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Recent advances in understanding dengue.

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This summary is machine-generated.

This review examines dengue virus (DENV) clinical features, pathogenesis, and vaccines. Antibody-dependent enhancement and DENV non-structural protein 1 (NS1) are key to severe dengue, with ongoing research into protective immunity.

Keywords:
denguedengue feverepidemiologyflavivirusimmunitypathogenesissevere denguevaccines

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Area of Science:

  • Virology
  • Immunology
  • Epidemiology

Background:

  • Dengue viruses (DENVs) cause diverse disease severity influenced by viral, host, and genetic factors.
  • Antibody-dependent enhancement (ADE) links secondary heterotypic DENV infections to severe dengue.
  • DENV non-structural protein 1 (NS1) is implicated in severe dengue's pathophysiology.

Purpose of the Study:

  • To review recent advances in dengue clinical features, epidemiology, pathogenesis, and vaccine development.
  • To contextualize current findings within historical observations spanning 50 years.
  • To explore factors influencing dengue infection outcomes and identify research gaps.

Main Methods:

  • Selective review of recent publications on dengue.
  • Analysis of historical observations and epidemiological data.
  • Evaluation of in vivo and in vitro studies on DENV pathogenesis and vaccine efficacy.

Main Results:

  • ADE explains severe dengue in secondary heterotypic infections and with passively acquired antibodies.
  • DENV NS1 is a key driver of severe dengue's pathophysiological features.
  • Human movement significantly impacts dengue epidemiology; country-wide surveys inform control strategies.

Conclusions:

  • Understanding DENV pathogenesis, particularly NS1's role and ADE, is crucial for managing severe dengue.
  • Live-attenuated tetravalent vaccines show progress but face challenges.
  • Key research questions remain regarding protective immunity and severe dengue's clinical manifestations.