期刊
JOURNAL OF INFECTIOUS DISEASES
卷 214, 期 2, 页码 265-272出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiw143
关键词
dengue; placental transfer; IgG; newborn; antibody dependent enhancement
资金
- National Council for Scientific and Technological Development of the Brazilian government [482915/2010-2 MCT/CNPq-14/2010]
- Strategic Program to Support Health Research/PAPES VI [407697/2012-8]
- Fogarty Training Program [D43TW006592 Pitt GIDRTP/NIH]
Background. Maternal-fetal transferred dengue virus ( DENV)-specific antibodies have been implicated in the immunopathogenesis of dengue during infancy. Methods. A prospective birth cohort was established in a dengue-endemic area in the Northeast Region of Brazil. DENV-specific immunoglobulin G ( IgG) and DENV-1-4 serotype-specific neutralizing antibody ( NAb) levels were assessed in 376 paired maternal and umbilical cord blood samples. The kinetics of enhancing activity by maternally acquired DENV antibodies was determined in serum samples from children enrolled in the cohort. Results. Mothers were mostly immune to DENV-3 alone ( 53.7%) or combined with DENV-4 ( 30.6%). Levels of DENV-specific IgG, DENV-3 NAbs, and DENV-4 NAbs were significantly higher in newborns than in their respective mothers. Mothers immune to a single serotype transferred greater levels of DENV-specific IgG ( P =.02) and DENV-3 NAbs ( P =.04) than mothers immune to multiple DENV serotypes. Maternally acquired DENV-3 NAbs disappeared in > 90% of the children by the age of 4 months. The peak enhancing activity was detected by the age of 2 months ( P <.0001) and rapidly declined by the age of 4 months ( P =.0035). Conclusions. Unlike Asian infants, the enhancing activity of DENV infection by maternally transferred DENV antibodies occurs at earlier ages in Brazilian children. These findings might explain the low occurrence of severe dengue among infants in our setting.
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