Severe dengue evolution in obesity: Possible role of angiotensin II

Introduction Obesity is a risk factor for infections and severe comorbidities. Patients with obesity infected with dengue virus (DENV) may have a severe course of the disease. This is attributed to several factors, including immunomodulation, endothelial damage, production of pro-inflammatory cytokines, and cellular accumulation of lipids, factors that promote viral replication. Angiotensin II (Ang II) has been linked to obesity and DENV biology, but its role in dengue severity in patients with obesity remains understudied. Method The literature was searched in databases by using the search engines (PubMed, SCOPUS, Web of Sciences, Science Direct, and Google Scholar) Conclusions This review highlights factors present in obesity such as the intracellular lipid droplets, proteins such as MIF (macrophage migration inhibitory factor), and furin (important in DENV replication), presence of chymase (linked to Ang II synthesis), caveolin-1 (related to obesity, dengue, and Ang II) and the different entry receptors of DENV as factors involved in the possible action of Ang II in patients with obesity and dengue. Pro-inflammatory actions of Ang II can increase the inflammatory effects of DENV and the obesity associated chronic inflammatory state, and may be contributing to explain in part the severe progression of dengue in individuals with obesity.