Mini-review: Can non-human leucocyte antigen genes determine susceptibility to severe dengue syndromes?

Abstract

Dengue viral infections are endemic or epidemic in virtually all tropical countries. Among individuals infected with the dengue virus, severe dengue syndromes (i.e., dengue haemorrhagic fever and dengue shock syndromes) tend to affect only some and this may be due to a combination of host genetic susceptibility and viral factors. In this review article we analyse and discuss the present knowledge of non-human leucocyte antigen host genetic susceptibility to severe dengue syndromes. The relevance of genetic polymorphisms in the pathways of antigen recognition, uptake, processing and presentation, activation of interferon α responses, mast cell and complement activation and T cell activation and dengue disease severity has been reviewed and analysed.

Insight into the Tropism of Dengue Virus in Humans

“…Therefore, the autopsy studies do not indicate the tropism of DENV in major cases of DENV infection. (2) The contradictory results obtained during the tropism studies of various organs (brain, thymus, heart, kidney, GI tract and bone marrow) can be explained depending on the fact that the severity of DENV infection depends on multiple factors such as virus strain and its virulence, age of the individual, sex, high BMI, immune status and host genetics [1,[5][6][7]. Similarly, the above factors along with the sample preparation technique, and the stage (primary or secondary) and severity (DF, DHF or DSS) of the infection when the patient died may also contribute to DENV tropism.…”

“…DENV infection is endemic in hot climatic regions of the world and according to WHO 2017 reports, an estimated 390 million DENV infection cases per year have been reported-of which, 96 million cases display the symptoms of the disease [4]. The acuteness of the infection depends on various factors such as virus strain and its virulence, age of the individual, sex, high BMI, immune status and host genetics [1,[5][6][7]. It leads to asymptomatic infection in the majority of cases but, in some circumstances, it may lead to self-healing, mild flu-like symptoms known as Dengue fever (DF) or other severe forms of the disease such as Dengue hemorrhagic fever (DHF).…”

Dengue Infections and the Surgical Patient

“…7 There has been a change in disease patterns with increasing involvement of gastrointestinal, hepatic, renal, hematological, neurological, respiratory, and cardiac systems. [8][9][10][11][12][13][14][15] Abdominal pain is a recognized feature during the critical phase of DHF. 1,7 Some patients with dengue may present with surgical complications such as gastrointestinal bleeding, acute pancreatitis, and splenic rupture, and others may mimic an acute abdomen without any true complications.…”

The World Health Organization dengue case classifications

“…The 1997 World Health Organization (WHO) dengue classification, classified the disease as: dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS). In 2009, a revised classification was released which classified the disease into "dengue" and "severe dengue", with or without "warning signs" (Table 1) (8,10).…”