Figure 9. Positive association between IgG4 induction and dengue severity in humans.

(A) A heatmap representing the DENV-specific IgG3 and IgG4 levels in pediatric dengue patients with secondary DENV infections. Patients diagnosed with DHF are indicated by an X to the right of the heatmap. (B) IgG4 and (C) IgG3 endpoint titers in the serum of secondary dengue patients who were diagnosed with DF or DHF, measured in the serum isolated on days 6 to 7 after fever onset. (D) Ratio of DENV-specific IgG4 to IgG3. For panels B–D, endpoint values were compared between groups by Student’s unpaired t test. ****P < 0.001. For all panels, n = 26 (DF) and n = 22 (DHF) patients.