Expert Reviews in Molecular Medicine

Review Article

Molecular mechanisms of antibody-mediated neutralisation of flavivirus infection

Theodore C. Piersona1 c1 and Michael S. Diamonda2

a1 Viral Pathogenesis Section, Laboratory of Viral Diseases, NIAID, NIH, Bethesda, MD 20892, USA.

a2 Departments of Medicine, Molecular Microbiology, and Pathology & Immunology, Washington University School of Medicine, St Louis, MO 63110, USA.


Flaviviruses are a group of positive-stranded RNA viruses that cause a spectrum of severe illnesses globally in more than 50 million individuals each year. While effective vaccines exist for three members of this group (yellow fever, Japanese encephalitis, and tick-borne encephalitis viruses), safe and effective vaccines for several other flaviviruses of clinical importance, including West Nile and dengue viruses, remain in development. An effective humoral immune response is critical for protection against flaviviruses and an essential goal of vaccine development. The effectiveness of virus-specific antibodies in vivo reflects their capacity to inhibit virus entry and spread through several mechanisms, including the direct neutralisation of virus infection. Recent advances in our understanding of the structural biology of flaviviruses, coupled with the use of small-animal models of flavivirus infection, have promoted significant advances in our appreciation of the factors that govern antibody recognition and inhibition of flaviviruses in vitro and in vivo. In this review, we discuss the properties that define the potency of neutralising antibodies and the molecular mechanisms by which they inhibit virus infection. How recent advances in this area have the potential to improve the development of safe and effective vaccines and immunotherapeutics is also addressed.


c1 Corresponding author: Theodore C. Pierson, Laboratory of Viral Diseases, NIAID, NIH, 33 North Drive, Room 1E19A.2, Bethesda, MD 20814, USA. Tel: +1 301 451 7977; Fax: 1 301 451 7978; E-mail: