Dados do Trabalho

Título

INFLAMMATION, FIBROSIS AND E1 GLYCOPROTEIN PERSISTENCE IN JOINT TISSUE OF PACIENTS WITH POST- CHIKUNGUNYA CHRONIC ARTICULAR DISEASE

Introdução

Chronic inflammatory joint disease post-Chikungunya is responsible for debilitating arthralgia compromising the quality of life of individuals. Immunological and molecular mechanisms that have been implicated in the development of chronic disease remain unclear, interfering with the introduction of specific therapy.

Objetivo (s)

This study aimed to characterize the histological joint findings and serum levels of a panel of cytokines in chronic symptomatic CHIKV patients from South-Central Mato Grosso, after a large outbreak of CHIKF during 2016-2018.

Material e Métodos

In this study, patients (n=17) diagnosed and recruited at an outpatient’s clinic, were subjected to clinical follow up in three months intervals, joint biopsy, and serum dosage of cytokines pre-biopsy (n=5) and 24 months post-biopsy (n=11).

Resultados e Conclusão

These patients had disease for 12 months (29.41%), 24 months (52.94%) and 36 months (17.64%). All are female aged 50 (+13.67) years, 58% with hypertension and an average of 12 painful and stiff joints, 41.17% in moderate disease activity, using corticosteroids (58.82%) and with normal inflammatory proofs on the day of biopsy procedure. Histopathology revealed fibrosis in the joint biopsies of all 17 patients, intense (3/17) or mild (14/17) inflammation, with a predominance of synovitis (4/17), fat necrosis (1/17), synovitis with the presence of histiocytes (1/17), periarticular inflammatory infiltrate (1/17) with predominance of collagen deposition (10/17). In indirect immunofluorescence, CHIKV glycoprotein E1 antigen was detect in 14/17 joint tissues, 57.14% with moderate staining. Key mediators such as TNF-α, MCP-1, IP-10, IL-17, IL-4 and IL-2 were increased, whereas IFN-α (n=4), IFN-γ (n=6), IL-12 (n=2), IL-8 (n=1) and IL-10 (n=1) increases were less frequently detected. Persistent inflammation and absence of viral antigens clearance by effective antiviral immune responses in the joints may contribute for chronic CHIKV arthritis.

Palavras-chave

Chikungunya; Chronic disease; Joint biopsy; Cytokines.