Rheumatic manifestations of chikungunya: emerging concepts and interventions.,Nature Reviews Rheumatology

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Rheumatic manifestations of chikungunya: emerging concepts and interventions.
Nature Reviews Rheumatology ( IF 29.4 ) Pub Date : 2019-09-03 , DOI: 10.1038/s41584-019-0276-9
Andreas Suhrbier _{1,

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Affiliation

The largest epidemic ever recorded for chikungunya, a disease caused by infection with the chikungunya virus (CHIKV), began in Africa in 2004 and spread to >100 countries on four continents. The epidemic caused >10 million cases of often debilitating rheumatic disease, classically involving rapid onset of fever and polyarthralgia, often with polyarthritis. The clinical diagnosis of chikungunya is often complicated by infections with dengue or Zika virus. For many individuals with chikungunya, the disease is benign and self-limiting; however, some patients have a complex spectrum of atypical and severe manifestations. Many patients also experience a chronic phase of the disease, primarily involving arthralgia (which can be protracted (>1 year)), and a number of sequelae are also recognized. CHIKV-induced arthropathy arises from infection of multiple cell types in the joint and the infiltration of mainly mononuclear cells. Innate responses (primarily involving type I interferon responses and natural killer cells) and cognate responses (primarily involving CD4 T helper 1 cells), alongside activation of macrophages and monocytes, mediate CHIKV-induced arthritic immunopathology. Ideally, improved anti-inflammatory treatments should not compromise antiviral immunity. New concepts in mosquito control are being field tested and a number of CHIKV vaccines are being developed.

中文翻译：

基孔肯雅的风湿表现：新兴的概念和干预措施。

基孔肯雅热是有史以来最大的流行病，基孔肯雅热是由基孔肯雅病毒（CHIKV）感染引起的疾病，始于2004年在非洲，并扩散到四大洲的100多个国家。该流行病导致超过1000万例经常使风湿性疾病衰弱的病例，通常涉及发烧和多关节痛的快速发作，并常常伴有多关节炎。基孔肯雅热的临床诊断通常并发登革热或寨卡病毒感染。对于许多患有基孔肯雅热的人来说，这种疾病是良性的，并且是自限性的。但是，有些患者具有复杂的非典型和严重表现。许多患者还经历了该病的慢性阶段，主要涉及关节痛（可能会持续（> 1年）），并且也认识到许多后遗症。CHIKV诱导的关节炎源自关节中多种细胞类型的感染以及主要是单核细胞的浸润。先天反应（主要涉及I型干扰素反应和自然杀伤细胞）和同类反应（主要涉及CD4 T辅助细胞1），以及巨噬细胞和单核细胞的激活，介导CHIKV诱导的关节炎免疫病理学。理想地，改进的抗炎治疗不应损害抗病毒免疫性。蚊虫控制的新概念正在现场测试，许多CHIKV疫苗正在开发中。伴随巨噬细胞和单核细胞的激活，介导CHIKV诱导的关节炎免疫病理学。理想地，改进的抗炎治疗不应损害抗病毒免疫性。蚊虫控制的新概念正在现场测试，许多CHIKV疫苗正在开发中。伴随巨噬细胞和单核细胞的激活，介导CHIKV诱导的关节炎免疫病理学。理想地，改进的抗炎治疗不应损害抗病毒免疫性。蚊虫控制的新概念正在现场测试，许多CHIKV疫苗正在开发中。

更新日期：2019-09-04

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