Abstract

In dengue virus (DENV) infection, complement system (CS) activation appears to have protective and pathogenic effects. In severe dengue fever (DF), the levels of DENV non-structural-1 protein and of the products of complement activation, including C3a, C5a and SC5b-9, are higher before vascular leakage occurs, supporting the hypothesis that complement activation contributes to unfavourable outcomes. The clinical manifestations of DF range from asymptomatic to severe and even fatal. Here, we aimed to characterise CS by their receptors or activation product, in vivo in DF patients and in vitro by DENV-2 stimulation on monocytes. In comparison with healthy controls, DF patients showed lower expression of CR3 (CD11b), CR4 (CD11c) and, CD59 on monocytes. The DF patients who were high producers of SC5b-9 were also those that showed more pronounced bleeding or vascular leakage. Those findings encouraged us to investigate the role of CS in vitro, using monocytes isolated from healthy subjects. Prior blocking with CR3 alone (CD11b) or CR3 (CD11b/CD18) reduced viral infection, as quantified by the levels of intracellular viral antigen expression and soluble DENV non-structural viral protein. However, we found that CR3 alone (CD11b) or CR3 (CD11b/CD18) blocking did not influence major histocompatibility complex presentation neither active caspase-1 on monocytes, thus probably ruling out inflammasome-related mechanisms. Although it did impair the secretion of tumour necrosis factor alpha and interferon alpha. Our data provide strategies of blocking CR3 (CD11b) pathways could have implications for the treatment of viral infection by antiviral-related mechanisms.

Highlights

  • By augmenting the neutralising activity of antiviral antibodies, complement activation inhibits infection with many viruses [1,2,3,4,5]

  • Our study revealed that the monocyte expression of CR3 (CD11b), CR4 (CD11c) and CD59 is significantly reduced in dengue virus (DENV)-infected patients, whereas plasma levels of SC5b-9 are elevated, markedly so in patients with pronounced haemorrhagic manifestations and vascular leakage, suggests that complement activation is strongly linked to unfavourable outcomes in dengue

  • The modified monocyte expression of complement receptors (CRs) in DENV-infected patients prompted us to investigate the role of these systems in the DENV infection in vitro of the isolated monocytes from healthy subjects

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Summary

Introduction

By augmenting the neutralising activity of antiviral antibodies, complement activation inhibits infection with many viruses [1,2,3,4,5] In flavivirus infection, such activation appears to play a protective or a pathogenic role, depending on the immune status of the host, the specific virus and infectious phase [6,7]. The role of the complement was confirmed by addition of heat-inactivated human serum or commercial C1q- or C3-depleted human sera, which decreased enhancing activities, thereby increasing the percentage of infected cells. These results indicate that a single antibody species plays two distinct roles (neutralising and enhancing), depending on the level of complement [18]

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