Chikungunya viral arthritis in the United States: a mimic of seronegative rheumatoid arthritis.
Chikungunya viral arthritis in the United States: a mimic of seronegative rheumatoid arthritis.
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DOI：
10.1002/art.39027
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Yokoyama WM
中科院分区：
文献类型：
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作者：
Miner JJ;Aw-Yeang HX;Fox JM;Taffner S;Malkova ON;Oh ST;Kim AHJ;Diamond MS;Lenschow DJ;Yokoyama WM
基孔肯雅病毒（CHIKV）是一种致关节炎的蚊子传播的甲病毒，于2013年传播到加勒比地区，2014年传播到美国。CHIKV感染的患者发生炎性关节炎，可持续数月至数年，但对人类CHIKV关节炎的流变学和免疫学特征知之甚少，特别是与类风湿性关节炎（RA）相比。在这里，我们描述了2014年6月访问海地时几乎同时感染的10名美国旅行者的这些特征。通过病史、体格检查和实验室检查对患者进行评估。所有患有CHIKV关节炎的患者都具有可检测的抗CHIKV IgG。使用飞行时间流式细胞术（CyTOF），我们分析了CHIKV感染患者，健康对照组和未经治疗的活动性RA患者的外周血单核细胞。在10名CHIKV感染者中，有8名发展为持续性对称性多关节炎，他们符合2010年ACR/EULAR（血清阴性）RA标准。CyTOF分析显示，RA和CHIKV感染患者的活化和效应CD 4+和CD 8 + T细胞的百分比高于健康对照组。除了相似的临床特征之外，患有CHIKV感染和RA的患者还发展出高度相似的外周T细胞表型。这些重叠的临床和免疫学特征强调了风湿病学家在评估新发对称性多关节炎患者时需要考虑CHIKV感染。
Chikungunya virus (CHIKV) is an arthritogenic mosquito-transmitted alphavirus that spread to the Caribbean in 2013 and the United States in 2014. CHIKV-infected patients develop inflammatory arthritis that can persist for months to years, but little is known about the rheumatologic and immunologic features of CHIKV arthritis in humans, particularly as compared to rheumatoid arthritis (RA). Here, we describe these features in a group of 10 American travelers who were nearly simultaneously infected while visiting Haiti in June 2014. Patients were assessed by history, physical examination, and laboratory studies. All patients with CHIKV arthritis had detectable anti-CHIKV IgG. Using cytometry by time of flight (CyTOF), we analyzed peripheral blood mononuclear cells in CHIKV-infected patients, healthy controls, and patients with untreated, active RA. Among ten CHIKV-infected individuals, eight developed persistent symmetric polyarthritis, who otherwise met the 2010 ACR/EULAR criteria for (seronegative) RA. CyTOF analysis revealed that RA and CHIKV-infected patients had greater percentages of activated and effector CD4+ and CD8+ T cells than healthy controls. In addition to similar clinical features, patients with CHIKV infection and RA develop highly similar peripheral T cell phenotypes. These overlapping clinical and immunologic features highlight a need for rheumatologists to consider CHIKV infection when evaluating patients with new, symmetric polyarthritis.