Blog

Shock results from a fall in cardiac output (CO) (for e.g. and almost half of the global population is at risk for contracting the infection (2). Dengue is usually Rabbit Polyclonal to GIT1 caused by at least four different dengue virus (DENV) serotypes, DENV1, DENV2, DENV3, and DENV4. In recent years, most endemic countries, e.g., Asia-Pacific and Latin American nations, are reporting almost all the four different DENV serotypes (3), which altogether cause ~20000 deaths annually (4). The surge in endemicity is usually attributed to rapid urbanization, increasing population density and a rise in vector-breeding sites (5). (mosquitos, that in turn, would drive the IPI-145 (Duvelisib, INK1197) dissemination of the dengue disease further (8). DENV is IPI-145 (Duvelisib, INK1197) usually a member of the genus of the family. DENV has a spherical shape with icosahedral symmetry. It is a single-stranded positive sense RNA virus with a genome size of ~11 kb (9). It has a single long open reading frame (ORF) that encodes for three structural and seven IPI-145 (Duvelisib, INK1197) non-structural (NS) proteins. The structural proteins are capsid (C), pre-membrane/membrane (prM/M), and envelope glycoproteins (E), and the NS proteins are NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. The NS proteins are not present in the virion, but contribute to viral replication and immune evasion within an infected cell (10C12). Of all the NS proteins, only NS1 is displayed on the infected cell surfaces, and is eventually secreted into the systemic circulation making it an appropriate diagnostic marker. While detection of DENV genomic RNA (by RT-PCR) and NS1 are the mainstay of laboratory diagnosis, detection of NS1 has an edge over the detection of DENV genomic RNA. Albeit being highly sensitive, the RT-PCR viral detection rate has a finer window period where detection rate IPI-145 (Duvelisib, INK1197) appears to drop dramatically by day 4 onwards following the onset of clinical symptoms (13, 14). Conversely, NS1 can be detected in the serum for a wider time range, viz., from the first day of symptom onset, with the concentration average of 2 g/ml (can reach as high as 50 g/ml in the same cases) (15) that remains detectable between 9 and 18 days (16, 17). Furthermore, the level of NS1 appears to correlate with disease severity, rendering it an ideal biomarker, both for diagnosis as well as prognosis in dengue (12, 18, 19). Dengue contamination results in clinical manifestations ranging from a predominantly asymptomatic or a symptomatic, moderate undifferentiated febrile illness to severe life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) that can be fatal (6). The hallmarks of severe dengue are coagulopathy and leaky vasculature that eventually can lead to life-threatening hemodynamic shock and organ failure (20, 21). Evidence suggests that young age, female biological sex, high body-mass index, virus strain, and genetic variants of the human MHC class ICrelated sequence B, and phospholipase C epsilon 1 genes could serve as risk factors for development IPI-145 (Duvelisib, INK1197) of severe dengue (6). The human and economic burden caused by dengue fever remains enormous as specific antiviral drugs, or effective vector-control mechanisms is lacking. Although no specific treatment is available, prompt hospital admission, triage, and fluid restoration are critical to prevent death (22). In 2016, (CYD-TDV) DengVaxia?, a tetravalent vaccine was licensed to prevent severe secondary dengue in seropositive individuals. However, the vaccine was not recommended for seronegative individuals as the levels of vaccine-induced antibodies reportedly decreased over time (23). The current review will focus.