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Petphong V, Kosoltanapiwat N, Limkittikul K, Maneekan P, Chatchen S, Jittmittraphap A, Sriburin P, Chattanadee S, Leaungwutiwong P. Detection of Anti-ZIKV NS1 IgA, IgM, and Combined IgA/IgM and Identification of IL-4 and IL-10 as Potential Biomarkers for Early ZIKV and DENV Infections in Hyperendemic Regions, Thailand. Trop Med Infect Dis 2023; 8:tropicalmed8050284. [PMID: 37235332 DOI: 10.3390/tropicalmed8050284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The frequency of Zika virus (ZIKV)-specific IgA and IgM and the cytokine expression profile of ZIKV-infected patients in hyperendemic areas remain unclear. This study investigated the rates of ZIKV non-structural protein 1 (NS1)-specific IgA and IgM and evaluated serum cytokine levels of ZIKV and Dengue virus (DENV) cases in Thailand to identify potential diagnostic biomarkers, elucidate the immunity against ZIKV and DENV, and investigate the association between cytokine levels and ZIKV symptoms. Low rates of positivity for ZIKV NS1-specific IgA and IgM were detected in our study. ZIKV NS1 IgA/M (11%, 11/101) in combination was more frequently detected than ZIKV NS1 IgM (2%, 2/101) or ZIKV NS1 IgA (4%, 4/96) alone, especially in acute ZIKV cases with previous DENV exposure (14%, 10/72). Cytokine analysis showed that both ZIKV and DENV infections induced polyfunctional immunity, and the latter triggered more prolonged responses. The existence of significant differences in IL-4 and IL-10 levels between acute ZIKV and acute DENV cases suggested that IL-4 (p = 0.0176) and IL-10 (p = 0.0003) may represent biomarkers for acute ZIKV and acute DENV infections, respectively. Analysis of the association between increased cytokine levels and ZIKV symptoms indicated that CXCL10 (p = 0.0029) was associated with exanthema, while IL-5 (p = 0.0496) was linked to headache. The detection of ZIKV NS1 IgA and IgM in combination may enhance the diagnosis of early ZIKV infection, particularly when levels of IgM or IgA alone are low or undetectable. IL-4 and IL-10 may serve as targets for the development of diagnostic tools to detect ZIKV and DENV infections early, respectively, in flavivirus-endemic regions.
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Affiliation(s)
- Vajee Petphong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Nathamon Kosoltanapiwat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pannamas Maneekan
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Supawat Chatchen
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Akanitt Jittmittraphap
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pimolpachr Sriburin
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Siriporn Chattanadee
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pornsawan Leaungwutiwong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Machain-Williams C, Reyes-Solis GC, Blitvich BJ, Laredo-Tiscareño V, Dzul-Rosado AR, Kim S, AbuBakar S. Evaluation of an Immunoglobulin E Capture Enzyme-Linked Immunosorbent Assay for the Early Diagnosis of Dengue. Viral Immunol 2023; 36:101-109. [PMID: 36862827 DOI: 10.1089/vim.2022.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Dengue virus (DENV) is the etiological agent of dengue, the most important mosquito-transmitted viral disease of humans worldwide. Enzyme-linked immunosorbent assays (ELISAs) designed to detect DENV IgM are commonly used for dengue diagnosis. However, DENV IgM is not reliably detected until ≥4 days after illness onset. Reverse transcription-polymerase chain reaction (RT-PCR) can diagnose early dengue but requires specialized equipment, reagents, and trained personnel. Additional diagnostic tools are needed. Limited work has been performed to determine whether IgE-based assays can be used for the early detection of vector-borne viral diseases, including dengue. In this study, we determined the efficacy of a DENV IgE capture ELISA for the detection of early dengue. Sera were collected within the first 4 days of illness onset from 117 patients with laboratory-confirmed dengue, as determined by DENV-specific RT-PCR. The serotypes responsible for the infections were DENV-1 and DENV-2 (57 and 60 patients, respectively). Sera were also collected from 113 dengue-negative individuals with febrile illness of undetermined etiology and 30 healthy controls. The capture ELISA detected DENV IgE in 97 (82.9%) confirmed dengue patients and none of the healthy controls. There was a high false positivity rate (22.1%) among the febrile non-dengue patients. In conclusion, we provide evidence that IgE capture assays have the potential to be explored for early diagnosis of dengue, but further research is necessary to address the possible false positivity rate among patients with other febrile illnesses.
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Affiliation(s)
- Carlos Machain-Williams
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico
| | - Guadalupe C Reyes-Solis
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico
| | - Bradley J Blitvich
- Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Viridiana Laredo-Tiscareño
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico.,Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | | | - Sungmin Kim
- Department of Infectious Diseases in Internal Medicine, Sejong Chungnam National University Hospital, School of Medicine, Chungnam National University, Sejong, Korea
| | - Sazaly AbuBakar
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Higher Institution Center of Excellence (HICOE), Universiti Malaya, Kuala Lumpur, Malaysia
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Huong NTC, Ngan NT, Reda A, Dong V, Tam DTH, The Van T, Manh DH, Quan NH, Makram AM, Dumre SP, Hirayama K, Huy NT. Association of self-reported allergic rhinitis with dengue severity: A case-control study. Acta Trop 2022; 236:106678. [PMID: 36063904 DOI: 10.1016/j.actatropica.2022.106678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The severity of dengue infection has been reportedly associated with patients' allergic reactions. To further elucidate the role of allergy in dengue severity, we conducted a matched case-control study to assess the association between allergic background and dengue shock syndrome. METHODS This is a matched case-control study that was carried out in the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from January to December 2017. Dengue infection was determined by non-structure protein 1 (NS1) diagnostic quick test or anti-dengue antibodies (IgM). The total and dengue-specific IgE levels were measured using ELISA. Patients' demographics, clinical, and allergic profiles were collected using a structured questionnaire. RESULTS A total of 572 dengue patients with positive NS1 (92.7%) or IgM antibodies (7.3%) results were included in this study. Of these patients, 143 patients developed dengue shock syndrome (case group) while the other 429 patients did not (control group). None of the baseline characteristics including age, sex, or being overweight was significantly different between the two groups (p>0.05). In multivariable analysis, having a history of dengue infection (OR=3.35, 95% CI: 1.8-6.17, p<0.001) and allergic rhinitis (OR=1.95, 95% CI: 1.11-3.4, p = 0.019) were found to be associated with dengue shock syndrome. Higher levels of dengue-specific IgE were not associated with worse outcomes in patients with allergies (p = 0.204) or allergic rhinitis (p = 0.284). CONCLUSION Dengue patients presenting with a history of a previous dengue infection or allergic rhinitis should be considered high-risk patients for the development of dengue shock syndrome.
