The pathology of dengue hemorrhagic fever

Leong, Anthony S.‐Y.; Wong, Kum Thong; Leong, Trishe; Tan, Puay Hoon; Wannakrairot, Pongsak

doi:10.1053/j.semdp.2007.07.002

Cited by 79 publications

(66 citation statements)

References 71 publications

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“…3,5,7 The present understanding of the immunopathogenesis is that the target cells of the dengue virus includes dendritic cells, monocytes and vascular endothelial cells, and inflammatory changes through the proinflammatory mediators, interferon-γ, tumour necrosis factor-α and interleukin-2, -6, and -8, lead to vascular leakage, haemorrhage and ischaemia. [13][14][15][16][17] Based on standard OCT, the three patterns of maculopathy include diffuse retinal thickening, cystoid macular oedema and foveolitis. 11 As with our case, it is recognised that whilst the structural changes seen on the standard OCT and clinically fundal abnormalities spontaneously return to normal within a few days, central/paracentral scotoma can persist.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Tavassoli¹,

Carreño²,

Teoh³

et al. 2016

Ophthalmic Surg Lasers Imaging Retina

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100 words (93 words)The ophthalmic manifestations of dengue fever include a visually impairing maculopathy, where patients are left with a central or paracentral relative scotoma. We present a case of a 26-year old female patient returning from Thailand with unilateral reduction in visual acuity and a central scotoma associated with dengue fever. We report the use of the OCTA as a non-invasive imaging platform to demonstrate its value in showing the persistent changes corresponding to the functional central scotoma in dengue-related maculopathy, which often cannot be visualised clinically, or by standard OCT and fundus fluorescein angiography. Introduction:

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Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Tavassoli¹,

Carreño²,

Teoh³

et al. 2016

Ophthalmic Surg Lasers Imaging Retina

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“…1 It is estimated that about 100 million infections occur each year in tropical and subtropical areas around the world, with approximately 500 000 cases of DHF/DSS. 2,3 The DENV genome consists of a positive single-strand RNA molecule of approximately 11 kb that encodes a polyprotein precursor, which is co-and post-translationally processed into three structural and seven non-structural proteins. During replication, the virus RNA polymerase (the non-structural 5 protein) synthesizes negative-strand RNA molecules that will further be used as templates for positivestrand RNA, which in turn will be incorporated into the new viral particles.…”

mentioning

confidence: 99%

“…Most of the knowledge was obtained in studies of human cases and suggests that the target cells for virus infection are dendritic cells, monocytes, lymphocytes, hepatocytes and vascular endothelial cells. 1,[3][4][5][6] Histopathology of tissue specimens obtained from DF and DHF patients postmortem indicates that lymphoid organs and also the liver are implicated with DENV replication. [3][4][5][6][7][8][9] Nevertheless, the knowledge obtained from studies in humans alone is insufficient either to clarify the pathogenesis, or to build strategies on the prevention or treatment of dengue disease.…”

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confidence: 99%

Hepatic damage associated with dengue-2 virus replication in liver cells of BALB/c mice

Paes

Lenzi

Nogueira

et al. 2009

Laboratory Investigation

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One difficulty in studying dengue virus (DENV) is the lack of an experimental model that reproduces the human disease. In a previous work, we have shown that BALB/c mice intraperitoneally inoculated with a DENV-2 isolate presented viremia and mild focal areas of liver injuries. In this study, mice were inoculated by the intravenous route and presented extensive damage areas in the liver tissue, which were evaluated by histopathological and ultrastructural analysis. Hepatic injury was noted mainly around the central vein and portal tracts. Damages consist of hepatocyte injury, including steatosis, swelling and necrosis. Further, erythrophagocytosis, intercellular edema and vascular damages were evident, including hemorrhage, which is characteristic of the dengue-induced hepatitis in human liver. Hepatic lesions were already noted 2 days post infection (p.i.), although effects were more extensive after the seventh day p.i. An increase in alanine aminotransferase and aspartate aminotransferase serum levels was detected 7 and 14 days p.i., respectively, and had correlation to hepatic lesions. Alterations caused by the DENV infection were self-limiting, with a remarkable reduction of all liver damages 49 days p.i. Virus antigens were detected in hepatocytes, Kupffer cells and vascular endothelium, suggesting virus replication in these cells. In situ hybridization, using a probe that anneals in the virus negative RNA strand, showed positive reaction in hepatocytes and vascular endothelium cells of infected mice, thus confirming virus replication in such cells. In general, results revealed that this mouse model reproduces some histopathological effects observed in humans and supports previous findings indicating virus replication in the hepatic tissue.

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“…Furthermore, plasma leakage in DHF occurs rapidly, and is likely caused by altered vascular function rather than destructive effects on endothelial cells. The elevation of cytokine and immune mediator levels in DHF patients probably has an effect on the functional alterations of endothelial cells (4).…”

Section: Introductionmentioning

confidence: 99%

Synergistic Effect of TNF-α and Dengue Virus Infection on Adhesion Molecule Reorganization in Human Endothelial Cells

2017

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SUMMARY: Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a severe pathological manifestation of dengue virus (DENV) infection. Enhanced production of cytokines in dengue patients is proposed to induce endothelial barrier instability resulting in increased vascular leakage. Tumor necrosis factor (TNF)-a is an inflammatory cytokine that activates endothelial cells and enhances vascular permeability and plasma leakage in DHF/DSS. The present study investigated the in vitro effect of TNF-a and DENV infection on the expression of adherence junction proteins, tight junction proteins, and membrane integrity of human endothelial cell lines. Immunofluorescence staining and western blot analysis demonstrated platelet endothelial cell adhesion molecule-1 (PECAM-1) reorganization and decreased levels of the tight junction protein occludin in human endothelial cells treated with TNF-a and DENV, compared to mock, DENV, or TNF-a-treated cells. Permeability assessed by FITC-dextran as a transport molecule was increased and correlated with the unusual reorganization of PECAM-1. The altered distribution of PECAM-1 and low occludin protein levels in human endothelial cells treated with TNF-a and DENV correlated with increased permeability. In conclusion, the synergistic effect of TNF-a and DENV induced permeability changes in endothelial cells. These results contribute to the understanding of the mechanisms underlying enhanced vascular permeability in DENV infection.

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The pathology of dengue hemorrhagic fever

Cited by 79 publications

References 71 publications

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Hepatic damage associated with dengue-2 virus replication in liver cells of BALB/c mice

Synergistic Effect of TNF-α and Dengue Virus Infection on Adhesion Molecule Reorganization in Human Endothelial Cells

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The pathology of dengue hemorrhagic fever

Cited by 79 publications

References 71 publications

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Optical Coherence Tomography Angiography Findings in Dengue-Related Maculopathy: A Case Report

Hepatic damage associated with dengue-2 virus replication in liver cells of BALB/c mice

Synergistic Effect of TNF-&alpha; and Dengue Virus Infection on Adhesion Molecule Reorganization in Human Endothelial Cells

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Synergistic Effect of TNF-α and Dengue Virus Infection on Adhesion Molecule Reorganization in Human Endothelial Cells