A Tale of Two Viruses

Does Heterologous Flavivirus Immunity Enhance Zika Disease?

Carlos A. Sariol, Mauricio L. Nogueira, Nikos Vasilakis

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The rise of Zika virus (ZIKV) and its unusual clinical manifestations provided ground for speculative debate. The clinical severity of secondary dengue virus (DENV) infections is associated with antibody-dependent enhancement (ADE), and it was recently suggested that previous exposure to DENV may worsen ZIKV clinical outcomes. In this Opinion article we analyze the relationship among different flaviviruses and ADE. We discuss new evidence obtained in non-human primates and human cohorts demonstrating that there is no correlation to ADE when ZIKV infection occurs in the presence of pre-existing DENV immunity. We propose a redefinition of ADE in the context of complex immunological flavivirus interactions to provide a more objective perspective when translating in vitro or in vivo observations into the clinical setting. Zika virus (ZIKV) caused atypical clinical manifestations in areas with previous exposure to other flaviruses.Different dengue-ZIKV cross-reacting antibodies neutralize or enhance ZIKV in vitro, but the percentage of dengue immune serum neutralizing ZIKV is very low.Antibody-dependent enhancement (ADE) of ZIKV by dengue and West Nile immune sera has been shown in vitro and induced in immunosuppressed mice by dengue and West Nile immune sera.No ADE of ZIKV by previous dengue immunity was detected in non-human primates.No ADE of ZIKV was documented in a human cohort previously exposed to dengue.ADE needs to be redefined in the context of clinical outcomes. In vitro and experimental results in small animals need to be carefully weighed when translating results to humans.Prospective epidemiological and clinical studies are needed to reassure that previous exposure to dengue or other flaviviruses does not increase the pathogenesis of ZIKV.

Original languageEnglish (US)
JournalTrends in Microbiology
DOIs
StateAccepted/In press - 2017

Fingerprint

Heterologous Immunity
Antibody-Dependent Enhancement
Flavivirus
Dengue
Viruses
Dengue Virus
Immune Sera
Primates
Immunity
Zika Virus
Virus Diseases
Epidemiologic Studies

Keywords

  • ADE
  • Dengue
  • Flavivirus
  • Zika

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

A Tale of Two Viruses : Does Heterologous Flavivirus Immunity Enhance Zika Disease? / Sariol, Carlos A.; Nogueira, Mauricio L.; Vasilakis, Nikos.

In: Trends in Microbiology, 2017.

Research output: Contribution to journalArticle

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