Amdekar Sarika, Parashar Deepti, Alagarasu Kalichamy
Dengue/Chikungunya Group, ICMR-National Institute of Virology , Pune, India .
Viral Immunol. 2017 Dec;30(10):691-702. doi: 10.1089/vim.2017.0052. Epub 2017 Sep 14.
Chikungunya virus (CHIKV), a member of Alphavirus genus, is responsible for chikungunya fever (CHIKF), which is characterized by the presence of fever, rash, myalgia, and arthralgia. Reemergence of CHIKV has become a significant public health concern in Asian and African countries and is newly emerging in the Middle East, Pacific, American, and European countries. Cytokines, innate (monocytes, natural killer cells) and adaptive immune response (role of B cells and T cells i.e. CD4 and CD8), and/or viral factors contribute to CHIKV-induced arthritis. Vector factors such as vector competence (that includes extrinsic and intrinsic factors) and effect of genome mutations on viral replication and fitness in mosquitoes are responsible for the spread of virus, although they are not directly responsible for CHIKV-induced arthritis. CHIKV-induced arthritis mimics arthritis by involving joints and a common pattern of leukocyte infiltrate, cytokine production, and complement activation. Successful establishment of CHIKV infection and induction of arthritis depends on its ability to manipulate host cellular processes or host factors. CHIKV-induced joint damage is due to host inflammatory response mediated by macrophages, T cells, and antibodies, as well as the possible persistence of the virus in hidden sites. This review provides insight into mechanisms of CHIKV-induced arthritis. Understanding the pathogenesis of CHIKV-induced arthritis will help in developing novel strategies to predict and prevent the disease in virus-infected subjects and combat the disease, thereby decreasing the worldwide burden of the disease.
基孔肯雅病毒（CHIKV）是甲病毒属的成员，可引发基孔肯雅热（CHIKF），其特征为发热、皮疹、肌痛和关节痛。CHIKV的再度出现已成为亚洲和非洲国家的重大公共卫生问题，并且在中东、太平洋、美洲和欧洲国家也新出现了该病毒。细胞因子、固有免疫反应（单核细胞、自然杀伤细胞）和适应性免疫反应（B细胞和T细胞即CD4和CD8的作用）以及/或者病毒因素会导致CHIKV诱发关节炎。媒介因素，如媒介能力（包括外在和内在因素）以及基因组突变对病毒在蚊子体内复制和适应性的影响，是病毒传播的原因，尽管它们并非直接导致CHIKV诱发关节炎。CHIKV诱发的关节炎通过累及关节以及白细胞浸润、细胞因子产生和补体激活的常见模式来模拟关节炎。CHIKV感染的成功建立和关节炎的诱发取决于其操纵宿主细胞过程或宿主因素的能力。CHIKV诱发的关节损伤是由于巨噬细胞、T细胞和抗体介导的宿主炎症反应，以及病毒可能在隐蔽部位持续存在所致。本综述深入探讨了CHIKV诱发关节炎的机制。了解CHIKV诱发关节炎的发病机制将有助于制定新策略来预测和预防病毒感染患者的疾病并对抗该疾病，从而减轻全球范围内的疾病负担。
