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Defining dengue virus infection in human skin

Duangkhae, Parichat (2018) Defining dengue virus infection in human skin. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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The skin is the primary site of dengue virus (DENV) replication following the bite of an infected mosquito, but the factors that contribute to productive infection in human skin and virus spread out of skin are not understood. We defined the dynamics of DENV infection in human skin explants using quantitative in situ imaging. A transient interferon-α response occurred prior to detectable virus replication, which initially established in cells in the epidermis. DENV infected a wide variety of cell types including Langerhans cells (LC), dermal macrophages (Mϕ), dermal dendritic cells (DC), fibroblasts, mast cells, and lymphatic endothelium, but keratinocytes were the earliest and quantitatively most important target of DENV infection, contributing to 60% of overall infected skin cell over time. DENV infection led to the recruitment and infection of LC, dermal DC, and dermal Mϕ. These immune cells emigrated out of the skin in increased number as a result of infection, presumably leading to dissemination of virus. Infection of keratinocytes led to the abundant production of inflammatory mediators, most significantly IL-1β. Blocking keratinocyte-derived IL-1β reduced the infection of LC, dermal DC, and dermal Mϕ by 75-90% and decreased the total number of infected cells in epidermis and dermis by 33% and 65%, respectively. In the first demonstration of antibody-dependent enhancement of DENV infection in human skin, we showed that the presence of heterotypic DENV-immune serum enhanced the recruitment and infection of dermal Mϕ by 50-70%, and increased emigration of myeloid cells out of skin. Aedes aegypti mosquito salivary gland extract did not impact dermal Mϕ recruitment or infection with DENV, with or without immune serum. Blocking FcγRIa and FcγRIIa inhibited antibody-mediated infection of dermal Mϕ, and decreased the number of cell emigrants, resulting in reduction of the overall number of infected cells in the dermis by 70%, without notable changes in the epidermis. Ethnic differences in skin immune responses to DENV were observed for the first time in our study. In comparison with skin from Caucasians donors, skin from African American donors maintained robust antiviral IFN-α responses for at least 48 hours. This was observed in association with less DENV replication, a reduced production of IL-1β in the epidermis, less recruitment and infection of LC and dermal Mϕ, and less cell emigration out of the skin. These findings suggest that innate immune responses in skin control DENV replication and spread, and equates with epidemiologic data that African ancestry protects against severe dengue. Our findings highlight the importance of skin and the complex interplay between resident and immune skin cell populations in DENV infection and dengue pathogenesis. Defining DENV infection in human skin therefore has considerable public health significance because these data will provide a rationale for exploration of therapeutic strategies through targeting the mechanism DENV exploits skin microenvironment and preventing the risk of systemic infection as well as severe dengue.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Duangkhae, Parichatpad54@pitt.edupad540000-0001-6931-417X
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBarratt-Boyes,
Committee MemberWatkins,
Committee MemberLarregina,
Committee MemberMarques,
Date: 28 June 2018
Date Type: Publication
Defense Date: 3 April 2018
Approval Date: 28 June 2018
Submission Date: 24 March 2018
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 214
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Dengue virus, keratinocytes, myeloid cells, human skin, infection
Date Deposited: 28 Jun 2018 20:32
Last Modified: 01 May 2020 05:15


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