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Affiliation(s)
- Nguyen Thi Cam Huong
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Ngan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; Medicine Department, Xuyen A General Hospital, Vinh Long Province, Vietnam
| | - Abdullah Reda
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Vinh Dong
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Dong Thi Hoai Tam
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam; Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, Ho Chi Minh City, Vietnam
| | - Trung The Van
- Department of Dermatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam
| | - Dao Huy Manh
- Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Hoang Quan
- Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Abdelrahman M Makram
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Public Health, Imperial College London, London, United Kingdom; Faculty of Medicine, October 6 University, Giza, Egypt
| | | | - Kenji Hirayama
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Nguyen Tien Huy
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, 852-8523, Japan.
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The Specificity of the Persistent IgM Neutralizing Antibody Response in Zika Virus Infections among Individuals with Prior Dengue Virus Exposure. J Clin Microbiol 2021; 59:e0040021. [PMID: 33980647 DOI: 10.1128/jcm.00400-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Dengue viruses (DENV) and Zika virus (ZIKV) are related mosquito-borne flaviviruses with similar disease manifestations, vector ecologies, and geographic ranges. The ability to differentiate these viruses serologically is vital due to the teratogenic nature of ZIKV and the potential confounding of preexisting cross-reactive anti-DENV antibodies. Here, we illustrate the kinetics of the IgM neutralizing antibody (NAb) response using longitudinal samples ranging from acute ZIKV infection to late convalescence from individuals with evidence of prior DENV infection. By serially depleting antibody isotypes prior to the neutralization assay, we determined that IgM contributes predominantly to ZIKV neutralization and is less cross-reactive than the IgG NAb. The IgM NAb peaked around 14 days (95% confidence interval [95% CI], 13 to 15) and had a median duration of 257 days (95% CI, 133 to 427). These results demonstrate the persistence of IgM NAb after ZIKV infection and imply its potential role in diagnosis, vaccine evaluation, serosurveillance, and research on flavivirus-host interactions.
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Kien ND, El-Qushayri AE, Ahmed AM, Safi A, Mageed SA, Mehyar SM, Hashan MR, Karimzadeh S, Hirayama K, Huy NT. Association of Allergic Symptoms with Dengue Infection and Severity: A Systematic Review and Meta-analysis. Virol Sin 2020; 35:83-92. [PMID: 31637633 PMCID: PMC7035405 DOI: 10.1007/s12250-019-00165-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/23/2019] [Indexed: 10/25/2022] Open
Abstract
The relationship between the severity of dengue infection and allergy is still obscure. We conducted an electronic search across 12 databases for relevant articles reporting allergic symptoms, dengue infection, and dengue classification. These studies were categorized according to dengue severity and allergy symptoms, and a meta-analysis was performed by pooling the studies in each category. Among the included 57 articles, pruritus was the most common allergic sign followed by non-specified allergy and asthma (28.6%, 13%, and 6.5%, respectively). Despite the reported significant association of dengue with pruritus and total IgE level (P < 0.05), in comparison with non-dengue cases and healthy controls, there was no association between the different severe dengue group with pruritus, skin allergy, food allergy or asthma. However, removing the largest study revealed a significant association between asthma with dengue hemorrhagic fever (DHF) rather than dengue fever (DF). In comparison with DF, DHF was associated with IgE positivity. Furthermore, specific-IgE level was higher in secondary DF rather than primary DF. There was a possible association between allergy symptoms and dengue severity progression. Further studies are needed to clarify this association.
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Affiliation(s)
- Nguyen Dang Kien
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
| | - Amr Ehab El-Qushayri
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Faculty of Medicine, Minia University, Minia, 61519, Egypt
| | - Ali Mahmoud Ahmed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Faculty of Medicine, Al-Azhar University, Cairo, 11865, Egypt
| | - Adnan Safi
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Nishtar Medical University, Multan, 60000, Pakistan
| | - Sarah Abdel Mageed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Faculty of Medicine, Tanta University, Tanta, 31511, Egypt
| | - Samar Muhammed Mehyar
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Istishari Hospital, Amman, 11953, Jordan
| | - Mohammad Rashidul Hashan
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- Infectious Disease Division, Respiratory and Enteric Infections Department, International Center for Diarrheal Disease Research, Dhaka, GPO Box 128, Dhaka, 1000, Bangladesh
| | - Sedighe Karimzadeh
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan
- School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, 00989156113915, Iran
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam.
- Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam.
