The rise of Zika virus (ZIKV) and its unusual clinical manifestations provided ground for speculative debate. The clinical severity of secondary dengue virus (DENV) infections is associated with antibody-dependent enhancement (ADE), and it was recently suggested that previous exposure to DENV may worsen ZIKV clinical outcomes. In this Opinion article we analyze the relationship among different flaviviruses and ADE. We discuss new evidence obtained in non-human primates and human cohorts demonstrating that there is no correlation to ADE when ZIKV infection occurs in the presence of pre-existing DENV immunity. We propose a redefinition of ADE in the context of complex immunological flavivirus interactions to provide a more objective perspective when translating in vitro or in vivo observations into the clinical setting.

中文翻译：

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两种病毒的故事：异源黄病毒免疫是否会增强寨卡病？

寨卡病毒（ZIKV）的兴起及其异常的临床表现为投机性辩论奠定了基础。继发登革热病毒（DENV）感染的临床严重程度与抗体依赖性增强（ADE）有关，最近有人提出，以前接触DENV可能会使ZIKV的临床结果恶化。在这篇观点文章中，我们分析了不同的黄病毒和ADE之间的关系。我们讨论了在非人类灵长类动物和人类队列中获得的新证据，这些证据表明，在已有DENV免疫力的情况下发生ZIKV感染时，ADE与ADE没有相关性。我们建议在复杂的免疫性黄病毒相互作用的背景下重新定义ADE，以便在将体内或体外观察结果转化为临床情况时提供更客观的观点。