ELISA as a Key Diagnostic Tool in Dengue Vaccine and Drug Development

Dengue Vaccine Development

Several dengue vaccines have entered clinical application. The licensed dengue vaccine currently operates in multiple countries and regions and proves moderately effective in reducing disease incidence. The vaccine shows limitations that become apparent after initial infection and pose increased health risks for specific population groups. Ongoing research focuses on the development of vaccines that deliver improved safety alongside greater effectiveness in disease prevention. Researchers are working to produce mRNA-based vaccines for dengue with expectations of major advancements in the next few years.

The first quadrivalent live virus vaccine developed globally targets protection against all four different serotypes of dengue virus. The vaccine triggers a strong immune response yet poses a severe dengue threat for first-time vaccinated children who have never encountered the virus. Children who have already experienced dengue infection should receive this vaccine to minimize the chances of developing antibody-dependent enhancement (ADE).

Dengue Testing

The transmission of dengue virus continues to accelerate which makes precise testing results essential for the progress of vaccine and drug development.

1. Antibody Tests: Medical professionals use antibody testing as a diagnostic tool for dengue by identifying IgM and IgG antibodies. During the first 3 to 5 days after infection IgM antibodies emerge for acute diagnosis followed by IgG antibodies appearing at 2 weeks to show past infections.
2. Antigen Tests: NS1 antigen testing represents a novel diagnostic method for detecting the dengue-specific NS1 antigen shortly after infection begins (1 to 2 days post-infection). This method enables fast dengue diagnosis during the initial phase of infection.
3. Viral Nucleic Acid Testing (RT-PCR): Viral nucleic acid testing methods like RT-PCR function as essential tools for dengue confirmation especially when antibody tests fail or symptoms do not provide clear indications.
4. Antibody-Dependent Enhancement (ADE) Testing: During secondary infections antibodies target the same serotype as the initial infection but make symptoms worse for different serotypes. ADE testing remains uncommon but select experts employ serological techniques like ELISA to evaluate antibody levels and determine ADE risk.
5. Other Testing Methods: There are other biomarkers beyond serological tests which doctors can use to detect dengue.
   • Blood routine tests: Platelet count and white blood cell count undergo changes during dengue infection.
   • Liver function tests: Because dengue causes liver dysfunction doctors need to track ALT, AST, and additional markers to monitor how the disease develops.

Figure 1. Dengue virus, antigen and antibody responses used in diagnosis. (Source: Guzman M, et al., 2010)

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