Table 2 Metabolic changes flaviviruses infection occurring in vivo and in vitro in skin and blood as well as the central nervous system during infection

Pro-oxidants regulation

 Skin

↑ ROS

↑ ROS

No data so far

↑ ROS, MDA

No data so far

 Blood

N/A

↑ ROS, MDA

↑ XO, ROS, 4HNE, 8-isoPGF2α

N/A

N/A

 OUN

N/A

↑ ROS

N/A

N/A

↑ ROS, MDA

Antioxidants regulation

 Skin

↑ GSH

↓ Nrf2

↓ Nrf2

N/A

↓SOD, CAT, Nrf2, GSH, HO-1

N/A

 Blood

N/A

↓ GSH, SOD, CAT

↑ Nrf2

↓ GSH

N/A

N/A

 OUN

N/A

N/A

N/A

N/A

↑ SOD

↓CAT, GSH

Inflammation

 Skin

↑TNF-α, NFκB, IL-6, IFN-β

↓IL-10

↑ TNF-α, IL-6, IL-1β, IL-10

chemokines, ↓ IFN-γ, IL-12

N/A

↑ TNF-α, NF-κB, IL-6, IL-1β, chemokines

↓ IL-10

↑ TNF-α, IFN-β, IL-6

 Blood

N/A

↑ TNF-α, NF-κB,IL-6

↑ TNF-α, NF-κB

N/A

N/A

 OUN

↑TNF-α,IL-6, chemokines

↑ IL-6, IL-8, CCL5

↑TNF-α, IFN-γ, IFN-α, IL-6, IL-8, IL-1β, chemokines

↓IL-10

↑TNF-α,

IL-6,

IL-1β

↑ TNF-α, NF-κB, IFN-γ,IL-6,IL-1β, chemokines

↓ IL-10

Medical consequences of disease

 Skin

Rash without pruritus shit on the trunk and lower limbs

“white islands in a sea of red”

N/A

Itchy maculopapular rash

N/A

 Blood

Thrombocytopenia

- ↑ Hematocrit

- Thrombocytopenia

- Leukopenia

- ↑ ALT/AST

N/A

- Thrombocytopaenia

- Leukopenia

- Lymphocytosis

- Monocytosis

- ↑ALT/AST/LDH

- Thrombocytopenia

- Leukopenia

- Hyponatremia

- ↑ ALT/AST

 OUN

- Meningitis,

- Encephalitis and/or myelitis

Encephalitis

- Meningitis,

- Encephalitis

- Cerebellitis

- Myelitis

- Microcephaly with underdevelopment of the cerebrum

- Psychomotor disorders

- Spastic hemiplegia

- Encephalitis with disturbance of consciousness

- Generalized seizures

- Aseptic meningitis

- Acute psychosis