# Project 2:  Dengue infection and vaccination enhancement of ZIKV in pregnancy

> **NIH NIH P01** · UNIVERSITY OF WISCONSIN-MADISON · 2021 · $69,693

## Abstract

Project 2 - Project Summary/Abstract 
The project goal is to understand the impact of pre-existing dengue virus immunity (both wildtype- and 
vaccine-derived) on subsequent Zika virus (ZIKV) infection during pregnancy. Understanding the re- 
lationship between dengue immunity on subsequent ZIKV infection is important because it has been 
hypothesized that the unexpectedly high rate of adverse consequences associated with ZIKV infection 
during pregnancy may be the result of previous infection with one of the four serotypes of dengue virus 
(DENV). Primary infection with one of the four DENV serotypes is protective against secondary infection 
with the same serotype. Secondary infection with a different serotype can lead to enhanced disease 
due to cross-reactive antibodies facilitating enhanced viral replication and skewed immune responses. 
DENV and ZIKV are similar enough in the envelope protein (the major target of these enhancing antibod- 
ies) that ZIKV could theoretically function as a “fifth” DENV serotype. This has been explored to some 
degree but the reports have been controversial with some groups reporting cross-protection, while 
others have reported the potential for enhanced disease. Critically, this has not been explored in the 
setting of pregnancy. Accordingly, through this NIH/NIAD P01 we will use our nonhuman primate model 
of ZIKV infection to evaluate whether the severity of maternal and fetal ZIKV infection during pregnancy 
are enhanced by previous exposure to DENV. There are two Specific Aims: 
 Specific Aim 1. Define the impact of prior DENV infection on the severity of maternal and neonatal 
 ZIKV infection in pregnant macaques. 
 Specific Aim 2. Define the impact of prior DENV vaccination on the severity of maternal and neonatal 
 ZIKV infection in pregnant macaques. 
In these studies, we will contrast maternal viremia, immune responses, and fetal outcomes with those in 
DENV-naive individuals infected identically with ZIKV in Project 1. Our strategy to induce DENV-specific 
immune responses includes exposure to both wildtype DENV and a leading DENV vaccine candidate- 
Sanofi Pasteur’s Dengvaxia®. These studies are critically important because 1) ZIKV is circulating in 
many locations where DENV is hyperendemic and 2) dengue vaccines currently are licensed for use or 
licensure is imminent in areas where ZIKV is circulating. Vaccination creates a scenario whereby a naive 
population will become DENV-immune. Whether individuals immunized with Dengvaxia®—where an 
individual is simultaneously exposed to all four DENV serotypes—can lead to more severe ZIKV disease 
is unknown. The results from these experiments will provide important answers to an epidemiologically 
relevant question; is it safe to vaccinate against dengue where ZIKV also is co-endemic?

## Key facts

- **NIH application ID:** 10220703
- **Project number:** 5P01AI132132-04
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Matthew T Aliota
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $69,693
- **Award type:** 5
- **Project period:** 2018-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10220703

## Citation

> US National Institutes of Health, RePORTER application 10220703, Project 2:  Dengue infection and vaccination enhancement of ZIKV in pregnancy (5P01AI132132-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10220703. Licensed CC0.

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