Quantitative and qualitative differences in anti-Envelope IgG-secreting cells distinguish subclinical and hospitalized dengue in a Cambodian pediatric cohort.

Hospitalized dengue patients produce fewer high-affinity, broadly reactive IgG-secreting cells compared to subclinical cases, with a threefold reduction in affinity for DENV1 E-dimers.

• Why it matters: Understanding the immune features that differentiate mild from severe dengue is crucial for developing effective vaccines and therapies, yet these antibody responses are not well characterized at the single-cell level.
• What they did: The study analyzed over 3,300 single IgG-secreting cells from Cambodian children with either subclinical or hospitalized dengue, measuring antibody affinity, cross-reactivity, and epitope recognition using droplet-based microfluidic imaging.
• The result: Findings reveal that severe dengue correlates with fewer IgG-secreting cells, lower antibody affinity, and a predominance of monomer-reactive antibodies, highlighting the importance of high-affinity, quaternary epitope-specific responses for protection.