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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/31261
Title: Challenges for the formulation of a universal vaccine against dengue
Authors: Kulkanya Chokephaibulkit
Guey Chuen Perng
Mahidol University
National Cheng Kung University Medical College
National Cheng Kung University
Emory University School of Medicine
Keywords: Biochemistry, Genetics and Molecular Biology
Issue Date: 1-Aug-2013
Citation: Experimental Biology and Medicine. Vol.238, No.5 (2013), 566-578
Abstract: Dengue is rapidly becoming a disease of an escalating global public health concern. The disease is a vector-borne disease, transmitted by the bite of an Aedes spp. mosquito. Dynamic clinical manifestations, ranging from asymptomatic, flu-like febrile illness, dengue fever (DF) to dengue hemorrhagic fever (DHF) with or without dengue shock syndrome (DSS), make the disease one of the most challenging to diagnose and treat. DF is a self-limited illness, while DHF/DSS, characterized by plasma leakage resulting from an increased vascular permeability, can have severe consequences, including death. The pathogenesis of dengue virus infection remains poorly understood, mainly due to the lack of a suitable animal model that can recapitulate the cardinal features of human dengue diseases. Currently, there is no specific treatment or antiviral therapy available for dengue virus infection and supportive care with vigilant monitoring is the principle course of treatment. Since vector control programs have been largely unsuccessful in preventing outbreaks, vaccination seems to be the most viable option for prevention. There are four dengue viral serotypes and each one of them is capable of causing severe dengue. Although immunity induced by infection by one serotype is effective in protection against the homologous viral serotype, it only has a transient protective effect against infection with the other three serotypes. The meager cross protective immunity generated wanes over time and may even induce a harmful effect at the time of subsequent secondary infection. Thus, it is imperative to have a vaccine that can elicit equal and long-lasting immunity to all four serotypes simultaneously. Numerous tetravalent vaccines are currently either in the pipeline for clinical trials or under development. For those frontrunner tetravalent vaccines in clinical trials, despite good safety and immunogenicity profiles registered, issues such as imbalanced immune responses between serotypes and questions with regard to whether the optimum formulation have been identified remain unresolved. This review centers on these issues and offers strategies that may improve the tetravalent vaccine formulation. © 2013 by the Society for Experimental Biology and Medicine.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84881606622&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/31261
ISSN: 15353699
15353702
Appears in Collections:Scopus 2011-2015

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