Inflammation, fibrosis and E1 glycoprotein persistence in joint tissue of patients with post-Chikungunya chronic articular disease

Brito, Maíra Sant Anna Genaro de; Marchi, Micheli Said de; Perin, Matheus Yung; Côsso, Isabelle da Silva; Bumlai, Renan Urt Mansur; Silva Júnior, Waldemar Vaz da; Prado, Adriana Yuki Mello; Cruz, Thais Campos Dias da; Avila, Eudes Thiago Pereira; Damazo, Amílcar Sabino; Slhessarenko, Renata Dezengrini

doi:10.1590/0037-8682-0278-2023

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Short Communication • Rev. Soc. Bras. Med. Trop. 56 • 2023 • https://doi.org/10.1590/0037-8682-0278-2023 copy

Inflammation, fibrosis and E1 glycoprotein persistence in joint tissue of patients with post-Chikungunya chronic articular disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Chikungunya chronic joint disease causes debilitating arthralgia, significantly impacting the quality of life of affected individuals.

Methods:

In this study, patients underwent clinical follow-ups, joint biopsies, and pre-biopsy and 24 months post-biopsy serum dosage of cytokines.

Results:

All participants were female and had pain in 12 joints on average, with 41.17% exhibiting moderate disease activity. Histopathological analysis revealed collagen deposition. Indirect immunofluorescence detected the CHIKV glycoprotein E1 antigen, and an increase in cytokines.

Conclusions:

Persistent inflammation and ineffective antiviral immune responses leading to antigen persistence may contribute to chronic CHIKV arthritis.

Keywords:
Chikungunya; Inflammatory; Cytokines

Patient	Study inclusion	Age*	Duration of disease**	Comorbidities	CDAI		Therapy on biopsy day	Histopathology	IFI score***
					Study inclusion	Pre-biopsy
01	04/2018	61	24	HBP	32	3	-	+++ diffuse inflammation in the fatty and in the connective tissue	0
02	12/2018	50	24	HBP	31	12	immunomodulator	++ inflammation, fat necrosis, +++ fibrosis****	2
03	12/2018	60	11	HBP/T2DM	22	24	-	+ inflammation, + fibrosis**** +++	2
04	05/2018	31	24	-	15	3	immunomodulator	+ inflammation +; ++ fibrosis	0
05	04/2018	62	7	HBP	10	3	NSAID+ immunomodulator	+ inflammation (synovitis); +++ fibrosis	3
06	03/2018	48	5	-	25	25	-	++ inflammation (synovitissynovitis); +++ fibrosis	3
07	08/2017	50	21	-	9	4	immunomodulator	+ inflammation (synovitis); +++ fibrosis	2
08	06/2018	44	30	-	35	5	NSAID	++ inflammation (synovitis); + fibrosis	1
09	02/2019	74	29	HBP	10	10	corticoid+ NSAID	+++ inflammation (histiocytes); + fibrosis	2
10	10/2018	56	33	-	11	0	immunomodulator	+++ inflammation (neutrophile infiltration); + fibrosis	2
11	02/2018	58	11	HBP/T2DM	12	6	immunomodulator	+ inflammation; +++ fibrosis	2
12	10/2018	52	33	HBP/T2DM	27	5	-	++ inflammation; +++ fibrosis	0
13	06/2018	57	7	HBP	5	2	immunomodulator	+ inflammation in the fat cells; +++ fibrosis	3
14	03/2018	50	35	-	13	12	-	+ inflammation; ++ fibrosis
15	12/2018	38	35	HBP/T2DM	12	25	immunomodulator	+ inflammation; +++ fibrosis	2
16	06/2019	24	29	-	21	6	immunomodulator	+ inflammation + (synovitis); +++ fibrosis	1
17	10/2018	36	32	HBP/T2DM	30	8	immunomodulator	++ inflammation (synovitis); +++ fibrosis	2

Patient	Age (years)	Duration of disease (months)*	CDAI		CDAI			Cytokines/chemokines (pg/mL)
			Study inclusion	Pre-biopsy	12 months post-biopsy	24 months post-biopsy	Time**	IL-7	GM-CSF	IFN-α	TNF-α	IL-6	IL-8	IL-12p70	IL-2	IL-4	IFN-γ	IL-17a	IL-10	IP-10	MCP-1
01	61	24	32	3	0	10	Pre-	76	29	31	71	55	116	37	40.5	162	65	34	31	4,921	660.5
							Post	158	23	20	26	24	187.5	22	26	74	52	23	27	652	975
02	50	24	31	12	19	14	Post	72	20	19	27	34	119.5	20	26	51	40	21	18.5	2,187	2,968
03	60	11	22	24	5	30	Post	54	16	14	20	33	365.5	19	21	57	31	20	32	5,172	5,784
04	31	24	15	3	0	8	Post	60	18	14	42	37	122.5	17	22	28	29	17	24	2,264	3,640
05	62	7	10	3	5	4	Pre-	68	20	21	35	32	99.5	22	25	70	46	20	28	3,499	996
06	48	5	25	25	0	0	Post	36	16	10	23	41.5	394	13	18	33	43	16	19	1,301.5	5,225
07	50	21	9	4	5	3	Pré-	188	19	19	25	24	199	23	30	82	54.5	22	29	803	1383
08	44	30	35	5	4	33	ND	-	-	-	-	-	-	-	-	-	-	-	-	-	-
09	74	29	10	10	0	0	ND	-	-	-	-	-	-	-	-	-	-	-	-	-	-
10	56	33	11	0	3	25	Post	151	23	17	30.5	32	82.5	18	29	42	38	21	21	2,758	2,466
11	58	11	12	6	11	15	Pre-	42	20	19	27	32	169	19	28	53	70	20	33	6,252.5	3,215.5
							Post	60	17	19	24.5	34	198	20	24	17	28	28	29	505	4,146.5
12	52	33	27	5	0	9	Post	62	22	21	37	29.5	138	23.5	25	40	34	25	27	1619	2456
13	57	7	5	2	2	8	Pre-	24	14	13	14	31	164	16	18	18	24	15	21	1,508	4,767
							Post	51.5	20	20	26	24	122.5	23	25	32	32.5	20	26	1,678	2,492.5
14	50	35	13	12	0	0	Post	53	20	15	31	59.5	74	20	23	44	23	18	21	1,157	1,482
15	38	35	12	25	10	20	ND	-	-	-	-	-	-	-	-	-	-	-	-	-	-
16	24	29	21	6	0	7	Post	69	27	32	51	46	115	1,349	40	87	55	34	47	9,156	2,136
17	36	32	30	8	26	27	ND	-	-	-	-	-	-	-	-	-	-	-	-	-	-

Sociedade Brasileira de Medicina Tropical - SBMT Sociedade Brasileira de Medicina Tropical - SBMT, Núcleo de Medicina Tropical UnB, Sala 43C 70904-970, E-mails: rsbmt@uftm.edu.br | artes.rsbmt@gmail.com | sbmt@sbmt.org.br , WhatsApp: SBMT (61) 9.9192-6496, WhatsApp: RSBMT (34) 9.9996-5807 - Brasília - DF - Brazil
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[1] Corresponding author: Renata Dezengrini Slhessarenko. e-mail: renatadezengrini@yahoo.com.br