Dengue, transmitted by Aedes mosquitoes, can progress to severe symptoms like hemorrhagic fever and shock syndrome. While the virus and host immune response contribute to severity, other factors, such as small extracellular vesicles (sEVs), may play a role. sEVs mediate intercellular communication by transferring cellular components; however, their role in vivo infection remains unclear. We isolated and characterized sEVs from DENV-infected C6/36 mosquito cells, finding that they interact with mammalian cells and internalize the content. Using sEVs populations (with a size between 100 and 200 nm), we demonstrated enhanced infection in in vitro and in vivo murine models, including immunocompetent and immunosuppressed mice, which developed severe dengue-like symptoms. Our study reveals that sEVs from DENV-infected mosquito cells contribute to dengue pathogenesis, inducing severe symptoms in in vivo models, highlighting their potential role in disease progression and severe outcomes.

The cellular membrane is a dynamic structure composed of lipids and proteins organized into specialized domains that facilitate interactions between extracellular molecules and the intracellular environment. Tetraspanins are a family of transmembrane proteins involved in diverse cellular processes, including membrane stabilization and fusion, endocytosis, extracellular vesicle formation, and the organization of proteins and lipids at specific membrane sites known as Tetraspanin-Enriched Microdomains (TEMs). These lipid–protein interactions play a critical role in the replicative cycle of Orthoflavivirus, including dengue, Zika, and West Nile, by facilitating viral entry, replication, assembly, and egress. In addition, tetraspanins also regulate the biogenesis and function of extracellular vesicles, contributing to viral dissemination, persistent infection, and immune evasion. This review summarizes the current knowledge on the structural and functional aspects of tetraspanins, their interplay with lipids, and their emerging roles in the Orthoflavivirus replicative cycle. We also discuss how these insights may inform the development of antiviral strategies targeting membrane organization and virus–host interactions.