Kliks S C, Nisalak A, Brandt W E, Wahl L, Burke D S
Department of Virus Disease, Walter Reed Army Institute of Research, Washington, DC.
Am J Trop Med Hyg. 1989 Apr;40(4):444-51. doi: 10.4269/ajtmh.1989.40.444.
Serum specimens collected during a prospective study of dengue infections among schoolchildren in Bangkok were tested for their ability to enhance dengue 2 (DEN-2) virus growth in human monocytes in vitro. Two groups of dengue-immune sera were compared: 32 dengue antibody positive serum specimens from children who subsequently developed asymptomatic secondary dengue infections; and 9 dengue antibody positive serum specimens from children who subsequently developed severe symptomatic secondary dengue infections, 8 of which were clinically diagnosed as dengue hemorrhagic fever. Antibody-dependent enhancement of virus growth was quantitated by measurement of virus yields in supernatant fluids of normal human monocyte cultures that were infected with DEN-2 virus in the presence of undiluted test serum. Only 4 of 32 (12%) preinfection sera from asymptomatic children, but 6 of 9 (67%) preinfection sera from symptomatic children, had significant enhancing activity (P less than 0.001). High serum DEN-2 antibody dependent enhancing activity is a significant (relative risk = 6.2) risk factor for severe illness among children in a dengue hemorrhagic fever endemic region. Dengue antibodies can be neutralizing and therefore protective, or they can be enhancing and increase the risk of dengue hemorrhagic fever.
在曼谷学童登革热感染的前瞻性研究中收集的血清标本，检测其在体外增强登革2型（DEN-2）病毒在人单核细胞中生长的能力。比较了两组登革热免疫血清：32份来自随后发生无症状继发登革热感染儿童的登革热抗体阳性血清标本；以及9份来自随后发生严重症状性继发登革热感染儿童的登革热抗体阳性血清标本，其中8例临床诊断为登革出血热。通过测量在未稀释的测试血清存在下感染DEN-2病毒的正常人单核细胞培养物上清液中的病毒产量，对病毒生长的抗体依赖性增强进行定量。无症状儿童的32份感染前血清中只有4份（12%），但有症状儿童的9份感染前血清中有6份（67%）具有显著的增强活性（P小于0.001）。高血清DEN-2抗体依赖性增强活性是登革出血热流行地区儿童患重病的一个重要（相对风险=6.2）危险因素。登革热抗体可以是中和性的，因此具有保护作用，或者它们可以是增强性的，并增加登革出血热的风险。
