were selected from an ongoing study of suspected arboviral infections in metropolitan Asunción, Paraguay. Cases included dengue virus types 1, 2, and 4, and severity was categorized according to the 2009 World Health Organization guidelines. Testing for anti-dengue virus IgM and IgG and serum biomarkers (lipopolysaccharide binding protein and chymase) was performed on acute-phase sera in plate-based ELISAs; in addition, a multiplex ELISA platform was used to measure anti-dengue virus and anti-Zika virus IgM and IgG. Complete blood counts and chemistries were performed at the discretion of the care team. Age, gender, and pre-existing comorbidities were associated with SD vs. dengue with/without warning signs in logistic regression with odds ratios (ORs) of 1.07 (per year; 95% confidence interval, 1.03, 1.11), 0.20 (female; 0.05,0.77), and 2.09 (presence; 1.26, 3.48) respectively. In binary logistic regression, for every unit increase in anti-DENV IgG in the multiplex platform, odds of SD increased by 2.54 (1.19-5.42). Platelet count, lymphocyte percent, and elevated chymase were associated with SD in a combined logistic regression model with ORs of 0.99 (1,000/μL; 0.98,0.999), 0.92 (%; 0.86,0.98), and 1.17 (mg/mL; 1.03,1.33) respectively. CONCLUSIONS Multiple, readily available factors were associated with SD in this population. These findings will aid in the early detection of potentially severe dengue cases and inform the development of new prognostics for use in acute-phase and serial samples from dengue cases.
Collapse
|
43
|
Khan M, Altamish M, Samal M, Srivastav V, Insaf A, Parveen R, Akhtar J, Krishnan A, Ahmad S. Antiviral Potential of Traditional Unani Medicine with Special Emphasis on Dengue: A Review. Curr Drug Targets 2023; 24:1317-1334. [PMID: 38037908 DOI: 10.2174/0113894501257577231103044735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 12/02/2023]
Abstract
Dengue fever has become a major public health concern. It is usually related to intravascular leaking, bleeding disorders, and thrombocytopenia and is recognized as a potent threat to humans. The scarcity of anti-dengue medication or vaccine for such a serious disease leads to an upsurge in the usage of traditional medicines for its proper management. India has diverse biodiversity and a long history of using plant-based remedies. Several medicinal plant extracts have been studied for producing anti-dengue viral activity. AYUSH traditional systems provide a plethora of plants that have been reported to be useful in the treatment of fever. Single and compound plant- based formulations in natural form have been used in Unani holistic approaches. This review serves as a new approach to illustrate the most recent evidence regarding the antiviral activity of various plants by providing scientific proof and also to validate the traditional formulations as effective treatments in dengue fever for global acceptance.
Collapse
Affiliation(s)
- Muzayyana Khan
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Mohammad Altamish
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Monalisha Samal
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
- Department of Pharmacognosy and phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Varsha Srivastav
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
- Department of Pharmacognosy and phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Areeba Insaf
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Rabea Parveen
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Jamal Akhtar
- Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, New Delhi, 110058, India
| | - Anuja Krishnan
- Department of Molecular Medicine, School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
| | - Sayeed Ahmad
- Centre of Excellence in Unani Medicine, Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
- Department of Pharmacognosy and phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| |
Collapse
|
44
|
Nainggolan L, Dewi BE, Hakiki A, Pranata AJ, Sudiro TM, Martina B, van Gorp E. Association of viral kinetics, infection history, NS1 protein with plasma leakage among Indonesian dengue infected patients. PLoS One 2023; 18:e0285087. [PMID: 37130105 PMCID: PMC10153689 DOI: 10.1371/journal.pone.0285087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 04/14/2023] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVES Plasma leakage, a hallmark of disease in Dengue virus (DENV) infection, is an important clinical manifestation and is often associated with numerous factors such as viral factors. The aim of this study is to investigate the association of virus serotype, viral load kinetics, history of infection, and NS1 protein with plasma leakage. METHODS Subjects with fever ≤ 48 hours and positive DENV infection were included. Serial laboratory tests, viral load measurements, and ultrasonography examination to assess plasma leakage were performed. RESULTS DENV-3 was the most common serotype found in the plasma leakage group (35%). Patients with plasma leakage demonstrated a trend of higher viral load and a longer duration of viremia compared to those without. This was significantly observed on the fourth day of fever (p = 0.037). We found higher viral loads on specific days in patients with plasma leakage in both primary and secondary infections compared to those without. In addition, we also observed more rapid viral clearance in patients with secondary infection. NS1 protein, especially after 4 days of fever, was associated with higher peak viral load level, even though it was not statistically significant (p = 0.470). However, pairwise comparison demonstrated that peak viral load level in the group of patients with circulating NS1 detected for 7 days was significantly higher than the 5-day group (p = 0.037). CONCLUSION DENV-3 was the most common serotype to cause plasma leakage. Patients with plasma leakage showed a trend of higher viral load and a longer duration of viremia. Higher level of viral load was observed significantly on day 5 in patients with primary infection and more rapid viral clearance was observed in patients with secondary infection. Longer duration of circulating NS1 protein was also seen to be positively correlated with higher peak viral load level although not statistically significant.
