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    8 views9 pages

    Dengue 2

    Uploaded by

    FikaAulia

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    © All Rights Reserved
    Download as PDF or read online from Scribd
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    American Journal of fectious Diseases 4 (1): 1-9, 2008 Immunopathogenesis of Dengue Hemorrhagic Fever ‘Huan-Yao Lei,'Kao-Jean Huang, 'Yee-Shin Lin, "Trai-Ming Yeh,'Hsiao-Sheng Liu and ‘Ching-Chuan Liu Departments of Microbiology and Immunology, “Medical Technology and ‘Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan Abstracts Dengue virus infection causes Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) whose pathogeneses were not clearly understood. A new hypothesis of immunopathogenesis is proposed for the development of the DHE/DSS. An aberrant immune over- activation afier dengue virus infection not only impair the immune response to clear the virus, but also result in overproduction of cytokines that affeet monocytes, endothelial cells, and hepatocytes, as well as the abnormal production of autoantibodies to platelet and endothelial cells. A molecular mimicry ‘occurs between plateletsendothelial cells and dengue virus antigens, Platelets and endothelial cells are bound by the cross-reactive anti-dengue virus antibodies such as anti-NSI or anti-prM antibodies. The TFN-y activated macrophage would phagocytosize the osponized targets. Dengue virus-induced vasculopathy and coagulopathy are involved in the pathogenesis of hemorthage, and the unbalance between coagulation and fibrinolysis activation inereases the likelihood of severe hemorrhage in This theory of transient hemophagocytic activity in immunopathogenesis of DHE/DS account for specific characteristics of elinical, pathologic, and epidemiological observations in dengue virus infection, Key words: Dengue virus, ADE, autoantibody, macrophage symptoms, sometime is fatal"). The pathogenesis, especially the mechanistic steps toward the Dengue fever is an acute infectious disease caused by four serotypes of dengue virus. It is characterized by biphasic fever, myalgia, headache, pain in various parts DF is self-limited, but, it will progress to Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS) in certain conditions. DHF is a severe febrile disease characterized by abnormalities of hemostasis and increased vascular permeability, and severe progression may result in DSS. DSS is a form of hhypovolemic shock that is associated clinically with emoconcentration and which might lead to death if appropriate care is not given, Alter dengue virus infection, there is a continuum from mild DF to severe DIF or DSS. Tt has been estimated that only 4-6% of individuals with secondary infection develop severe DHF disease". Dengue virus can infect infant, children and adult. Tn endemic area such as southeastern Asia or Latin American, most of the DHF/DSS are children while some are infants However, in non-endemic area like Taiwan, the majority of the DHE/DSS case is adult or the ekder. The dengue-infected elder will have more severe clinical ‘manifestation of DHF/DSS, involved in this process is rnot clearly understood, “Any explanation of the DHF/DSS pathogenesis must account for specific characteristics of clinical, pathologic, and epidemiological observations that are unique in dengue vieus induced disease, the pathogenesis of dengue everal hypotheses for the pathogenesis of dengue hemorrhagic fever have been proposed. Among them, — Antibody-Dependent Enhancement (ADE) of infection has Tong been thought to play a central role”, The ADE hypothesis. was formulated to explain the finding that severe manifestations of DHF/DSS occur in children’ experiencing a second dengue virus infection that has a different serotype from previous one. There are indeed preexisting antibodies to previous dengue virus that cannot neutralize but rather enhance infection in vino. Sera obtained before infection from children who later developed DHF/DSS were much more likely t0 demonstrate ADE in vitro than those who had only DE", Newborn babies less than I year old who acquire ‘Corresponding Author: Dr. Huan-Yao Lei, Depariment of Microbiology and Immunology, College of Melcin, ‘National Cheng Kung University, Tainan 701, Taiwan, Republic of China 1 Am. J Infect. Dis, 4 (1): 1-9, 2008 maternal anti

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