Department of Rheumatology and Internal Diseases, Poznań University of Medical Sciences, Poznań, Poland.
Clin Exp Rheumatol. 2018 May-Jun;36(3):494-501. Epub 2018 Mar 2.
Chikungunya virus (CHIKV) is an arthropod-borne alphavirus, transmitted by Aedes aegypti and Aedes albopictus mosquitoes. It is responsible for a febrile illness, typically accompanied by maculopapular rash and severe, incapacitating arthralgia. The disease, although generally self-limiting, frequently evolves into a long-lasting, debilitating rheumatic disorder, which shares many clinical features with rheumatoid arthritis (RA). The underlying mechanism by which CHIKV induces persistent arthritis remains under investigation, however, currently, attention is drawn to the fact, that chronic chikungunya (CHIK) and RA have many common cellular and cytokine pathways involved in their pathogenesis. Over the past decades, the virus has dispersed unexpectedly from tropical and subtropical regions of Africa and Asia, affecting millions of people worldwide. No licensed vaccine, nor antiviral drug against CHIKV is yet available. Treatment of acute CHIK is symptomatic, whereas in chronic stages, different disease-modifying anti-rheumatic drugs (DMARDs) have been used with variable success. Hence, chronic CHIK is an emerging rheumatic condition that rheumatologists have to deal with. This review provides brief insights into the epidemiology, pathogenesis, clinical features and management of Chikungunya disease, with special regard to post-chikungunya rheumatic disorder and its relationship with RA.
基孔肯雅热病毒（CHIKV）是一种虫媒黄病毒，通过埃及伊蚊和白纹伊蚊传播。它可引起发热性疾病，通常伴有斑丘疹和严重的、使人丧失能力的关节炎。尽管该病通常是自限性的，但经常发展为持久的、使人虚弱的风湿性疾病，与类风湿关节炎（RA）有许多共同的临床特征。目前，人们对 CHIKV 引起持续性关节炎的潜在机制仍在研究中，但请注意，慢性基孔肯雅热（CHIK）和 RA 有许多共同的细胞和细胞因子途径参与其发病机制。在过去几十年中，该病毒出人意料地从非洲和亚洲的热带和亚热带地区传播开来，影响了全世界数百万人。目前还没有针对 CHIKV 的许可疫苗或抗病毒药物。急性 CHIK 的治疗是对症的，而在慢性阶段，已经使用了不同的疾病修饰抗风湿药物（DMARDs），但效果不一。因此，慢性 CHIK 是一种新出现的风湿性疾病，风湿科医生必须加以处理。本文简要介绍了基孔肯雅热的流行病学、发病机制、临床特征和管理，特别关注了 post-chikungunya 风湿性疾病及其与 RA 的关系。
