Añez Germán
Invest Clin. 2007 Sep;48(3):273-6.
Dengue is a viral disease present in tropical developing countries where cause an important number of new cases annually. There are four serotypes (DENV-1 to 4), which can cause a clinical spectrum varying from a mild disease; dengue fever, to a potential life-threatening form; dengue hemorrhagic fever (DHF). The molecular mechanism to explain the developing of DHF remains uncertainly, but it has been related to previous immunity to a different serotype, host-depending factors (age, nutritional status, HLA type) and to viral genotypes. In this sense, have been described a number of genotypes among the serotypes, some of which has been associated with increased severity. In Venezuela, since 1989 have been reported cases due to all the viral serotypes, but there are few studies attempting to determine the genotype circulating in both epidemic and endemic situations. In all the reports, Venezuelan isolates are related to Asian genotypes, some of which have been associated with high risk to develop DHF. It is necessary more studies to analyze the whole viral genome from isolates collected in last years, in order to get information about how and why occur the viral extinction process in epidemics settings, its geographical origin and if certainly there are genotypes associated with DHF circulating in the country. Despite its importance to public health, it is necessary more research to understand deeply the dengue physiopathology. Genomics seems to be an important tool to achieve this objective and to help to develop required therapeutics and prophylactic strategies in a short time.
登革热是一种存在于热带发展中国家的病毒性疾病,每年都会导致大量新病例。有四种血清型(DENV-1至4),可引起从轻度疾病(登革热)到潜在危及生命形式(登革出血热,DHF)的临床谱。解释DHF发生的分子机制仍不确定,但它与先前对不同血清型的免疫、宿主相关因素(年龄、营养状况、HLA类型)以及病毒基因型有关。从这个意义上说,在血清型中已经描述了许多基因型,其中一些与疾病严重程度增加有关。在委内瑞拉,自1989年以来已报告了所有病毒血清型引起的病例,但很少有研究试图确定在流行和地方病情况下传播的基因型。在所有报告中,委内瑞拉分离株与亚洲基因型有关,其中一些与发生DHF的高风险有关。有必要进行更多研究,以分析近年来收集的分离株的整个病毒基因组,以便了解在流行环境中病毒灭绝过程如何以及为何发生、其地理起源,以及该国是否确实存在与DHF相关的基因型在传播。尽管其对公共卫生很重要,但仍需要更多研究来深入了解登革热的病理生理学。基因组学似乎是实现这一目标并有助于在短时间内开发所需治疗和预防策略的重要工具。