Abstract

BackgroundDengue virus (DENV) infection has a global impact on public health. The clinical outcomes (of DENV) can vary from a flu-like illness called dengue fever (DF), to a more severe form, known as dengue hemorrhagic fever (DHF). The underlying innate immune mechanisms leading to protective or detrimental outcomes have not been fully elucidated. Helper innate lymphoid cells (hILCs), an innate lymphocyte recently discovered, functionally resemble T-helper cells and are important in inflammation and homeostasis. However, the role of hILCs in DENV infection had been unexplored.MethodsWe performed flow cytometry to investigate the frequency and phenotype of hILCs in peripheral blood mononuclear cells from DENV-infected patients of different disease severities (DF and DHF), and at different phases (febrile and convalescence) of infection. Intracellular cytokine staining of hILCs from DF and DHF were also evaluated by flow cytometry after ex vivo stimulation. Further, the hILCs were sorted and subjected to transcriptome analysis using RNA sequencing. Differential gene expression analysis was performed to compare the febrile and convalescent phase samples in DF and DHF. Selected differentially expressed genes were then validated by quantitative PCR.ResultsPhenotypic analysis showed marked activation of all three hILC subsets during the febrile phase as shown by higher CD69 expression when compared to paired convalescent samples, although the frequency of hILCs remained unchanged. Upon ex vivo stimulation, hILCs from febrile phase DHF produced significantly higher IFN-γ and IL-4 when compared to those of DF. Transcriptomic analysis showed unique hILCs gene expression in DF and DHF, suggesting that divergent functions of hILCs may be associated with different disease severities. Differential gene expression analysis indicated that hILCs function both in cytokine secretion and cytotoxicity during the febrile phase of DENV infection.ConclusionsHelper ILCs are activated in the febrile phase of DENV infection and display unique transcriptomic changes as well as cytokine production that correlate with severity. Targeting hILCs during early innate response to DENV might help shape subsequent immune responses and potentially lessen the disease severity in the future.

Highlights

  • Dengue virus (DENV) infection is a serious public health threat, especially in tropical and subtropical areas

  • To the best of our knowledge, this study showed the first evidence of Helper innate lymphoid cells (hILCs) responses in human DENV infection, a pressing public health problem worldwide

  • By assessing blood samples from a well-characterized human DENV infection cohort, we found that hILCs were activated in the febrile phase of DENV infection and their cytokine production as well as transcriptional profiles in the febrile phase were distinct between dengue fever (DF) and dengue hemorrhagic fever (DHF) patients

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Summary

Introduction

Dengue virus (DENV) infection is a serious public health threat, especially in tropical and subtropical areas. This important mosquito-borne virus infects approximately 390 million people annually [1]. The high prevalence, absence of specific treatment and lack of effective vaccine result in prominent global burden, clinically, and economically. This is in part due to the inadequate understanding of immune responses to DENV infection. Dengue virus (DENV) infection has a global impact on public health. The clinical outcomes (of DENV) can vary from a flu-like illness called dengue fever (DF), to a more severe form, known as dengue hemorrhagic fever (DHF). The role of hILCs in DENV infection had been unexplored

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