PDF(Pubmed)
Abstract：
Dengue is a very serious public health problem that can manifest a wide range of symptoms from asymptomatic to fatal conditions, such as dengue shock syndrome (DSS). It is a life-threatening mosquito-borne viral infection widely spread in tropical areas. Dengue virus transmission occurs from an infected Aedes mosquito to humans. Various factors are responsible for the occurrence of the disease, such as viral load, age of the host, immune status of the host, and genetic variability. Dengue infection occurs in three phases: febrile, critical, and recovery. The febrile phase lasts for seven days and manifests symptoms such as high-grade fever, headache, arthralgia, and backache, and in some cases, the upper respiratory tract and gastrointestinal tract are also involved. Severe dengue is characterized by endothelial dysfunction that causes vascular permeability and plasma leakage. The fundamental mechanisms of these immune pathologies are not yet known. Dengue manifests various complications such as dengue encephalopathy, encephalitis, stroke, ocular involvement, acute transverse myelitis, myalgia, and cerebellar syndrome, but the most commonly seen is liver involvement. Dengue is managed supportively because there are no proven curative treatments. The cornerstone of care during the critical period of dengue is prudent fluid resuscitation. The first fluid of preference is a crystalloid. Prophylactic transfusion of platelets is not advised. The occurrence of four antigenically different dengue virus serotypes, each able to elicit a cross-reactive and disease-enhancing antibody response against the other three serotypes, has made the creation of the dengue vaccine a difficult undertaking. The development of a dengue vaccine has faced significant challenges due to a lack of the best animal models and a variety of immunological conditions in people, particularly in endemic locations. Dengvaxia is a live attenuated vaccine, which was developed by Sanofi. It is made up of four chimeric vaccine viruses produced by Vero cells.
摘要：
登革热是一个非常严重的公共卫生问题，可以表现出从无症状到致命的各种症状，如登革热休克综合征（DSS）。它是一种威胁生命的蚊媒病毒感染，在热带地区广泛传播。登革病毒从感染的伊蚊传播到人类。多种因素是导致疾病发生的原因,比如病毒载量，主人的年龄,宿主的免疫状态，和遗传变异。登革热感染发生在三个阶段：高热，关键,和恢复。高热阶段持续七天,出现高烧等症状,头痛,关节痛,背痛,在某些情况下,上呼吸道和胃肠道也受累。严重登革热的特征是内皮功能障碍，导致血管通透性和血浆渗漏。这些免疫病理的基本机制尚不清楚。登革热表现出各种并发症，如登革热脑病，脑炎,中风,眼部受累,急性横贯性脊髓炎,肌痛，和小脑综合征,但最常见的是肝脏受累。登革热是支持性管理，因为没有经过证实的治愈性治疗方法。登革热关键时期的护理基石是审慎的液体复苏。优选的第一流体是晶体。不建议预防性输注血小板。四种抗原不同的登革热病毒血清型的发生，每个都能够引发针对其他三种血清型的交叉反应性和疾病增强抗体反应，使登革热疫苗的研制成为一项艰巨的任务。由于缺乏最好的动物模型和人们的多种免疫状况，登革热疫苗的开发面临着重大挑战，特别是在当地。Dengvaxia是一种减毒活疫苗，是赛诺菲开发的.它由Vero细胞产生的四种嵌合疫苗病毒组成。
