Table 2.

 Various mechanisms proposed for immunopathogenesis of DHF

Group	Mechanism	Effects	References *
Antibody	Enhancement of infection	Increased cellular infection and viral load	Halstead (1989, 2007)
	Immune complex	Complement activation	Theofilopoulos et al. (1976), Malasit (1987)
	Cross‐reactivity with endothelial cell and coagulation proteins	Bleeding	Chungue et al. (1994), Markoff et al. (1991), Falconar (1997)
	Cross‐reactivity with endothelial cell and NS1 protein	Apoptosis, inflammatory activation	Lin et al. (2005)
T lymphocytes	Suppressor T cells	Prevention of DHF, increased pathology	Chaturvedi et al. (2007)
	Memory T cell	Increased pathology	Mongkolsapaya et al. (2006)
	Shift from Th1 to Th2	Increased pathology	Chaturvedi et al. (2000)
	Cytokine Tsunami	Increased capillary permeability	Chaturvedi et al. (1999, 2000, 2001)
	Bystander cell lysis	Liver injury	Gagnon et al. (1999)
Macrophage and dendritic cells	Cytokine tsunami	Increased capillary permeability	Chaturvedi et al. (2006a)
	Free radicals: NO, O2 –, etc.	Increased capillary permeability	Chaturvedi et al. (2006a)
	Metalloprotein	Increased capillary permeability	Luplertlop et al. (2006)
Vascular endothelial cells (mainly in vitro work)	eNOS, NO	Increased capillary permeability	Yuan (2006)
	Endothelin etc.	Increased capillary permeability	Jiang et al. (1999)
	IL‐8, IL‐6	Increased capillary permeability	1998, 2000
	Decreased soluble vascular endothelial growth receptor 2	Increased capillary permeability	Srikiatkhachorn et al. (2007)
Virus virulence	Asian genotype	Increased transmissibility and cellular infection.	Leitmeyer et al. (1999), Rico‐Hesse (2003)
		Selection of virulent strains in humans and mosquitoes.	Cologna et al. (2005)
	American genotype	Do not produce DHF/DSS	Watts et al. (1999)
Host genetics	Polymorphism of genes	Increased or decreased predisposition for DHF	Chaturvedi et al. (2006b)

^* Mainly review papers, to save space.