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Abstract
Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. It is a single-stranded positive-sense ribonucleic acid virus with 10,700 bases. The genus Flavivirus includes other arthropod borne viruses such as yellow fever virus, West Nile virus, Zika virus, tick-borne encephalitis virus. It infects ~50–200 million people annually, putting over 3.6 billion people living in tropical regions at risk and causing ~20,000 deaths annually. The expansion of dengue is attributed to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement, and also viral evolution. There are four antigenically different serotypes of DENV based on the differences in their viral structural and nonstructural proteins. DENV infection causes a spectrum of illness ranging from asymptomatic to dengue fever to severe dengue shock syndrome. Infection with one serotype confers lifelong immunity against that serotype, but heterologus infection leads to severe dengue hemorrhagic fever due to antibody-dependent enhancement. Diagnosis of dengue infections is based mainly on serological detection of either antigen in acute cases or antibodies in both acute and chronic infection. Viral detection and real-time PCR detection though helpful is not feasible in resource poor setup. Treatment of dengue depends on symptomatic management along with fluid resuscitation and may require platelet transfusion. Although vaccine development is in late stages of development, developing a single vaccine against four serotypes often causes serious challenges to researchers; hence, the main stay of prevention is vector control and management.
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7
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Warnecke JM, Lattwein E, Saschenbrecker S, Stöcker W, Schlumberger W, Steinhagen K. Added value of IgA antibodies against Zika virus non-structural protein 1 in the diagnosis of acute Zika virus infections. J Virol Methods 2019; 267:8-15. [DOI: 10.1016/j.jviromet.2019.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/16/2022]
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Incorporation of IgG Depletion in a Neutralization Assay Facilitates Differential Diagnosis of Zika and Dengue in Secondary Flavivirus Infection Cases. J Clin Microbiol 2018; 56:JCM.00234-18. [PMID: 29618505 DOI: 10.1128/jcm.00234-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/26/2018] [Indexed: 11/20/2022] Open
Abstract
Zika virus (ZIKV) has emerged as a major global public health concern due to its link as a causative agent of human birth defects. Laboratory diagnosis of suspected ZIKV infections by serological testing of specimens collected a week or more after symptom onset primarily relies on detection of anti-ZIKV-specific IgM antibodies by enzyme-linked immunosorbent assay coupled with detection of ZIKV-specific neutralizing antibody by neutralization tests. A definitive diagnosis based on serological assays is possible during primary ZIKV infections; however, due to the cross-reactivity of antibodies elicited during flaviviral infections, a definitive diagnosis is not always possible, especially among individuals who have previously been exposed to closely related flaviviruses, such as dengue virus (DENV). Here, we investigated the neutralizing IgM antibody profiles of 33 diagnostic specimens collected from individuals with suspected primary and secondary flaviviral infections acquired when visiting areas experiencing active ZIKV transmission in 2015 and 2016. Specimens collected between 1 day and 3 months postexposure were tested for ZIKV and dengue virus type 1 (DENV1) and type 2 (DENV2) by the plaque reduction neutralization test (PRNT) before and after IgG depletion. We found that IgG depletion prior to neutralization testing had little effect in differentiating samples from individuals with secondary infections taken less than 3 weeks postexposure; however, IgG depletion significantly reduced the cross-reactive neutralizing antibody titers and increased the percentage of cases discernible by PRNT from 15.4% (95% confidence interval [CI], 4.3 to 42.2%) to 76.9% (95% CI, 49.7 to 91.8%) for samples collected between roughly 3 and 12 weeks postexposure. These results highlight the potential of IgG depletion to improve the specificity of PRNT for better confirmation and differential diagnosis of flavivirus infections.
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Barros JBDS, da Silva PAN, Koga RDCR, Gonzalez-Dias P, Carmo Filho JR, Nagib PRA, Coelho V, Nakaya HI, Fonseca SG, Pfrimer IAH. Acute Zika Virus Infection in an Endemic Area Shows Modest Proinflammatory Systemic Immunoactivation and Cytokine-Symptom Associations. Front Immunol 2018; 9:821. [PMID: 29774022 PMCID: PMC5943559 DOI: 10.3389/fimmu.2018.00821] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/04/2018] [Indexed: 12/11/2022] Open
Abstract
An early immune response to Zika virus (ZIKV) infection may determine its clinical manifestation and outcome, including neurological effects. However, low-grade and transient viremia limits the prompt diagnosis of acute ZIKV infection. We have investigated the plasma cytokine, chemokine, and growth factor profiles of 36 individuals from an endemic area displaying different symptoms such as exanthema, headache, myalgia, arthralgia, fever, hyperemia, swelling, itching, and nausea during early-phase infection. These profiles were then associated with symptoms, revealing important aspects of the immunopathophysiology of ZIKV infection. The levels of some cytokines/chemokines were significantly higher in acute ZIKV-infected individuals compared to healthy donors, including interferon (IFN) gamma-induced protein 10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), IFN-γ, interleukin (IL)-9, IL-7, IL-5, and IL-1ra, including some with predominantly immunoregulatory activity. Of note, we found that higher levels of IP-10 and IL-5 in ZIKV-infected individuals were strongly associated with exanthema and headache, respectively. Also, higher levels of IL-1ra were associated with subjects with arthralgia, whereas those with fever showed lower levels of granulocyte-colony stimulating factor (G-CSF). No correlation was observed between the number of symptoms and ZIKV viral load. Interestingly, only IP-10 showed significantly decreased levels in the recovery phase. In conclusion, our results indicate that acute ZIKV infection in a larger cohort resident to an endemic area displays a modest systemic immune activation profile, involving both proinflammatory and immunoregulatory cytokines and chemokines that could participate of virus control. In addition, we showed that differential cytokine/chemokine levels are related to specific clinical symptoms, suggesting their participation in underlying mechanisms.
