Dengue is a mosquito-transmitted infection endemic in tropical and subtropical locations of the world
where nearly half of the world’s population resides. The disease may present as mild febrile illness to
severe and can even be fatal if untreated. There are four genetically related but antigenically distinct
dengue virus (DENV) serotypes. Immune responses to DENV infection are in general protective but
under certain conditions, they can also aggravate the disease. The importance of the cellular immune
responses and the antibody responses involving IgG and IgM has been well-studied. In contrast, not
much has been described on the potential role of hypersensitivity reactions involving IgE in dengue.
Several studies have shown elevated levels of IgE in patients with dengue fever, but its involvement
in the immune response against the virus and disease is unknown. Activation of mast cells (MCs) and
basophils mediated through dengue-specific IgE could result in the release of mediators affecting dengue
virus infection. The present review explores the relationships between the induction of IgE in dengue
virus infection, and the potential role of MCs and basophils, exploring both protective and pathogenic
aspects, including antibody-dependent enhancement (ADE) of infection in dengue.