Denguen patogeneesi on huonosti tunnettua runsaista tutkimuksista huolimatta. Tässä uusinta katsausta: Denguevirusekn primääri kohdesolu on dendriittisolu ja monosyytti/makrofagi, joista tulee runsaat kemokiinit ja sytokiinit infektion aikana. Niistä taas endoteeli aktivoituu ja suonisto alkaa tulla läpivuotavaksi.
(Kommenttini: Ilmiö on tältä alkuosalta ja kohdesoluvalinnalta samantyyppistä kuin ebolassakin, mutta ebola on rajumpi kulkuinen eikä säästä soluja elossa ja iskee koko immuunivasteen alueen) .
DENV lisääntyy, replikoituu, myös endoteelisoluissa, jotka osallistuvat suoraan viremiaan, immuuniaktivaatioon, suonen läpäisevyyteen ja vasta-aineitten kohdistautumiseen suonen sisäpintaan. Myös viruksen NS proteiinin 1 ja erittyneen proteiinin vasta-aineet ovat osaltaan syynä endoteelin toiminnanhäiriössä.
Rev Med Virol. 2014 Nov 27. doi: 10.1002/rmv.1818. [Epub ahead of print]
Endothelial dysfunction in dengue virus pathology.
Abstract
Dengue virus (DENV) is a leading cause of illness and death, mainly in the (sub)tropics, where it causes dengue fever and/or the more serious diseases dengue hemorrhagic fever and dengue
shock syndrome that are associated with changes in vascular
permeability. Despite extensive research, the pathogenesis of DENV is
still poorly understood and, although endothelial cells represent the
primary fluid barrier of the blood vessels, the extent to which these
cells contribute to DENV pathology is still under debate. The primary
target cells for DENV are dendritic cells and monocytes/macrophages that
release various chemokines and cytokines upon infection, which can
activate the endothelium and are thought to play a major role in
DENV-induced vascular permeability. However, recent studies indicate
that DENV also replicates in endothelial cells and that DENV-infected
endothelial cells may directly contribute to viremia, immune activation,
vascular permeability and immune targeting of the endothelium. Also,
the viral non-structural protein-1 and antibodies directed against this
secreted protein have been reported to be involved in endothelial cell
dysfunction. This review
provides an extensive overview of the effects of DENV infection on
endothelial cell physiology and barrier function. Copyright © 2014 John
Wiley & Sons, Ltd.Copyright © 2014 John Wiley & Sons, Ltd.
- PMID:
- 25430853
- [PubMed - as supplied by publisher]
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