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Affiliation(s)
- Jéssica Barletto de Sousa Barros
- Department of Master in Environmental Sciences and Health, School of Medical, Pharmaceutical and Biomedical Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Paulo Alex Neves da Silva
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Rosemary de Carvalho Rocha Koga
- Department of Master in Environmental Sciences and Health, School of Medical, Pharmaceutical and Biomedical Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Patrícia Gonzalez-Dias
- Department of Pathophysiology and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - José Rodrigues Carmo Filho
- Department of Master in Environmental Sciences and Health, School of Medical, Pharmaceutical and Biomedical Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Patrícia Resende Alo Nagib
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Verônica Coelho
- Laboratory of Immunology, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil.,Institute for Investigation in Immunology - National Institute of Science and Technology - iii - INCT, São Paulo, Brazil
| | - Helder I Nakaya
- Department of Pathophysiology and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Simone Gonçalves Fonseca
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.,Institute for Investigation in Immunology - National Institute of Science and Technology - iii - INCT, São Paulo, Brazil
| | - Irmtraut Araci Hoffmann Pfrimer
- Department of Master in Environmental Sciences and Health, School of Medical, Pharmaceutical and Biomedical Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
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Dengue Specific Immunoglobulin A Antibody is Present in Urine and Associated with Disease Severity. Sci Rep 2016; 6:27298. [PMID: 27250703 PMCID: PMC4890044 DOI: 10.1038/srep27298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 05/16/2016] [Indexed: 11/09/2022] Open
Abstract
The kinetics of dengue virus (DENV)-specific IgA antibody in urine and the potential correlation with disease severity remain elusive. In this study, 262 serial urine samples from 78 laboratory-confirmed patients were assayed by a commercial immunoglobulin A (IgA) kit against DENV. All cases were classified into dengue fever (DF) and severe dengue (SD) according to the 2009 WHO/TDR guideline. The total positive rate of IgA in urine was 59%. DENV-specific IgA was detected in urine from day 2 to day 13 after the onset of illness in DF patients; While for SD patients, anti-DENV IgA could be detected till day 14. The positive rate of IgA in patients with secondary infection was higher than that in patients with primary infection. Importantly, during 4-7 days after the onset of illness, the IgA positive rate of SD patients was significantly higher than that of DF patients. Especially, the intensity of IgA signal in SD patients was obviously stronger than that in DF patient at the recovery stage. Overall, our results suggested that the existence of DENV-specific IgA antibodies in urine might be a warning sign for the severity of disease and its measurement might provide valuable guidance for proper patient management.
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11
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A meta-analysis of the diagnostic accuracy of dengue virus-specific IgA antibody-based tests for detection of dengue infection. Epidemiol Infect 2015; 144:876-86. [DOI: 10.1017/s0950268815001922] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYImmunoglobulin A (IgA)-based tests have been evaluated in different studies for their utility in diagnosing dengue infections. In most of the studies, the results were inconclusive because of a small sample size. Hence, a meta-analysis involving nine studies with 2096 samples was performed to assess the diagnostic accuracy of IgA-based tests in diagnosing dengue infections. The analysis was conducted using Meta-Disc software. The results revealed that IgA-based tests had an overall sensitivity, specificity, diagnostic odds ratio, and positive and negative likelihood ratios of 73·9%, 95·2%, 66·7, 22·0 and 0·25, respectively. Significant heterogeneity was observed between the studies. The type of test, infection status and day of sample collection influenced the diagnostic accuracy. The IgA-based diagnostic tests showed a greater accuracy when the samples were collected 4 days after onset of symptoms and for secondary infections. The results suggested that IgA-based tests had a moderate level of accuracy and are diagnostic of the disease. However, negative results cannot be used alone for dengue diagnosis. More prospective studies comparing the diagnostic accuracy of combinations of antigen-based tests with either IgA or IgM are needed and might be useful for suggesting the best strategy for dengue diagnosis.
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Higher levels of dengue-virus-specific IgG and IgA during pre-defervescence associated with primary dengue hemorrhagic fever. Arch Virol 2015; 160:2435-43. [PMID: 26175069 DOI: 10.1007/s00705-015-2519-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Abstract
Dengue hemorrhagic fever (DHF), although predominantly associated with secondary infections, has also been reported in primary infections. An enhanced immune response including antibodies and cytokines is implicated in the pathogenesis of secondary DHF. However, the factors operating in primary DHF are poorly understood. To understand the role of the antibody response, the relative levels of different antibody isotypes during the acute phase of infection in primary and secondary dengue infections were determined. Levels of DENV-specific IgM, IgG, IgA and IgE were measured in the serum samples of 200 dengue patients and 20 dengue-naïve individuals. Samples were collected within 15 days of onset of illness. The DENV-specific IgM levels were significantly higher in DF cases compared to DHF, which was more evident in secondary infections and in post-defervescence samples. The levels of IgG, IgA and IgE were higher in DHF cases, with greater significance in primary infections. A higher level of IgG in DHF cases was evident in pre-defervescence samples, whilst the IgE level was higher in pre- and post-defervescence samples. There was a significant correlation of IgG titres with platelet counts, with higher titres associated with lower platelet counts. It is speculated that IgG, IgA and IgE produced in response to primary infections may contribute to pathogenesis, whilst IgM produced in response to secondary infections may protect against progression to severe disease.
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13
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Wong WR, Krupin O, Sekaran SD, Mahamd Adikan FR, Berini P. Serological diagnosis of dengue infection in blood plasma using long-range surface plasmon waveguides. Anal Chem 2014; 86:1735-43. [PMID: 24410440 DOI: 10.1021/ac403539k] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a compact, cost-effective, label-free, real-time biosensor based on long-range surface plasmon polariton (LRSPP) gold (Au) waveguides for the detection of dengue-specific immunoglobulin M (IgM) antibody, and we demonstrate detection in actual patient blood plasma samples. Two surface functionalization approaches are proposed and demonstrated: a dengue virus serotype 2 (DENV-2) functionalized surface to capture dengue-specific IgM antibody in blood plasma and the reverse, a blood plasma functionalized surface to capture DENV-2. The results obtained via these two surface functionalization approaches are comparable to, or of greater quality, than those collected by conventional IgM antibody capture enzyme linked immunosorbent assay (MAC-ELISA). Our second functionalization approach was found to minimize nonspecific binding, thus improving the sensitivity and accuracy of the test. We also demonstrate reuse of the biosensors by regenerating the sensing surface down to the virus (or antibody) level or down to the bare Au.
