{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T18:42:31Z","timestamp":1744396951286,"version":"3.37.3"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T00:00:00Z","timestamp":1563148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"WBDST","award":["326(SANC)\/ST\/P\/S & T\/9G-22\/2015"],"award-info":[{"award-number":["326(SANC)\/ST\/P\/S & T\/9G-22\/2015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,17]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Global incidence of dengue has drastically increased in the last few years. Despite the global morbidity and mortality associated with dengue infection, mechanisms of immune control and viral pathogenesis are poorly explored. Pancytopenias, along with increased oxidative stress, are salient clinical findings in severe dengue patients. Previously, we demonstrated significant differences of circulating immune complexes (CICs) among severe and non-severe dengue patients. Accordingly, here we sought to determine the contributory role of affinity-purified antibody-bound CICs in dengue severity. To characterize intracellular oxidative stress induced by antibody-bound CICs, 5-(and-6)-chloromethyl-2\u2032-7\u2032-dichlorodihydrofluorescein diacetate (DCFDA) was measured by flow cytometry. At the same time, CICs sensitized healthy red blood cells (RBC) and patients\u2019 RBC morphology was determined by scanning electron microscopy and flow cytometry analysis. Erythrophagocytosis and ferritin levels were further determined in severe and non-severe dengue patients. Our results showed that the severe patients had high titres of immunoglobulin (Ig)M-bound CICs (P &amp;lt; 0\u00b70001) in their sera, increased intracellular oxidative stress (P &amp;lt; 0\u00b70001), high ferritin levels (P &amp;lt; 0\u00b70001), altered morphology of RBC and finally enhanced erythrophagocytosis. This study shows for the first time that RBC morphology is altered in severe dengue patients. Taken together, this study suggests that the enhanced IgM-bound CICs could contribute to the increased oxidative stress and act directly on RBC destruction of severe dengue patients, and is an important pathophysiological determinant. Hence, IgM-bound CICs can serve as an important laboratory parameter to monitor dengue infection progression.<\/jats:p>","DOI":"10.1111\/cei.13346","type":"journal-article","created":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T15:09:50Z","timestamp":1561993790000},"page":"251-260","source":"Crossref","is-referenced-by-count":5,"title":["High titres of IgM-bound circulating immune complexes and erythrocytic oxidative damage are indicators of dengue severity"],"prefix":"10.1093","volume":"198","author":[{"given":"G","family":"Patra","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1400-3715","authenticated-orcid":false,"given":"S","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,15]]},"reference":[{"key":"2022021406250948700_cei13346-bib-0001","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nature12060","article-title":"The global distribution and burden of dengue","volume":"496","author":"Bhatt","year":"2013","journal-title":"Nature"},{"key":"2022021406250948700_cei13346-bib-0002","first-page":"3","volume-title":"Dengue, guidelines for diagnosis, treatment, prevention and control new edition","author":"World Health Organization","year":"2009"},{"key":"2022021406250948700_cei13346-bib-0003","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1128\/CMR.11.3.480","article-title":"Dengue and dengue hemorrhagic fever","volume":"11","author":"Gubler","year":"1998","journal-title":"Clin Microbiol Rev"},{"key":"2022021406250948700_cei13346-bib-0004","first-page":"8","article-title":"Evaluation of diagnostic tests: dengue","author":"Peeling","year":"2010","journal-title":"Nat Rev Microbiol"},{"key":"2022021406250948700_cei13346-bib-0005","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1053\/jinf.2001.0802","article-title":"Dengue and other emerging flaviviruses","volume":"42","author":"Solomon","year":"2001","journal-title":"J Infect"},{"key":"2022021406250948700_cei13346-bib-0006","doi-asserted-by":"crossref","first-page":"4738","DOI":"10.1128\/JVI.73.6.4738-4747.1999","article-title":"Dengue virus structural differences that correlate with pathogenesis","volume":"73","author":"Leitmeyer","year":"1999","journal-title":"J Virol"},{"key":"2022021406250948700_cei13346-bib-0007","first-page":"29","volume-title":"Recent epidemiological trends, the global strategy and public health advances in dengue. 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