ArticlePLoS neglected tropical diseases2025
Engineered Nanobodies for early and accurate diagnosis of dengue virus infection.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDengue virus (DENV), a mosquito-borne flavivirus responsible for dengue disease, has emerged as an escalating global health concern, with cases increasing sharply in recent decades. In Argentina, dengue has transitioned from a sporadic disease to a recurrent epidemic, now affecting 18 of 23 provinces and exposing gaps in diagnostic capacity. METHODOLOGY AND PRINCIPAL
findingsThe DENV genome encodes the non-structural protein 1 (NS1), a key biomarker for early infection detection. Given the limited access to commercially available diagnostic kits within the public health system, we developed a combined ELISA system incorporating Nanobodies designed to target NS1 across all four DENV serotypes as detection antibodies. This system demonstrates excellent discriminative performance (AUC > 0.9), with a diagnostic sensitivity of 93.6% (95% CI: 86.6-97.6%) and a specificity of 81.1% (95% CI: 70.3-89.3%). The analytical sensitivity showed strong correlation between sera pool dilutions and detected signals, with a limit of detection aligning with reported NS1 concentrations in human samples. While the system exhibits limitations in detecting NS1 from DENV-4, it successfully identified cases in patients five days post-symptom onset who were initially considered epidemiologically negative for dengue infection. SIGNIFICANCE: Our results underscore the urgent need for accessible, high-precision diagnostic tools in regions facing a surge in dengue outbreaks. Additionally, they highlight the necessity of revising current diagnostic algorithms to enhance the detection of late-presenting cases.
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