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Affiliation(s)
- Wei Ru Wong
- Photonics Research Group, Department of Electrical Engineering, Faculty of Engineering, University of Malaya , 50603 Kuala Lumpur, Malaysia
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Subedi D, Taylor-Robinson AW. Laboratory Diagnosis of Dengue Infection: Current Techniques and Future Strategies. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojcd.2014.41012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Vazquez S, Lozano C, Perez AB, Castellanos Y, Ruiz D, Calzada N, Guzmán MG. Dengue specific immunoglobulins M, A, and E in primary and secondary dengue 4 infected Salvadorian children. J Med Virol 2013; 86:1576-83. [PMID: 24615872 DOI: 10.1002/jmv.23833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 11/11/2022]
Abstract
El Salvador is a Central American country that has been affected by several dengue outbreaks. This study investigated the levels of IgM, IgA, and IgE anti-dengue antibodies in serum samples from children in El Salvador, with a clinical and serological diagnosis of dengue infection during the dengue 4 outbreak in 2002-2003. Seventy one serum samples were tested by ELISA and cases were classified in three groups: 13 primary dengue fever (PDF), 21 secondary dengue fever (SDF), and 37 secondary dengue hemorrhagic fever (SDHF). Also, the specificity of anti-dengue IgM for the different serotypes was tested. No significant differences in the IgM response were found between PDF and SDF, but these were detected between PDF and SDHF (P = 0.0053) and between SDF and SDHF (P = 0.0003). The IgA and IgE values showed a statistically significant difference between primary and secondary groups. The highest positivity percentage of IgA was between 95% (SDF) and 100% (SDHF) towards day 7 of onset of fever. All secondary cases were positive for IgE antibodies. The specificity of IgM was determined for DENV-4 virus in primary and secondary DF groups. This is the first study on dengue cases in Salvadorian children related to the immune response of different immunoglobulins to the type of infection and the clinical picture. Further prospective studies are needed to define if the pattern of immunoglobulins can determine early dengue infection and/or severity.
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Affiliation(s)
- Susana Vazquez
- "Pedro Kourí" Tropical Medicine Institute, PAHO/WHO Collaborating Centre for the Study of Dengue and its Vector, Havana City, Cuba
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16
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Sierra B, Perez AB, Garcia G, Aguirre E, Alvarez M, Gonzalez D, Guzman MG. Role of CC chemokine receptor 1 and two of its ligands in human dengue infection. Three approaches under the Cuban situation. Microbes Infect 2013; 16:40-50. [PMID: 24157267 DOI: 10.1016/j.micinf.2013.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 10/03/2013] [Accepted: 10/13/2013] [Indexed: 01/08/2023]
Abstract
Any of the four dengue serotypes can cause a severe disease, partly due to systemic inflammation orchestrated by mediators like cytokines and chemokines. We addressed the role of CCR1 and its ligands CCL3/MIP-1α and CCL5/RANTES in dengue infection using three different approaches: an ex vivo model exploring memory immune response in subjects with a well characterized dengue immune background, an in vivo study in patients with primary or secondary dengue infection, and an approach in fatal dengue. CCR1 and CCL3/MIP-1α gene expression showed differences after homotypic and heterotypic challenge according to dengue immune background of subjects, in correspondence with previous observations in Cuban dengue outbreaks. CCL5/RANTES gene expression was higher after homotypic challenge. CCR1 and CCL3/MIP-1α gene expression was higher in patients with secondary infection during critical days of the dengue disease, while the increase in RANTES expression started earlier than the observed for CCR1 and CCL3/MIP-1α. CCR1 and CCL3/MIP-1α gene expression was as high in brain as in spleen tissue from necropsy. Our results confirm the strong influence of previous immunity in subsequent dengue infections, and confer a possible pathogenic role to CCR1 and CCL3/MIP-1α in dengue disease and a possible protective role for CCL5/RANTES, probably through CCR5 interaction.
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Affiliation(s)
- Beatriz Sierra
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba.
| | - Ana B Perez
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
| | - Gissel Garcia
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
| | - Eglys Aguirre
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
| | - Mayling Alvarez
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
| | - Daniel Gonzalez
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
| | - Maria G Guzman
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and Its Vector, Pedro Kouri Institute of Tropical Medicine, Autopista Novia del Mediodia, Km 6½, La Lisa, Habana, Cuba
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17
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de la Cruz-Hernández SI, Flores-Aguilar H, González-Mateos S, López-Martinez I, Alpuche-Aranda C, Ludert JE, del Angel RM. Determination of viremia and concentration of circulating nonstructural protein 1 in patients infected with dengue virus in Mexico. Am J Trop Med Hyg 2013; 88:446-54. [PMID: 23339203 DOI: 10.4269/ajtmh.12-0023] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Higher levels of viremia and circulating nonstructural protein 1 (NS1) have been associated with dengue disease severity. In this study, viremia and circulating NS1 levels were determined in 225 serum samples collected from patients in Mexico infected with dengue virus serotypes 1 and 2 (DENV-1 and DENV-2). Patients with dengue hemorrhagic fever (DHF) who were infected with DENV-1 showed higher levels of circulating NS1 than patients with dengue fever (DF) (P = 0.0175). Moreover, NS1 levels were higher in patients with primary infections with DENV-1 than in patient infected with DENV-2 (P < 0.0001) and in patients with primary infections with DENV-2 than in patients with secondary infections with DENV-2 (P = 0.0051). Unexpectedly, viremia levels were higher in patients with DF than in those with DHF infected with either DENV-1 or DENV-2 (P = 0.0019 and P = 0.001, respectively) and in patients with primary infections than those with secondary DENV-2 infections (P < 0.0001). Results indicate that levels of circulating NS1 vary according to the infecting serotype, immunologic status (primary or secondary infection), and dengue disease severity.
