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. 2001 Dec;39(12):4332-8.
doi: 10.1128/JCM.39.12.4332-4338.2001.

Kinetics of dengue virus-specific serum immunoglobulin classes and subclasses correlate with clinical outcome of infection

P Koraka  1 , C Suharti, T E Setiati, A T Mairuhu, E Van Gorp, C E Hack, M Juffrie, J Sutaryo, G M Van Der Meer, J Groen, A D Osterhaus
Affiliations

Kinetics of dengue virus-specific serum immunoglobulin classes and subclasses correlate with clinical outcome of infection

P Koraka et al. J Clin Microbiol. 2001 Dec.

Abstract

The kinetics of dengue virus (DEN)-specific serum immunoglobulin classes (immunoglobulin M [IgM] and IgA) and subclasses (IgG1 to IgG4) were studied in patients suffering from dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Serum samples from non-DEN febrile patients were included as controls. IgM, IgG1, and IgG3 serum antibodies were the predominant immunoglobulins throughout the course of illness in all three patient groups. In contrast, IgA antibodies were significantly higher in the acute phase in DSS patients compared to those in DF patients (P < 0.05). The levels of IgG1 differed significantly between patients with DF and those with DHF and DSS (P < 0.05). A significant difference was also found in IgG3 levels between DF patients and DHF patients (P < 0.05) but not between DF patients and DSS patients. Finally, levels of IgG4 antibodies differed significantly between DF patients and DSS patients (P < 0.05). Collectively, these data show that increased levels of DEN-specific IgA, IgG1, and IgG4 serum antibodies are risk markers for the development of DHF and DSS and that their measurement may provide valuable guidance for early therapeutic intervention.

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Figures

FIG. 1
FIG. 1
Kinetics of DEN-specific IgA, IgM, and IgG subclass responses in DEN patients with various disease severity, over a period of 2 weeks after onset of fever. Results are expressed as mean ratios. □, IgM response; ■, IgA response; ▿, IgG1 response; ●, IgG2 response; ○, IgG3 response; ▾, IgG4 response.
FIG. 2
FIG. 2
Comparison of DEN-specific Ig class and subclass responses in DEN patients with various severity, in the acute phase of disease (light grey bars) and the convalescent phase (black bars), of DEN disease. Error bars, standard deviation.
FIG. 3
FIG. 3
Comparison of DEN-specific Ig class and subclass responses in the acute phase of illness in patients with DEN disease of various severity ND febrile patients. Boxes indicate the interquartile range for each patient group. The median is indicated by the line within each box. The whiskers represent the extremes of Ig ratios.
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