Journal
SCIENCE
Volume 372, Issue 6546, Pages 1102-+Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.abc7303
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Funding
- Howard Hughes Medical Institute (HHMI)-Wellcome Trust [208710/Z/17/Z]
- National Institute of Allergy and Infectious Diseases (NIAID) [R01AI137276, U19AI111825]
- Rockefeller University
- EU Seventh Framework Programme (FP7/20072011)
- NHLBI [HHSN268201100001I]
- Roche Molecular Systems, Inc.
- Department of Health and Human Services, Biomedical Advanced Research and Development Authority [HHSO100201600010C]
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Antibodies against dengue virus can enhance disease susceptibility instead of providing protection. The fucosylation status of IgG1 plays a key role in predicting dengue disease severity, while antibody titers and neutralizing activity do not correlate with disease severity. Thus, IgG1 fucosylation status can serve as a robust prognostic tool for dengue disease.
Although antiviral antibodies generally confer protective functions, antibodies against dengue virus (DENV) are associated with enhanced disease susceptibility. Antibodies can mediate DENV infection of leukocytes via Fcg receptors, likely contributing to dengue disease pathogenesis. To determine if this mechanism accounts for variable disease severity, we examined Fab and Fc structures of anti-DENV antibodies from patients before and after infection and with variable disease outcomes. Neither antibody titers nor neutralizing activity correlated with disease severity in DENV-infected populations. Rather, DENV infection induced a specific increase in immunoglobulin G1 (IgG1) afucosylation, and the levels of afucosylated IgG1 were predictive of dengue disease severity. Thus, the IgG1 fucosylation status represents a robust prognostic tool for dengue disease, highlighting the key role of the Fc glycan structure in dengue pathogenesis.
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