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The development of a dengue vaccine presents numerous challenges, largely due to the complexity of the virus and the human immune response. One of the primary hurdles is Antibody-Dependent Enhancement (ADE), where antibodies from a previous dengue infection can facilitate a more severe secondary infection with a different serotype, exacerbating the disease. Cross-reactivity with other flaviviruses, such as Zika, complicates the immune response further. Additionally, the vaccine must elicit a balanced immune response against all four dengue serotypes, which is difficult to achieve. The role of T follicular helper (TFH) cells in enhancing vaccine efficacy has emerged as a critical area of focus. Efficiently targeting and inducing TFH cells through specific adjuvants could enhance neutralizing antibody production and long-lasting immunity, addressing some of the current vaccine limitations. Despite these challenges, ongoing research and trials continue to advance the field towards a more effective dengue vaccine.
Mannan et al. (Mon,) studied this question.