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Affiliation(s)
- Sergio I de la Cruz-Hernández
- Departament of Virology, Instituto de Diagnóstico y Referencia Epimiológicos, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico.
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18
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Allonso D, Belgrano FS, Calzada N, Guzmán MG, Vázquez S, Mohana-Borges R. Elevated serum levels of high mobility group box 1 (HMGB1) protein in dengue-infected patients are associated with disease symptoms and secondary infection. J Clin Virol 2012; 55:214-9. [DOI: 10.1016/j.jcv.2012.07.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 07/15/2012] [Accepted: 07/19/2012] [Indexed: 01/08/2023]
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19
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de la Cruz Hernández SI, González Mateos S, Flores Aguilar H, López Martinez I, Alpuche Aranda C, Ludert JE, Del Angel RM. Evaluation of a novel commercial rapid test for dengue diagnosis based on specific IgA detection. Diagn Microbiol Infect Dis 2012; 72:150-5. [PMID: 22248735 DOI: 10.1016/j.diagmicrobio.2011.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 10/31/2011] [Accepted: 11/08/2011] [Indexed: 01/31/2023]
Abstract
The performance of the novel commercial test ASSURE® Dengue IgA Rapid test (MP Diagnostics) was evaluated using a panel of 172 sera collected from dengue patients and 47 sera from healthy blood donors. The overall specificity and sensitivity were 61.0% and 85.1%, respectively. However, the positivity rate for IgA went from 33.3% for sera collected the same day of fever onset to 81.2% for sera collected 5 days after fever onset. Infections with serotype 2 viruses were detected more efficiently than those with serotype 1 viruses, and no sera from infections with serotypes 3 and 4 were available. In addition, the kit was twice more efficient at detecting secondary infections than at detecting primary infections. Finally, the ASSURE® test showed good repeatability and reproducibility. The results of this study suggest that the ASSURE® Dengue IgA Rapid test may become a useful and easy-to-use test for early dengue diagnosis.
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Affiliation(s)
- Sergio Isaac de la Cruz Hernández
- Departamento de Virología, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico D.F., Mexico
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20
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Association of MICA and MICB alleles with symptomatic dengue infection. Hum Immunol 2011; 72:904-7. [DOI: 10.1016/j.humimm.2011.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 06/16/2011] [Accepted: 06/27/2011] [Indexed: 01/29/2023]
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21
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Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders. Int J Infect Dis 2011; 15:e38-43. [DOI: 10.1016/j.ijid.2010.09.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 08/18/2010] [Accepted: 09/11/2010] [Indexed: 01/19/2023] Open
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22
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Guzman MG, Jaenisch T, Gaczkowski R, Ty Hang VT, Sekaran SD, Kroeger A, Vazquez S, Ruiz D, Martinez E, Mercado JC, Balmaseda A, Harris E, Dimano E, Leano PSA, Yoksan S, Villegas E, Benduzu H, Villalobos I, Farrar J, Simmons CP. Multi-country evaluation of the sensitivity and specificity of two commercially-available NS1 ELISA assays for dengue diagnosis. PLoS Negl Trop Dis 2010; 4:e811. [PMID: 20824173 PMCID: PMC2930874 DOI: 10.1371/journal.pntd.0000811] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 08/04/2010] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Early diagnosis of dengue can assist patient triage and management and prevent unnecessary treatments and interventions. Commercially available assays that detect the dengue virus protein NS1 in the plasma/serum of patients offers the possibility of early and rapid diagnosis. METHODOLOGY/PRINCIPAL FINDINGS The sensitivity and specificity of the Pan-E Dengue Early ELISA and the Platelia Dengue NS1 Ag assays were compared against a reference diagnosis in 1385 patients in 6 countries in Asia and the Americas. Platelia was more sensitive (66%) than Pan-E (52%) in confirmed dengue cases. Sensitivity varied by geographic region, with both assays generally being more sensitive in patients from SE Asia than the Americas. Both kits were more sensitive for specimens collected within the first few days of illness onset relative to later time points. Pan-E and Platelia were both 100% specific in febrile patients without evidence of acute dengue. In patients with other confirmed diagnoses and healthy blood donors, Platelia was more specific (100%) than Pan-E (90%). For Platelia, when either the NS1 test or the IgM test on the acute sample was positive, the sensitivity versus the reference result was 82% in samples collected in the first four days of fever. NS1 sensitivity was not associated to disease severity (DF or DHF) in the Platelia test, whereas a trend for higher sensitivity in DHF cases was seen in the Pan-E test (however combined with lower overall sensitivity). CONCLUSIONS/SIGNIFICANCE Collectively, this multi-country study suggests that the best performing NS1 assay (Platelia) had moderate sensitivity (median 64%, range 34-76%) and high specificity (100%) for the diagnosis of dengue. The poor sensitivity of the evaluated assays in some geographical regions suggests further assessments are needed. The combination of NS1 and IgM detection in samples collected in the first few days of fever increased the overall dengue diagnostic sensitivity.
