Dengue is caused by a flavivirus that has four unique serotypes, DENV-1, DENV-2, DENV-3, and DENV-4.Dengue hemorrhagic fever (HDF)/dengue shock syndrome (DSS), a more serious clinical variant of dengue infection was initially identified in the Philippines in 1954 before spreading to rest the of Southeast Asia1.According to WHO estimates, every year 390 million dengue virus infections occur and among these, 96 million show clinical symptoms. Even though infection is a concern in more than 100 nations, 70% of the burden occurs in Asia.11As of April 30, 2024, more than 7.6 million dengue cases have been reported to WHO this year, including 3.4 million confirmed cases, over 16,000 severe cases, and more than 3,000 deaths12.India had the highest number of cases, with roughly 33 million evident and the occurrence of 100 million asymptomatic cases every year13.
One of the most common assays used for the diagnosis of DENV is ELISA5.However,the commercial kits are costly and the expiry date will be short14.During the acute stage of dengue infection, diagnosis using the virus isolation method by animal models or cell culture is time-consuming and requires skilful personnel to handle15. Early dengue infection at febrile stages can be detected by reverse transcription-polymerase chain reaction,but it is an expensive procedure16.Since in the infected patient’s sera,a high level of NS1 antigen issecreted, it is being widely used as a promising diagnostic marker. Dengue NS1 antigen has been used in several types of polyclonal or monoclonal antibody-based immunoassays17–21.At the early stage of infection, NS1is detectable from zero days onwards and achieves peak by the fourth day. Later on, IgM starts appearing in the blood from the third day to the ninth day of infection but its presence does not affect detection of antigen5.
Polyclonal antibodies are a collection of immunoglobulin molecules released in response to a specific antigen; each antibody identifies a unique epitope. As a result, polyclonal antibodies are an assortment of different antibodies. Every kind of antibody in the combination is produced by a particular clone of plasma B cells. As a result, several plasma B cell clones are involved in the synthesis of polyclonal antibodies. The process of producing polyclonal antibodies also begins with immunization/natural infection. A specific antigen can immunize an animal. Numerous epitopes may be present in this antigen. Each of the epitopes on the injected antigen is targeted by a unique antibody that the immune system makes. Directly from the animal's serum, polyclonal antibodies can be obtained22. Polyclonal antibodies have been explored for a variety of general research applications and diagnostic procedures as they exhibit high affinity for the target antigen and tolerance for slight changes in the target protein(https://www.creative-diagnostics.com/polyclonal-vs-monoclonal-antibodies.htm).Considering these applications, the polyclonal antibodies generated against recombinant dengue NS1 antigen from rabbits were evaluated in the present study.
On comparing the animals for antibody responses, Animal 1 displayed higher OD at 500 ng rDNS1Ag concentration. The absorbance level gradually decreased from 6 at 1:10 to 2.5 at 1:10000 dilutions. A similar study with rabbit polyclonal and monoclonal antibodies tested by Young et al.,23showed the optimum dilution of 1:1500 for the absorbance. Further, the RPAD was tested by Western blotting which showed it as highly specific for detection of rDNS1Ag. We also purified the IgG using a commercial polyclonal antibody purification kit. The SDS-PAGE analysis of protein fractions showed two distinct protein bands at 25 kDa and 50 kDa corresponding to the IgG.
The sensitivity of RPAD for the detection of NS1 antigens of all the serotypes of DENV was carried out. It was observed that Animal-1 exhibited higher absorbance (OD ≥ 1) for Dengue serotypes 1, 2 and 3. In a similar study, with the polyclonal antibodies, as low as 1 ng per ml of NS1 protein of DENV-1 serotypes was detected in the dengue patients. However, the antibodies were not sensitive to detect NS1 of other serotypes of DENV as the assay was no less than 10 times lower for serotypes other than DENV-15. Since the polyclonal antibodies were purified against the NS1 antigen of the DENV-1 serotype, they were less sensitive to detect the NS1 antigen of other serotypes. On the contrary, we observed that RPAD displayed lower absorbance values for serotype 4 only. Further, to test the specificity of RPAD, for detection of recombinant NS1 antigens of only rDS1Ag, NS1 antigens of flaviviruses were tested. It was observed that none of the animals exhibited absorbance against the NS1 antigens of flavivirus indicating that RPAD is specific towards dengue only. We also compared the RPAD with commercial anti-DNS1 antibodies for the detection of rDNS1Ag. It was observedthat RPAD (as a secondary antibody)displayed almost similar antibody responses to that of anti-DNS1Ab. However, at 1 ng RPAD coating, RPAD displayed higher antibody responses as compared to anti-DNS1Ab. It is interesting to note that these observations were at 1:5000 dilutions of RPAD which is two-fold higher than the anti-DNS1Ab (i.e., 1: 2500).
Overall, using the RPAD, an in-house assay to detect recombinant dengue NS1 antigen is developed. Our preliminary study suggests that RPAD-ELISA may be further explored todiagnose dengue virus infection in humans as well as mosquito samples after laboratory confirmation. However, laboratory experiments require facilities such as insecticide biosafety level laboratories, culture and maintenance of dengue viruses and approval of the biosafety committee.