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Clinical Microbiology Reviews, October 2009, p. 564-581, Vol. 22, No. 4
0893-8512/09/$08.00+0     doi:10.1128/CMR.00035-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Dengue Virus Pathogenesis: an Integrated View

Byron E. E. Martina,* Penelope Koraka, and Albert D. M. E. Osterhaus Author Bios

Erasmus MC, Department of Virology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

Summary: Much remains to be learned about the pathogenesis of the different manifestations of dengue virus (DENV) infections in humans. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever (DHF), and eventually dengue shock syndrome (DSS). As both cell tropism and tissue tropism of DENV are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. More than 50 years of research on dengue has resulted in a host of literature, which strongly suggests that the pathogenesis of DHF and DSS involves viral virulence factors and detrimental host responses, collectively resulting in abnormal hemostasis and increased vascular permeability. Differential targeting of specific vascular beds is likely to trigger the localized vascular hyperpermeability underlying DSS. A personalized approach to the study of pathogenesis will elucidate the basis of individual risk for development of DHF and DSS as well as identify the genetic and environmental bases for differences in risk for development of severe disease.

* Corresponding author. Mailing address: Erasmus Medical Center, Institute of Virology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Phone: 3110 704 4279. Fax: 3110 704 4760. E-mail: b.martina{at}erasmusmc.nl

Clinical Microbiology Reviews, October 2009, p. 564-581, Vol. 22, No. 4
0893-8512/09/$08.00+0     doi:10.1128/CMR.00035-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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