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Antibody-Dependent Enhancement (ADE)

Slide 13

May 2012

It is well established that the primary risk factor of development of the shock and hemorrhagic syndrome is evidence of a previous infection with dengue fever. But why are secondary infections more severe? Antibodies formed in response to a dengue infection are not cross-protective against other subtypes of the virus. In fact they may result in more severe disease due to a phenomenon known as antibody-dependent enhancement or ADE.

This occurs when there is a formation of immune complexes between dengue virus and existing non-neutralizing antibodies. Non-neutralizing antibodies result from previous dengue infection, or low level of maternal antibodies in infant sera.

Mononuclear phagocytes are infected through their Fc receptors by immune complexes and severe disease then results by suppression of innate immune response secondary to ADE via release of inflammatory cytokines and chemokines, resulting in enhanced disease.

Antibody-Dependent Enhancement (ADE)
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