Abstract
Dengue virus (DV) is an important re‐emerging arthropod‐borne virus of global significance. The defining characteristic of DV infection‐associated pathology is haemorrhagic fever, which often leads to a fatal shock‐like syndrome (DHF/DSS) owing to an increase in vascular endothelial permeability. Here, we show, in a viral dose‐dependent manner, that DV‐infected immature dendritic cells overproduce soluble gelatinolytic matrix metalloproteinase (MMP)‐9—and to a lesser extent MMP‐2—which enhances endothelial permeability, but which are reduced by specific inhibitors and a neutralizing anti‐MMP‐9 antibody. This permeability was associated with a loss of expression of the platelet endothelial adhesion molecule 1 (PECAM‐1) and vascular endothelium (VE)‐cadherin cell adhesion molecules and redistribution of F‐actin fibres. These in vitro observations were confirmed in an in vivo vascular‐leakage mouse model. These results provide a molecular basis for DHF/DSS that could be a basis for a general model of haemorrhagic fever‐inducing viruses, and identify a new therapeutic approach for the treatment of viral‐induced vascular leakage by specifically targeting gelatinolytic metalloproteases.