Collapse
Affiliation(s)
- Leonard Nainggolan
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Beti Ernawati Dewi
- Department of Microbiology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Arif Hakiki
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Antony Joseph Pranata
- Department of Microbiology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | - Byron Martina
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric van Gorp
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
45
|
Antibody-Dependent Enhancement (ADE) and the role of complement system in disease pathogenesis. Mol Immunol 2022; 152:172-182. [PMCID: PMC9647202 DOI: 10.1016/j.molimm.2022.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
|
46
|
Thommes E, Coudeville L, Muhammad R, Martin M, Nelson CB, Chit A. Public health impact and cost-effectiveness of implementing a 'pre-vaccination screening' strategy with the dengue vaccine in Puerto Rico. Vaccine 2022; 40:7343-7351. [PMID: 36347720 DOI: 10.1016/j.vaccine.2022.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommended 'pre-vaccination screening' as its preferred implementation strategy when using the licensed dengue vaccine (CYD-TDV; Dengvaxia, Sanofi), so that only individuals with previous dengue infection are vaccinated. The US Centers for Disease Control and Prevention (CDC) recommended use of CYD-TDV to prevent dengue in children with previous laboratory-confirmed dengue infection in regions where dengue is endemic. Here, we evaluate the public health impact and cost-effectiveness of a 'pre-vaccination screening' strategy in Puerto Rico. METHODS The current analysis builds upon a previously published transmission model used to assess the benefits/risks associated with dengue vaccination. For 'pre-vaccination screening', three alternative testing methods were assessed: one using an immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) dengue serotest, another with dengue serotesting using a rapid diagnostic test (RDT), and one using both sequentially (as recommended in Puerto Rico). The time horizon considered was 10 years. RESULTS In Puerto Rico, the disability-adjusted life years (DALYs) averted for 'pre-vaccination screening' with an ELISA-based program, RDT-based program, and both sequentially would be a median 1,192 (95% CI: 716-2,232), 2,812 (95% CI: 1,579-5,019), and 1,017 (95% CI: 561-1,738), respectively. These benefits would arise from the reduction in cases: median 24,961 (95% CI: 17,480-36,782), 58,273 (95% CI: 40,729-84,796), 20,775 (95% CI: 14,637-30,374) fewer cases, respectively. The cost per DALY averted from a payer perspective would be US$12,518 (95 %CI: US$4,749-26,922), US$10,047 (95% CI: US$3,350-23,852), and US$12,334 (95% CI: US$4,965-26,444), respectively. All three strategies would be cost saving from a societal perspective. CONCLUSIONS Our study supports the WHO and CDC 'pre-vaccination screening' guidance for CYD-TDV implementation. In Puerto Rico, regardless of the testing strategy and even with a relatively low rate of testing, it would be cost-effective from a payer perspective and cost saving from a societal perspective.
