Abstract
Dengue virus (DENV) infection in children exhibits varied clinical presentations, wherein the role of monocytes is important in the innate immune response. In this study, laboratory-confirmed DENV pediatric patients (n = 120), with DENV-2 infection, were categorized into dengue fever (DF), dengue with warning signs (DWS) and severe dengue (SD) were assessed for monocyte subpopulation analysis using immunophenotyping involving CD14 and CD16 host-surface markers. Molecular docking was performed using HADDOCK 2.4 to analyze the interactions between CD14, CD16 and DENV envelope and capsid proteins. Among the cases, 84 (70%) were classified as DF and 36 (30%) as DWS & SD. Hematological and biochemical parameters indicated that thrombocytopenia and elevated hematocrit (> 40%) were significantly more common in DWS & SD, with markedly elevated liver enzymes (ALT and AST) in severe cases. Classical monocytes (CM-CD14++ CD16-) constituted 72.51% and 66.25% of the monocyte population in DF and DWS & SD cases, respectively. Intermediate monocytes (IM-CD14+ CD16+) comprised 9.89% and 30.86% in DF and DWS & SD cases, respectively. Non-classical monocytes (NCM-CD14+ CD16++) comprised 5.75% and 8.12% in DWS & SD and DF cases, respectively. In silico analysis revealed host CD16 and CD14 exhibited potential interactions with DENV capsid and envelope proteins, with binding energies - 8.9, - 10.1, - 8.6, and - 11.1 kcal/mol, respectively. IM was significantly increased in DWS & SD compared to DF (p < 0.05). These findings suggest that IM could act as host markers of DENV severity in children.