The goal of this Program Project is to understand the immunopathology of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), the severe complications of dengue virus infections. The frequency of DHF/DSS is much greater during secondary infections with dengue virus strains of a different dengue serotype than that which caused the primary infection. These immunopathological results have slowed down vaccine development because of safety concerns. The morbidity and mortality associated with severe dengue infections is a major public health problem which is increasing in frequency. We propose to define the molecular and cellular basis of the immunopathology associated with severe dengue infections. Project #1 consists of clinical investigations in Thailand. Quantitative markers of dengue infection and immune responses that may correlate with progression from uncomplicated dengue fever (D) to DDS/DSS will be determined early in the disease process: the number of dengue-infected peripheral blood mononuclear cells, the levels of cytokines produced as a result of dengue infection of monocytes and activation of T lymphocytes and monocytes. Project #2 will establish a molecular understanding of dengue specific human T lymphocyte and monocyte responses during severe dengue infections. Dengue specific human CD4+ T helper 1 and 2 subsets will be defined at the clonal level. TcR usage in DHF/DSS and D will be defined. Cytokine production from monocytes obtained during acute dengue infections will be determined. Titers in plasma of virus and infectious virus-antibody complexes will be determined. We will learn whether correlations exist between these parameters and disease activity. Project #3 will define the sequence of dengue virus isolates from children with DHF/DSS or D to determine whether there are consistent sequence differences. A Clinical Research Core and a Molecular Immunology Core are needed to support these research projects. An Administrative Core will be responsible for directing, coordinating and overseeing this Program Project. Our ultimate goal is to develop an improved molecular and cellular understanding of the immunopathology DHF/DSS as a basis for the earlier diagnosis of children at highest risk, as a basis for developing logical and safe interventions and vaccine approaches to prevent this severe illness.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program Projects (P01)
Project #
5P01AI034533-02
Application #
2069662
Study Section
Special Emphasis Panel (SRC (30))
Project Start
1994-01-01
Project End
1997-12-31
Budget Start
1995-01-01
Budget End
1995-12-31
Support Year
2
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
660735098
City
Worcester
State
MA
Country
United States
Zip Code
01655
Park, Sangshin; Srikiatkhachorn, Anon; Kalayanarooj, Siripen et al. (2018) Use of structural equation models to predict dengue illness phenotype. PLoS Negl Trop Dis 12:e0006799
Salje, Henrik; Cummings, Derek A T; Rodriguez-Barraquer, Isabel et al. (2018) Reconstruction of antibody dynamics and infection histories to evaluate dengue risk. Nature 557:719-723
Kang, Jeon-Young; Aldstadt, Jared (2017) The Influence of Spatial Configuration of Residential Area and Vector Populations on Dengue Incidence Patterns in an Individual-Level Transmission Model. Int J Environ Res Public Health 14:
Srikiatkhachorn, Anon; Mathew, Anuja; Rothman, Alan L (2017) Immune-mediated cytokine storm and its role in severe dengue. Semin Immunopathol 39:563-574
Rattanamahaphoom, Jittraporn; Leaungwutiwong, Pornsawan; Limkittikul, Kriengsak et al. (2017) Activation of dengue virus-specific T cells modulates vascular endothelial growth factor receptor 2 expression. Asian Pac J Allergy Immunol 35:171-178
Kalayanarooj, Siripen; Rothman, Alan L; Srikiatkhachorn, Anon (2017) Case Management of Dengue: Lessons Learned. J Infect Dis 215:S79-S88
Moulton, Steven L; Mulligan, Jane; Srikiatkhachorn, Anon et al. (2016) State-of-the-art monitoring in treatment of dengue shock syndrome: a case series. J Med Case Rep 10:233
Srikiatkhachorn, Anon; Yoon, In-Kyu (2016) Immune correlates for dengue vaccine development. Expert Rev Vaccines 15:455-65
Rothman, Alan L; Ennis, Francis A (2016) Dengue Vaccine: The Need, the Challenges, and Progress. J Infect Dis 214:825-7
Townsley, E; O'Connor, G; Cosgrove, C et al. (2016) Interaction of a dengue virus NS1-derived peptide with the inhibitory receptor KIR3DL1 on natural killer cells. Clin Exp Immunol 183:419-30

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