Palmal Shreemoyee, Kundu Suman, Ganguly Swagata, Dey Jayanta Bikash, Sandhukhan Susanta, Pattanayak Arup Kumar
Department of Microbiology, Lady Brabourne College, University of Calcutta, Kolkata, West Bengal 700 017, India.
Department of Microbiology, NRS Medical College, Kolkata, West Bengal 700 014, India.
ACS Omega. 2024 Aug 20;9(36):37418-37429. doi: 10.1021/acsomega.4c02506. eCollection 2024 Sep 10.
In tropical and subtropical regions, dengue fever is a common febrile illness that is mostly spread by Aedes mosquitoes. Urban population migration, inadequate water storage facilities, and high mosquito density are features associated with this disease. The severity of the illness ranges from mild to deadly dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), often with severe cases causing profound shock from extensive plasma leakage, and may result in demise. The symptoms of the illness include headache, myalgia, retro-orbital pain, and hemorrhagic signs. There may also be an intermittent shift in blood vessel integrity and coagulation, but recovery is typically complete and rapid. In this review, we emphasize the immunological aspects of this illness. The intricate interactions among the virus, host genes, and host immune systems impact the pathophysiology of dengue. Postinfection antibody-dependent enhancement is prominent, which significantly influences the etiology and virulence of the disease. Whereas the severe form only manifests when the host immune system is actively working to eradicate the infection by secreting several inflammatory cytokines, chemokines, and lipid mediators, for example, early dengue virus infection (DVI) resulted in the production of Interleukin 2 (IL-2), IL-6, and later infection, IL-4, IL-5, and IL-10. Higher concentrations of interferons gamma (IFN-gamma), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage migration inhibitory factor (MIF), IL-1, IL-2, IL-4, IL-6, IL-7, IL-10, IL-12, and IL-13 were found in DHF patients. These are significantly more prevalent in severe infections than in mild ones. Numerous immunopathogenic processes involving both virus and host variables influence the severity of dengue. There is growing evidence that a compromised immune system limits viral clearance and causes severe inflammation, which in turn causes dengue hemorrhagic fever and dengue shock syndrome. Furthermore, the capacity of DENV to infect a broad range of immune cells, such as macrophages, dendritic cells, mast cells, T and B cells, and monocytes, further dysregulates these cells' antiviral activities, leading to the spread of the virus. Even though a number of risk factors linked to the advancement of the disease have been suggested, further research and evaluation of novel technologies are necessary to understand the complicated etiology and develop reliable and effective vaccines to fight against this febrile illness.
在热带和亚热带地区,登革热是一种常见的发热性疾病,主要由伊蚊传播。城市人口迁移、储水设施不足以及蚊虫密度高是与这种疾病相关的特征。疾病的严重程度从轻度到致命的登革出血热(DHF)和登革休克综合征(DSS)不等,严重病例常因广泛的血浆渗漏导致严重休克,并可能导致死亡。该疾病的症状包括头痛、肌痛、眼眶后疼痛和出血迹象。血管完整性和凝血功能也可能出现间歇性变化,但通常能完全且迅速恢复。在本综述中,我们强调了该疾病的免疫学方面。病毒、宿主基因和宿主免疫系统之间复杂的相互作用影响着登革热的病理生理学。感染后抗体依赖性增强很突出,这对疾病的病因和毒力有显著影响。而严重形式仅在宿主免疫系统通过分泌多种炎性细胞因子、趋化因子和脂质介质积极努力清除感染时才会显现,例如,早期登革病毒感染(DVI)会导致白细胞介素2(IL - 2)、IL - 6的产生,后期感染则会产生IL - 4、IL - 5和IL - 10。在登革出血热患者中发现了更高浓度的干扰素γ(IFN - γ)、粒细胞 - 巨噬细胞集落刺激因子(GM - CSF)、巨噬细胞迁移抑制因子(MIF)、IL - 1、IL - 2、IL - 4、IL - 6、IL - 7、IL - 10、IL - 12和IL - 13。这些在严重感染中比在轻度感染中更为普遍。涉及病毒和宿主变量的众多免疫致病过程影响着登革热的严重程度。越来越多的证据表明,免疫系统受损会限制病毒清除并导致严重炎症,进而引发登革出血热和登革休克综合征。此外,登革病毒感染多种免疫细胞(如巨噬细胞、树突状细胞、肥大细胞、T细胞和B细胞以及单核细胞)的能力,进一步扰乱了这些细胞的抗病毒活性,导致病毒传播。尽管已经提出了一些与疾病进展相关的危险因素,但仍需要进一步研究和评估新技术,以了解其复杂的病因,并开发出可靠有效的疫苗来对抗这种发热性疾病。