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Rivino L, Kumaran EA, Thein TL, Too CT, Gan VCH, Hanson BJ, Wilder-Smith A, Bertoletti A, Gascoigne NRJ, Lye DC, Leo YS, Akbar AN, Kemeny DM, MacAry PA. Virus-specific T lymphocytes home to the skin during natural dengue infection. Sci Transl Med 2015; 7:278ra35. [PMID: 25761891 DOI: 10.1126/scitranslmed.aaa0526] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dengue, which is the most prevalent mosquito-borne viral disease afflicting human populations, causes a spectrum of clinical symptoms that include fever, muscle and joint pain, maculopapular skin rash, and hemorrhagic manifestations. Patients infected with dengue develop a broad antigen-specific T lymphocyte response, but the phenotype and functional properties of these cells are only partially understood. We show that natural infection induces dengue-specific CD8(+) T lymphocytes that are highly activated and proliferating, exhibit antiviral effector functions, and express CXCR3, CCR5, and the skin-homing marker cutaneous lymphocyte-associated antigen (CLA). In the same patients, bystander human cytomegalovirus -specific CD8(+) T cells are also activated during acute dengue infection but do not express the same tissue-homing phenotype. We show that CLA expression by circulating dengue-specific CD4(+) and CD8(+) T cells correlates with their in vivo ability to traffic to the skin during dengue infection. The juxtaposition of dengue-specific T cells with virus-permissive cell types at sites of possible dengue exposure represents a previously uncharacterized form of immune surveillance for this virus. These findings suggest that vaccination strategies may need to induce dengue-specific T cells with similar homing properties to provide durable protection against dengue viruses.
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Affiliation(s)
- Laura Rivino
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore. Programme in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore 169857, Singapore.
| | - Emmanuelle A Kumaran
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Tun-Linn Thein
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Chien Tei Too
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Victor Chih Hao Gan
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Brendon J Hanson
- Defense Medical and Environmental Research Institute, National Laboratories, Singapore 118230, Singapore
| | - Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Antonio Bertoletti
- Programme in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore 169857, Singapore. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
| | - Nicholas R J Gascoigne
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - David Chien Lye
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Yee Sin Leo
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Arne N Akbar
- Division of Infection and Immunity, University College of London, London WC1E 6BT, UK
| | - David M Kemeny
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Paul A MacAry
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
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Gan VCH, Leo YS. Current epidemiology and clinical practice in arboviral infections - implications on blood supply in South-East Asia. ISBT Sci Ser 2014; 9:262-267. [PMID: 25210534 PMCID: PMC4142006 DOI: 10.1111/voxs.12083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 01/09/2014] [Accepted: 01/10/2014] [Indexed: 12/11/2022]
Abstract
Arthropod-borne viruses (arboviruses) are a growing threat to global health. Complex vector-virus-host interactions lead to unpredictable epidemiological patterns. Difficulties in accurate surveillance including imperfect diagnostic tools impair effective response to outbreaks. With arboviral infections causing a wide spectrum of disease severity, from asymptomatic infection to fatal neuroinvasive and haemorrhagic fevers, the potential impact on blood safety is significant. Asymptomatic or presymptomatic individuals may introduce virus into the blood supply by donation, while recipients can potentially suffer severe consequences. Dengue, West Nile and chikungunya outbreaks have led to responses by blood transfusion services which can inform future planning. Reports of transfusion-associated transmission demonstrate the potentially fatal consequences of lack of haemovigilance. South-East Asia remains vulnerable to arboviruses with permissive climate and high levels of endemic transmission as well as the potential for emerging and re-emerging arboviral diseases. Resource limitations constrain the use of expensive technologies for donor screening. Continued surveillance and research will be required to manage the arboviral threat to the blood supply.
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Affiliation(s)
- V C H Gan
- Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital Singapore, Singapore
| | - Y-S Leo
- Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital Singapore, Singapore
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