- 作者: Huan-Yao Lei trai-Ming Yeh Hsiao-Sheng Liu Yee-Shin Lin Shun-Hua Chen Ching-Chuan LiU
- 作者服務機構: Departments of Microbioloogy and Immunology, Medical Technology, and Pediatrics, College of Medicine, National Cheng Kung university, tainan, ROC
- 中文摘要: --
- 英文摘要: Dengue virus infection causes dengue fever (DF), den-gue hemorrhagic fever (DHF), and dengue shock syn-drome (DSS), whose pathogeneses are not clearly un-derstood. Current hypotheses of antibody-dependentenhancement, virus virulence, and IFN- /TNF -mediatedimmunopathogenesis are insufficient to explain clinicalmanifestations of DHF/DSS such as thrombocytopeniaand hemoconcentration. Dengue virus infection inducestransient immune aberrant activation of CD4/CD8 ratioinversion and cytokine overproduction, and infection ofendothelial cells and hepatocytes causes apoptosis anddysfunction of these cells. The coagulation and fibrinoly-sis systems are also activated after dengue virus infec-tion. We propose a new hypothesis for the immunopa-thogenesis for dengue virus infection. The aberrant im-mune responses not only impair the immune responseto clear the virus, but also result in overproduction ofcytokines that affect monocytes, endothelial cells, andhepatocytes. Platelets are destroyed by crossreactiveanti-platelet autoantibodies. Dengue-virus-induced vas-culopathy and coagulopathy must be involved in thepathogenesis of hemorrhage, and the unbalance be-tween coagulation and fibrinolysis activation increasesthe likelihood of severe hemorrhage in DHF/DSS. Hemo-stasis is maintained unless the dysregulation of coagula-tion and fibrinolysis persists. The overproduced IL-6might play a crucial role in the enhanced production ofanti-platelet or anti-endothelial cell autoantibodies, ele-vated levels of tPA, as well as a deficiency in coagulation.Capillary leakage is triggered by the dengue virus itselfor by antibodies to its antigens. This immunopathogene-sis of DHF/DSS can account for specific characteristics ofclinical, pathologic, and epidemiological observations indengue virus infection.
- 中文關鍵字: --
- 英文關鍵字: Dengue virus