Anti-Platelet and Anti-Endothelial Cell Autoantibodies in Vietnamese Infants and Children with Dengue Hemorrhagic Fever

Abstract

Dengue hemorrhagic fever (DHF) is a serious public health problem. Increased vascular permeability and thrombocytopenia are the hallmarks of DHF. The mechanisms involved in DHF/Dengue shock syndrome (DSS) pathogenesis is not fully understood. This study gives evidence of the presence of antibodies which cross-reacted with platelets, and endothelial cells in the sera of Vietnamese infants and children with DHF/DSS. The anti-platelet, anti-endothelial cell IgM levels were higher in the sera of DHF/DSS infants and children, compared with controls. However, the levels of these autoantibodies were not correlated with the severity of DHF (non-shock DHF vs DSS). The antiplatelet, and anti-endothelial cell autoantibodies may play a role in the pathogenesis of DHF/DSS in infants and children with predominantly primary, and secondary dengue infections, respectively. The epitopes shared by surface molecules of platelets and endothelial cells and dengue virus antigens need to be identified and avoided in designing the safe candidate vaccines.

Dengue epidemics and adverse obstetrical outcomes in French Guiana: a semi‐ecological study

“…It has been speculated that these autoantibodies are linked to shared epitopes between NS1, platelet and endothelium surface molecules (Hung et al . ). It is possible that these autoantibodies are also associated with post‐partum haemorrhage and preterm birth.…”

“…) and antiendothelial cell antibodies (Hung et al . ), which can persist months after the initial dengue episode (Lin et al . ).…”

Proteomic Profile of Circulating Immune Complexes in Dengue Infected Patients

“…Lin et al [20] have detected that antibodies against NS1 cross-react with platelets and have higher binding activity to platelets in DHF/DSS than those in DF. Another study in Vietnamese children showed that levels of auto-antibodies against platelets and endothelial cells are higher in DHF/DSS compared to DF patients [21]. Level of CIC has been reportedly increased in dengue infection and peaked at the transition period of fever to defervescence [38].…”

“…There are many factors contributing the pathogenesis of dengue virus infection, including virulence factor, secondary infection [8], host genetic factors [9][10][11], host immune response [12][13][14] and physiological factors [15]. An auto-immune response has also been proposed as an underlying mechanism in the pathogenesis of dengue infection [16][17][18][19][20][21][22]. In this hypothesis, immune complexes (IC) formed by auto-antibodies and human proteins are the main feature resulting in severity of disease.…”