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Affiliation(s)
- Maria G. Guzman
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Thomas Jaenisch
- Section Clinical Tropical Medicine, Department of Infectious Diseases, University Hospital of Heidelberg, Heidelberg, Germany
| | - Roger Gaczkowski
- Section Clinical Tropical Medicine, Department of Infectious Diseases, University Hospital of Heidelberg, Heidelberg, Germany
| | - Vo Thi Ty Hang
- Oxford University, Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Shamala Devi Sekaran
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Axel Kroeger
- TDR-World Health Organization, Geneva, Switzerland
| | - Susana Vazquez
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Didye Ruiz
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Eric Martinez
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | | | | | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, United States of America
| | | | | | | | - Elci Villegas
- Instituto Experimental “Jose W Torrealba” Núcleo Universitario “Rafael Rangel”, Universidad de los Andes Trujillo, Bogotá, Venezuela
| | - Herminia Benduzu
- Instituto Experimental “Jose W Torrealba” Núcleo Universitario “Rafael Rangel”, Universidad de los Andes Trujillo, Bogotá, Venezuela
| | | | - Jeremy Farrar
- Oxford University, Clinical Research Unit, Ho Chi Minh City, Vietnam
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García G, Sierra B, Pérez AB, Aguirre E, Rosado I, Gonzalez N, Izquierdo A, Pupo M, Danay Díaz DR, Sánchez L, Marcheco B, Hirayama K, Guzmán MG. Asymptomatic dengue infection in a Cuban population confirms the protective role of the RR variant of the FcgammaRIIa polymorphism. Am J Trop Med Hyg 2010; 82:1153-6. [PMID: 20519616 DOI: 10.4269/ajtmh.2010.09-0353] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The role of human Fcgamma receptors (FcgammaR) has been recognized considerably over the last years. These receptors vary in their affinity for IgG subclasses and the intracellular signals elicited by them. Allelic variants of FcgammaR genes may influence the biological phagocyte activity, accounting for an inherited pre-disposition to disease. The specific FcgammaRIIa (CD32) contains a polymorphic variant (H/R131) that has been associated to a reduced risk for developing dengue hemorrhagic fever (DHF). Here, we investigated the role of this polymorphism in a very well-characterized group of Cuban individuals with antecedents of DHF, dengue fever (DF), or subclinical dengue infection. The HH131 genotype was significantly associated with dengue disease, either DF (*P = 0.016; odds ratio = 4.425; 95% confidence interval = 1.10-20.52) or DHF (P = 0.00018; odds ratio = 10.56; 95% confidence interval = 2.33-54.64) with respect to the subclinical infection.
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Affiliation(s)
- Gissel García
- Department of Virology, Tropical Medicine Institute "Pedro Kourí," Havana, Cuba.
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Immunoglobulin G antibody response in children and adults with acute dengue 3 infection. J Virol Methods 2009; 159:6-9. [DOI: 10.1016/j.jviromet.2009.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 02/04/2009] [Accepted: 02/12/2009] [Indexed: 11/21/2022]
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25
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Balmaseda A, Saborio S, Tellez Y, Mercado JC, Pérez L, Hammond SN, Rocha C, Kuan G, Harris E. Evaluation of immunological markers in serum, filter-paper blood spots, and saliva for dengue diagnosis and epidemiological studies. J Clin Virol 2008; 43:287-91. [PMID: 18783984 DOI: 10.1016/j.jcv.2008.07.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 06/30/2008] [Accepted: 07/15/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Numerous immunological approaches exist to diagnose dengue or detect dengue virus (DENV) infections. OBJECTIVES To determine the best immunological markers and specimen types for dengue diagnosis and for measuring incidence of DENV infection in community-based studies. STUDY DESIGN In one study, acute- and convalescent-phase samples were collected from hospitalized suspected pediatric dengue cases in Managua, Nicaragua, from September 2003 to February 2004. A second study examined specimens collected in a community setting in Managua before and after the 2003-2004 dengue season to measure incidence of DENV infection. In both studies, detection of anti-DENV IgM, IgA, and IgG in serum, filter-paper blood spots, and saliva was compared to a gold standard performed on serum samples. RESULTS For dengue diagnosis, the highest sensitivity and specificity was obtained by measuring IgM or IgA in serum or filter-paper blood spots; intermediate and poor results were obtained in saliva for IgM and IgA, respectively. Detection of IgG alone in serum, filter-paper blood spots, or saliva functioned best for measuring DENV infection. CONCLUSIONS Detection of IgM and IgA in serum and filter-paper blood spots yielded optimal results for diagnosis of dengue cases, whereas IgG was the best marker for measuring incidence of DENV infection.
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Affiliation(s)
- Angel Balmaseda
- Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Apartado Postal 2900, Managua, Nicaragua
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Vazquez S, Hafner G, Ruiz D, Calzada N, Guzman MG. Evaluation of immunoglobulin M and G capture enzyme-linked immunosorbent assay Panbio kits for diagnostic dengue infections. J Clin Virol 2007; 39:194-8. [PMID: 17521960 DOI: 10.1016/j.jcv.2007.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Revised: 03/15/2007] [Accepted: 04/03/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Serological assays are widely used to confirm dengue virus infections and to differentiate between a primary and a secondary infection. OBJECTIVE Two commercial dengue diagnostic kits, Panbio Dengue IgM Capture and Dengue IgG Capture ELISA (Brisbane, Australia) were evaluated. STUDY DESIGN Three hundred and seventy-three serum samples were tested. Panel sera included samples from dengue confirmed cases (representing both primary and secondary infections), from non-dengue infectious diseases, and from healthy individuals. The MAC-ELISA/Dengue IPK was used for the detection of anti-dengue virus IgM antibody in the sera and the ELISA inhibition method (EIM/Dengue IPK) was used to differentiate between primary and secondary infections. Both these reference assays, which were previously developed in the Arbovirus Laboratory at the "Pedro Kouri" Tropical Medicine Institute, were employed as the gold standard. RESULTS High sensitivity (96.8%) and specificity (99.4%) were found with the commercial diagnostics when compared to the reference methods. Furthermore, high concordance 95.5% in classifying dengue infection types (primary or secondary infections) was observed. CONCLUSIONS The Panbio Dengue IgM and IgG assays offer a good alternative for dengue diagnosis. They are easy to perform and results can be obtained in less than 3h.
