Immunologic Crosstalk and Host-Specific Immune Signature Associated with Dengue.

In tropical and subtropical regions, dengue fever is a common febrile illness that is mostly spread by Aedes mosquitoes. Urban population migration, inadequate water storage facilities, and high mosquito density are features associated with this disease. The severity of the illness ranges from mild to deadly dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), often with severe cases causing profound shock from extensive plasma leakage, and may result in demise. The symptoms of the illness include headache, myalgia, retro-orbital pain, and hemorrhagic signs. There may also be an intermittent shift in blood vessel integrity and coagulation, but recovery is typically complete and rapid. In this review, we emphasize the immunological aspects of this illness. The intricate interactions among the virus, host genes, and host immune systems impact the pathophysiology of dengue. Postinfection antibody-dependent enhancement is prominent, which significantly influences the etiology and virulence of the disease. Whereas the severe form only manifests when the host immune system is actively working to eradicate the infection by secreting several inflammatory cytokines, chemokines, and lipid mediators, for example, early dengue virus infection (DVI) resulted in the production of Interleukin 2 (IL-2), IL-6, and later infection, IL-4, IL-5, and IL-10. Higher concentrations of interferons gamma (IFN-gamma), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage migration inhibitory factor (MIF), IL-1, IL-2, IL-4, IL-6, IL-7, IL-10, IL-12, and IL-13 were found in DHF patients. These are significantly more prevalent in severe infections than in mild ones. Numerous immunopathogenic processes involving both virus and host variables influence the severity of dengue. There is growing evidence that a compromised immune system limits viral clearance and causes severe inflammation, which in turn causes dengue hemorrhagic fever and dengue shock syndrome. Furthermore, the capacity of DENV to infect a broad range of immune cells, such as macrophages, dendritic cells, mast cells, T and B cells, and monocytes, further dysregulates these cells' antiviral activities, leading to the spread of the virus. Even though a number of risk factors linked to the advancement of the disease have been suggested, further research and evaluation of novel technologies are necessary to understand the complicated etiology and develop reliable and effective vaccines to fight against this febrile illness.

Study of Hepatic Dysfunction Associated with Dengue Epidemiology in a Tertiary Care Hospital, Kolkata.

Dengue is a common arthropod-borne life-threatening febrile illness. This disease affects liver functions with an imbalance of liver enzymes followed by other clinical manifestations. The dengue serotypes can cause asymptomatic infection to more severe versions of hemorrhagic fever and dengue shock syndrome in West Bengal and around the globe. The main aim of this study is to establish how different liver enzymes act in identifying markers for dengue prognosis for the early detection of severe dengue fever (DF). The diagnosis of dengue patients was confirmed by enzyme-linked immunosorbent assay, and associated clinical parameters [aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase, total bilirubin, total albumin, total protein, packed cell volume, and platelet count] were analyzed. Furthermore, the viral load estimation was also carried out by RT PCR analysis. The majority of these patients had elevated AST and ALT levels; ALT levels were higher than AST levels, which were partially observed in all non-structural protein 1 antigen- and dengue immunoglobulin M antibody-reactive patients. Almost 25% of patients had very low platelet count or thrombocytopenia. Furthermore, the viral load shows a significant association with all the clinical parameters with a p-value of <0.0001. All these liver enzymes are significantly correlated with an increased level of T.BIL, ALT, and AST. This study depicts that the intensity of hepatic involvement may play a critical role in the morbidity and mortality of DF patients. As a result, all of these liver parameters can be useful early markers for determining the severity of the disease, allowing for early detection of high-risk cases.

Entomophthoromycosis in South Bengal (Eastern India): a 9 years study.

Subcutaneous mycoses caused by the family Entomophthoraceae is very rare type of disease and is being reported sporadically from various Tropical countries including India. Here we report 8 cases of rhinoentomophthoromycosis caused by Conidiobolous coronatus and 7 cases of chronic subcutaneous phycomycosis caused by Basidiobolus ranarum. Cases were detected during a span of 9 years between 1991 to 1999, from 9 districts in and around Kolkata (Eastern India). Former type of lesions were detected among 20 to 65 age group of healthy individuals, predominantly males (7:1). In the latter type, male-female ratio was 2:5, and except for one all cases belonged to below 20 years age group of healthy individuals. Several cases were detected only after examination of repeat biopsy samples. With high degree of clinical suspicion, right approach is needed for laboratory confirmation of diagnosis.