Chikungunya arthritis mechanisms in the americas: A cross-sectional analysis of chikungunya arthritis patients twenty-two months after infection demonstrating no detectable viral persistence in synovial fluid

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dc.contributor.authorChang, Aileen
dc.contributor.authorMartins, Karen A. O.
dc.contributor.authorEncinales, Liliana
dc.contributor.authorReid, Patrick
dc.contributor.authorAcuña, Marlon
dc.contributor.authorEncinales, Carlos
dc.contributor.authorMatranga, Christian B.
dc.contributor.authorPacheco, Nelly
dc.contributor.authorCure, Carlos
dc.contributor.authorShukla, Bhavarth
dc.contributor.authorRuiz Arteta, Teofilo
dc.contributor.authorAmdur, Richard
dc.contributor.authorCazares, Lisa H.
dc.contributor.authorGregory, Melissa
dc.contributor.authorWard, Michael D.
dc.contributor.authorPorras-Ramírez, Alexandra
dc.contributor.authorRico Mendoz, Alejandro
dc.contributor.authorDong, Lian
dc.contributor.authorKenny, Tara
dc.contributor.authorBrueggemann, Ernie
dc.contributor.authorDowney, Lydia G.
dc.contributor.authorKamalapathy, Priyanka
dc.contributor.authorLichtenberger, Paola
dc.contributor.authorFalls, Orlando
dc.contributor.authorSimon, Gary L.
dc.contributor.authorBethony, Jeffrey M.
dc.contributor.authorFirestein, Gary S.
dc.contributor.orcidPorras-Ramírez, Alexandra [0000-0002-0800-1388]
dc.date.accessioned2020-05-15T20:06:40Z
dc.date.available2020-05-15T20:06:40Z
dc.date.issued2018
dc.description.abstractenglishObjective To determine if chikungunya virus persists in synovial fluid after infection, potentially acting as a causative mechanism of persistent arthritis. Methods We conducted a cross‐sectional study of 38 Colombian participants with clinical chikungunya virus infection during the 2014–2015 epidemic who reported chronic arthritis and 10 location‐matched controls without chikungunya virus or arthritis. Prior chikungunya virus infection status was serologically confirmed, and the presence of synovial fluid chikungunya virus, viral RNA, and viral proteins was determined by viral culture, quantitative reverse transcription–polymerase chain reaction (qRT‐PCR), and mass spectrometry, respectively. Biomarkers were assessed by multiplex analysis. Results Patients with serologically confirmed chikungunya arthritis (33 of 38 [87%]) were predominantly female (82%) and African Colombian (55%) or white Colombian (33%), with moderate disease activity (mean ± SD Disease Activity Score in 28 joints 4.52 ± 0.77) a median of 22 months after infection (interquartile range 21–23 months). Initial symptoms of chikungunya virus infection included joint pain (97%), swelling (97%), stiffness (91%), and fever (91%). The most commonly affected joints were the knees (87%), elbows (76%), wrists (75%), ankles (56%), fingers (56%), and toes (56%). Synovial fluid samples from all patients with chikungunya arthritis were negative for chikungunya virus on qRT‐PCR, showed no viral proteins on mass spectrometry, and cultures were negative. Case and control plasma cytokine and chemokine concentrations did not differ significantly. Conclusion This is one of the largest observational studies involving analysis of the synovial fluid of chikungunya arthritis patients. Synovial fluid analysis revealed no detectable chikungunya virus. This finding suggests that chikungunya virus may cause arthritis through induction of potential host autoimmunity, suggesting a role for immunomodulating agents in the treatment of chikungunya arthritis, or that low‐level viral persistence exists in synovial tissue only and is undetectable in synovial fluid.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1002/art.40383
dc.identifier.issn2326-5191
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2858
dc.language.isoeng
dc.publisherWileyspa
dc.publisher.journalArthritis and rheumatologyspa
dc.relation.ispartofseriesArthritis and rheumatology, 2326-5191, Vol 70, Num 4, 2018, pag 585-593spa
dc.relation.urihttps://onlinelibrary.wiley.com/doi/full/10.1002/art.40383
dc.rights.creativecommons2018
dc.rights.localAcceso cerradospa
dc.subject.armarcChikungunyaspa
dc.subject.decsVirusspa
dc.subject.decsArtritisspa
dc.titleChikungunya arthritis mechanisms in the americas: A cross-sectional analysis of chikungunya arthritis patients twenty-two months after infection demonstrating no detectable viral persistence in synovial fluidspa
dc.title.translatedChikungunya arthritis mechanisms in the americas: A cross-sectional analysis of chikungunya arthritis patients twenty-two months after infection demonstrating no detectable viral persistence in synovial fluidspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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