Role of T cells, cytokines and antibody in dengue fever and dengue haemorrhagic fever

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Abstract
Dengue infections are a major cause of morbidity and mortality in the tropical and sub‐tropical regions of the world. There is no vaccine for dengue and also there are no anti‐viral drugs to treat the infection. Some patients, typically those experiencing a secondary infection with a different dengue serotype, may progress from an acute febrile disease to the more severe forms of disease, dengue haemorrhagic fever and dengue shock syndrome. Here we discuss the significant immunopathological component to severe disease and how T cells, cytokines and cross‐reactive antibody combine to contribute to the progression to dengue haemorrhagic fever. These events are thought to lead to vascular leakage, the signature event in dengue haemorrhagic fever, and are addressed in this review by incorporating the concept of heterologous T cell immunity. The need for effective measures against dengue and dengue‐related illness is clear. We propose that drugs against dengue virus, or the symptoms of severe dengue disease, are a viable goal. Copyright © 2006 John Wiley & Sons, Ltd.