ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India.
Department of Medicine, Hamdard Institute of Medical Sciences and Research (HIMSAR), Jamia Hamdard, New Delhi, India.
JCI Insight. 2020 Apr 9;5(7):130509. doi: 10.1172/jci.insight.130509.
Chikungunya virus (CHIKV) infection causes acute febrile illness in humans, and some of these individuals develop a debilitating chronic arthritis that can persist for months to years for reasons that remain poorly understood. In this study from India, we characterized antibody response patterns in febrile chikungunya patients and further assessed the association of these initial febrile-phase antibody response patterns with protection versus progression to developing chronic arthritis. We found 5 distinct patterns of the antibody responses in the febrile phase: no CHIKV binding or neutralizing (NT) antibodies but PCR positive, IgM alone with no NT activity, IgM alone with NT activity, IgM and IgG without NT activity, and IgM and IgG with NT activity. A 20-month follow-up showed that appearance of NT activity regardless of antibody isotype or appearance of IgG regardless of NT activity during the initial febrile phase was associated with a robust protection against developing chronic arthritis in the future. These findings, while providing potentially novel insights on correlates of protective immunity against chikungunya-induced chronic arthritis, suggest that qualitative differences in the antibody response patterns that have evolved during the febrile phase can serve as biomarkers that allow prediction of protection or progression to chronic arthritis in the future.
基孔肯雅病毒（CHIKV）感染会导致人类急性发热疾病，其中一些人会发展为致残性慢性关节炎，其持续时间为数月至数年，原因仍不清楚。在这项来自印度的研究中，我们对发热性基孔肯雅病患者的抗体反应模式进行了特征描述，并进一步评估了这些初始发热期抗体反应模式与预防或进展为慢性关节炎之间的关联。我们在发热期发现了 5 种不同的抗体反应模式：无 CHIKV 结合或中和（NT）抗体但 PCR 阳性、仅 IgM 无 NT 活性、仅 IgM 有 NT 活性、IgM 和 IgG 无 NT 活性以及 IgM 和 IgG 有 NT 活性。20 个月的随访表明，在初始发热期出现 NT 活性（无论抗体类型如何）或出现 IgG（无论 NT 活性如何）与未来发生慢性关节炎的强大保护作用有关。这些发现虽然为针对基孔肯雅诱导的慢性关节炎的保护性免疫相关因素提供了潜在的新见解，但表明在发热期演变的抗体反应模式的定性差异可以作为预测未来保护或进展为慢性关节炎的生物标志物。
