Katzelnick LC, Gresh L, Halloran ME, et al. Antibody-dependent enhancement of severe dengue disease in humans. Science. 2017;358(6365):929-932.
In this cohort study consisting of a study population of 8002 Nicaraguan children, Katzelnick et al. observed that a certain, narrow range of antibody concentrations can lead to enhancement of dengue versus low levels of antibodies which do not enhance disease and high antibody levels which confer protection. The authors note that these findings have implications for development of vaccines against flaviviruses; furthermore, the authors raise the importance of developing serological assays which have the capability to distinguish protective and enhancing antibodies. https://www.science.org/doi/full/10.1126/science.aan6836