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Affiliation(s)
- Susana Vazquez
- "Pedro Kourí" Tropical Medicine Institute, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Havana City, Cuba
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García G, Arango M, Pérez AB, Fonte L, Sierra B, Rodríguez-Roche R, Aguirre E, Fiterre I, Guzmán MG. Antibodies from patients with dengue viral infection mediate cellular cytotoxicity. J Clin Virol 2006; 37:53-7. [PMID: 16787760 DOI: 10.1016/j.jcv.2006.04.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Accepted: 04/24/2006] [Indexed: 11/25/2022]
Abstract
Acute and late convalescent sera (collected at day 5 of disease onset and 1 year later) from dengue fever (DF) and dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) laboratory confirmed cases, were tested for antibody-dependent cell-mediated cytotoxicity (ADCC) activity using dengue 1 (DENV-1) or dengue 2 (DENV-2) infected cells as target. All patients experienced their first dengue virus (DENV) infection 20 years before. ADCC activity was detected in acute sera from DHF/DSS but not in sera from DF patients. However, 1 year after illness, ADCC activity was observed in all cases. This preliminary report represents one of the few studies of ADCC in dengue patients and suggests that ADCC could be implicated in dengue pathogenesis.
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Affiliation(s)
- G García
- Department of Virology, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Tropical Medicine Institute, Autopista Novia del Mediodía, Km 6. P.O. Box Marianao 13, Havana, Cuba
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28
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Vázquez S, Cabezas S, Pérez AB, Pupo M, Ruiz D, Calzada N, Bernardo L, Castro O, González D, Serrano T, Sanchez A, Guzmán MG. Kinetics of antibodies in sera, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infections. Int J Infect Dis 2006; 11:256-62. [PMID: 16914345 DOI: 10.1016/j.ijid.2006.05.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Revised: 04/22/2006] [Accepted: 05/02/2006] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue infection were studied. DESIGN Serum, saliva, and urine samples were collected from 22 patients with clinical and confirmed dengue 3 virus infection during the outbreak in Havana City in 2001. They were tested by capture IgM (MAC-ELISA), IgA (AAC-ELISA), and IgE (EAC-ELISA) and IgG ELISA inhibition method (EIM) to detect specific dengue antibodies. RESULTS Similar kinetics were observed in IgM, IgA, and IgG antibodies in saliva and IgA and IgG in urine samples from secondary cases compared with kinetics in serum samples, although the values were lower. No IgG antibody was detected in saliva and urine samples in primary cases and IgM antibody was not detected in urine samples from either primary or secondary infection. All secondary cases were positive for IgG in saliva and urine samples at day 7. The kinetics of specific IgE antibodies in primary and secondary cases were different. CONCLUSIONS The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infection were studied for the first time, showing its behavior and usefulness in dengue virus diagnosis. The specific IgE could play a role as a serological marker in secondary infections.
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Affiliation(s)
- S Vázquez
- "Pedro Kourí" Tropical Medicine Institute, PAHO/WHO Collaborating Center for Dengue and its Vectors, Autopista Novia del Mediodía, Km 6 1/2, La Lisa, Havana City, Cuba.
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Tran TNT, de Vries PJ, Hoang LP, Phan GT, Le HQ, Tran BQ, Vo CMT, Nguyen NV, Kager PA, Nagelkerke N, Groen J. Enzyme-linked immunoassay for dengue virus IgM and IgG antibodies in serum and filter paper blood. BMC Infect Dis 2006; 6:13. [PMID: 16436203 PMCID: PMC1403783 DOI: 10.1186/1471-2334-6-13] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Accepted: 01/25/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reproducibilty of dengue IgM and IgG ELISA was studied in serum and filter paper blood spots from Vietnamese febrile patients. METHODS 781 pairs of acute (t0) and convalescent sera, obtained after three weeks (t3) and 161 corresponding pairs of filter paper blood spots were tested with ELISA for dengue IgG and IgM. 74 serum pairs were tested again in another laboratory with similar methods, after a mean of 252 days. RESULTS Cases were classified as no dengue (10 %), past dengue (55%) acute primary (7%) or secondary (28%) dengue. Significant differences between the two laboratories' results were found leading to different diagnostic classification (kappa 0.46, p < 0.001). Filter paper results correlated poorly to serum values, being more variable and lower with a mean (95% CI) difference of 0.82 (0.36 to 1.28) for IgMt3, 0.94 (0.51 to 1.37) for IgGt0 and 0.26 (-0.20 to 0.71) for IgGt3. This also led to differences in diagnostic classification (kappa value 0.44, p < 0.001) The duration of storage of frozen serum and dried filter papers, sealed in nylon bags in an air-conditioned room, had no significant effect on the ELISA results. CONCLUSION Dengue virus IgG antibodies in serum and filter papers was not affected by duration of storage, but was subject to inter-laboratory variability. Dengue virus IgM antibodies measured in serum reconstituted from blood spots on filter papers were lower than in serum, in particular in the acute phase of disease. Therefore this method limits its value for diagnostic confirmation of individual patients with dengue virus infections. However the detection of dengue virus IgG antibodies eluted from filter paper can be used for sero-prevalence cross sectional studies.
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Affiliation(s)
- Thanh Nga T Tran
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Microbiology, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Peter J de Vries
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
| | - Lan Phuong Hoang
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Giao T Phan
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Hung Q Le
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Binh Q Tran
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Chi Mai T Vo
- Department of Microbiology, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Nam V Nguyen
- Binh Thuan Malaria and Goiter Control Center, 133A Hai Thuong Lan Ong, Phan Thiet, Vietnam
| | - Piet A Kager
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
| | - Nico Nagelkerke
- Dept of Community Medicine, United Arab Emirates University, P.O. Box 17666 Al Ain, United Arab Emirates
| | - Jan Groen
- Department of Clinical Virology, Erasmus Medical Center Rotterdam, The Netherlands
- Department of Microbiology and Virology, Focus Diagnostics, Cypress CA, USA
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