Collapse
Affiliation(s)
- Edward Thommes
- Sanofi, 1755 Steeles Avenue W, Toronto, Ontario M2R 3T4, Canada; University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada; York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
| | | | | | - Maria Martin
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA.
| | | | - Ayman Chit
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.
| |
Collapse
|
47
|
Balasubramani S. COVID-19 Antibodies as Predictor of Severe Dengue among Hospitalized Children with Dengue Illness in the Post-third-wave Period of COVID-19 Infection in India. JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2022; 70:11-12. [DOI: 10.5005/japi-11001-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
48
|
Immune-Mediated Pathogenesis in Dengue Virus Infection. Viruses 2022; 14:v14112575. [PMID: 36423184 PMCID: PMC9699586 DOI: 10.3390/v14112575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
Dengue virus (DENV) infection is one of the major public health concerns around the globe, especially in the tropical regions of the world that contribute to 75% percent of dengue cases. While the majority of DENV infections are mild or asymptomatic, approximately 5% of the cases develop a severe form of the disease that is mainly attributed to sequential infection with different DENV serotypes. The severity of dengue depends on many immunopathogenic mechanisms involving both viral and host factors. Emerging evidence implicates an impaired immune response as contributing to disease progression and severity by restricting viral clearance and inducing severe inflammation, subsequently leading to dengue hemorrhagic fever and dengue shock syndrome. Moreover, the ability of DENV to infect a wide variety of immune cells, including monocytes, macrophages, dendritic cells, mast cells, and T and B cells, further dysregulates the antiviral functions of these cells, resulting in viral dissemination. Although several risk factors associated with disease progression have been proposed, gaps persist in the understanding of the disease pathogenesis and further investigations are warranted. In this review, we discuss known mechanisms of DENV-mediated immunopathogenesis and its association with disease progression and severity.
Collapse
|
49
|
SARS-CoV-2 and Dengue Virus Coinfection in a Mexican Pediatric Patient: A Case Report from Early Molecular Diagnosis. Pathogens 2022; 11:pathogens11111360. [PMID: 36422612 PMCID: PMC9695305 DOI: 10.3390/pathogens11111360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/17/2022] Open
Abstract
Mexico is an endemic region for dengue virus (DENV). The increase in this disease coincides with outbreaks of COVID-19, both of which are single-stranded positive RNA viruses. These characteristics make it difficult to distinguish each disease because they share clinical and laboratory features, which can consequently result in misdiagnoses. This is why the use of precision confirmatory tests (qRT-PCR) are crucial for early diagnosis. We herein report a pediatric patient who presented a coinfection for DENV and COVID-19, “SARS-CoV-2/Dengue”. This patient initially presented a fever, cough, and headache and, three days later, developed generalized pain and epistaxis. Blood studies revealed thrombocytopenia and leukopenia, and the patient was admitted to the hospital for a probable DENV infection. Within 48 h, qRT-PCR tests specific for SARS-CoV-2 and DENV were performed and resulted as positive. The patient immediately received pharmacological treatment with azithromycin, oseltamivir, and metamizole. During hospitalization (9 days), the patient had no signs of respiratory distress and maintained normal body temperature and normal blood oxygen saturation. This case warns of the need for early diagnosis and adequate clinical and pharmacological management in the face of a “SARS-CoV-2/Dengue” coinfection. Early molecular detection of both viruses and timely treatment helped the patient to achieve a favorable recovery.
Collapse
|
50
|
Ismanto HS, Xu Z, Saputri DS, Wilamowski J, Li S, Nugraha DK, Horiguchi Y, Okada M, Arase H, Standley DM. Landscape of infection enhancing antibodies in COVID-19 and healthy donors. Comput Struct Biotechnol J 2022; 20:6033-6040. [PMCID: PMC9635252 DOI: 10.1016/j.csbj.2022.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hendra S. Ismanto
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
| | - Zichang Xu
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
| | - Dianita S. Saputri
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
| | - Jan Wilamowski
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
| | - Songling Li
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Department of System Immunology, Immunology Frontier Research Center, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
| | - Dendi K. Nugraha
- Deparment of Molecular Bacteriology, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
| | - Yasuhiko Horiguchi
- Deparment of Molecular Bacteriology, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
| | - Masato Okada
- Deparment of Oncogene Research, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Department of Oncogene Research, Immunology Frontier Research Center, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
| | - Hisashi Arase
- Department of Immunochemistry, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Department of Immunochemistry, Immunology Frontier Research Center, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
| | - Daron M Standley
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Department of System Immunology, Immunology Frontier Research Center, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
- Corresponding author at: Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita 565-0871, Japan.
| |
Collapse
|