Department of Medicine, National University of Singapore, 5 Lower Kent Ridge, Singapore, 119074, Singapore,
Curr Infect Dis Rep. 2010 May;12(3):157-64. doi: 10.1007/s11908-010-0102-7.
Dengue virus is the most widespread geographically of the arboviruses and a major public health threat in the tropics and subtropics. Scientific advances in recent years have provided new insights about the pathogenesis of more severe disease and novel approaches into the development of antiviral compounds and dengue vaccines. Phylogenetic studies show an association between specific subtypes (within serotypes) and severity of dengue. The lack of association between maternal antibodies and development of severe dengue in infants in a recent study has called for the rethinking or refinement of the current antibody-dependent enhancement theory of dengue hemorrhagic syndrome in infancy. Such studies should stimulate new directions of research into mechanisms responsible for the development of severe dengue. The life cycle of dengue virus readily shows that virus entry and replication can be targeted by small molecules. Advances in a mouse model (AG 129 mice) have made it easier to test such antiviral compounds. The efforts to find specific dengue inhibitors are intensifying and the tools to evaluate the efficacy of new drugs are now in place for rapid translation into trials in humans. Furthermore, several dengue vaccine candidates are in development, of which the chimeric dengue/yellow fever vaccine has now entered phase 3 trials. Until the availability of a licensed vaccine, disease surveillance and vector population control remain the mainstay of dengue prevention.
登革病毒是分布最广的虫媒病毒，是热带和亚热带地区的主要公共卫生威胁。近年来，科学的进步为更严重疾病的发病机制提供了新的见解，并为抗病毒化合物和登革热疫苗的开发提供了新的方法。系统发育研究表明，特定亚型（血清型内）与登革热的严重程度之间存在关联。最近的一项研究表明，母体抗体与婴儿严重登革热之间缺乏关联，这要求重新思考或完善目前关于婴儿登革出血热综合征的抗体依赖性增强理论。此类研究应激发对导致严重登革热发展的机制的新研究方向。登革热病毒的生命周期表明，病毒进入和复制可以通过小分子靶向。在一种小鼠模型（AG129 小鼠）中的进展使测试此类抗病毒化合物变得更加容易。寻找特定登革热抑制剂的努力正在加强，评估新药疗效的工具现已到位，可迅速转化为人体试验。此外，正在开发几种登革热疫苗候选物，其中嵌合登革热/黄热病疫苗现已进入 3 期临床试验。在获得许可的疫苗可用之前，疾病监测和病媒种群控制仍然是登革热预防的主要手段。
