Acute Systemic Infection with Dengue Virus Leads to Vascular Leakage and Death through Tumor Necrosis Factor-α and Tie2/Angiopoietin Signaling in Mice Lacking Type I and II Interferon Receptors

PLoS One. 2016 Feb 4;11(2):e0148564. doi: 10.1371/journal.pone.0148564. eCollection 2016.

Abstract

Severe dengue is caused by host responses to viral infection, but the pathogenesis remains unknown. This is, in part, due to the lack of suitable animal models. Here, we report a non-mouse-adapted low-passage DENV-3 clinical isolate, DV3P12/08, derived from recently infected patients. DV3P12/08 caused a lethal systemic infection in type I and II IFN receptor KO mice (IFN-α/β/γR KO mice), which have the C57/BL6 background. Infection with DV3P12/08 induced a cytokine storm, resulting in severe vascular leakage (mainly in the liver, kidney and intestine) and organ damage, leading to extensive hemorrhage and rapid death. DV3P12/08 infection triggered the release of large amounts of TNF-α, IL-6, and MCP-1. Treatment with a neutralizing anti-TNF-α antibody (Ab) extended survival and reduced liver damage without affecting virus production. Anti-IL-6 neutralizing Ab partly prolonged mouse survival. The anti-TNF-α Ab suppressed IL-6, MCP-1, and IFN-γ levels, suggesting that the severe response to infection was triggered by TNF-α. High levels of TNF-α mRNA were expressed in the liver and kidneys, but not in the small intestine, of infected mice. Conversely, high levels of IL-6 mRNA were expressed in the intestine. Importantly, treatment with Angiopoietin-1, which is known to stabilize blood vessels, prolonged the survival of DV3P12/08-infected mice. Taken together, the results suggest that an increased level of TNF-α together with concomitant upregulation of Tie2/Angiopoietin signaling have critical roles in severe dengue infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Angiopoietins / metabolism*
  • Angiopoietins / pharmacology
  • Animals
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Neutralizing / pharmacology
  • Biomarkers
  • Capillary Permeability*
  • Cytokines / blood
  • Cytokines / genetics
  • Cytokines / metabolism
  • Dengue / genetics*
  • Dengue / metabolism*
  • Dengue / mortality
  • Dengue / virology
  • Dengue Virus*
  • Disease Models, Animal
  • Gene Expression
  • Inflammation Mediators / blood
  • Inflammation Mediators / metabolism
  • Liver / metabolism
  • Liver / pathology
  • Liver Function Tests
  • Mice
  • Mice, Knockout
  • Receptor, TIE-2 / metabolism*
  • Receptors, Interferon / deficiency*
  • Signal Transduction*
  • Thrombocytopenia / etiology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism*
  • Viral Load

Substances

  • Angiopoietins
  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Biomarkers
  • Cytokines
  • Inflammation Mediators
  • Receptors, Interferon
  • Tumor Necrosis Factor-alpha
  • Receptor, TIE-2

Grants and funding

This work was supported by: 1. A grant-in-aid (21790444 and 15K14885) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan for supporting reagents, preparation of the manuscript. 2. A program of the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) (http://www.crnid.riken.jp/jgrid/) launched by a project commissioned by the MEXT for supporting reagents, preparation of the manuscript.