“…Despite the fact that most antibodies directed against NS1 have been found to provide some level of passive protection to mice from a lethal flavivirus challenge (Henchal et al, 1988Schlesinger, 1985Schlesinger et al, 1986), a small number have been shown to increase morbidity (Falconar, 1997(Falconar, , 2008Henchal et al, 1988). Since these early observations, anti-NS1 antibodies have been shown to cross-react with a wide range of host cell components including extracellular matrix, blood clotting and integrin/adhesion proteins, platelets as well as to ATP synthase β chain, protein disulfide isomerise (PDI), vimentin and heat shock protein on endothelial cells (Cheng et al, 2009;Falconar, 1997Falconar, , 2007Immenschuh et al, 2013;Lin et al, 2001;Lin et al, 2003;Lin et al, 2002;Lin et al, 2006;Sun et al, 2007). The induction of auto-antibodies relatively early in acute secondary dengue infections as part of the anamnestic antibody response, that can bind platelets and uninfected endothelial cells has suggested a possible role for these antibodies in the endothelial cell dysfunction that underlies the haemorrhage and vascular leak in DHF/DSS patients (Sun et al, 2007).…”