Emerging Viruses, Inflammation, and Therapeutics Group, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
Division of Virology, National Health Laboratory Services, Bloemfontein, South Africa; Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
Lancet Infect Dis. 2021 May;21(5):e123-e133. doi: 10.1016/S1473-3099(20)30491-6. Epub 2020 Nov 5.
Mosquito-borne viruses, or arboviruses, have been part of the infectious disease landscape for centuries, and are often, but not exclusively, endemic to equatorial and subtropical regions of the world. The past two decades saw the re-emergence of arthritogenic alphaviruses, a genus of arboviruses that includes several members that cause severe arthritic disease. Recent outbreaks further highlight the substantial public health burden caused by these viruses. Arthritogenic alphaviruses are often reported in the context of focused outbreaks in specific regions (eg, Caribbean, southeast Asia, and Indian Ocean) and cause debilitating acute disease that can extend to chronic manifestations for years after infection. These viruses are classified among several antigenic complexes, span a range of hosts and mosquito vectors, and can be distributed along specific geographical locations. In this Review, we highlight key features of alphaviruses that are known to cause arthritic disease in humans and outline the present findings pertaining to classification, immunogenicity, pathogenesis, and experimental approaches aimed at limiting disease manifestations. Although the most prominent alphavirus outbreaks in the past 15 years featured chikungunya virus, and a large body of work has been dedicated to understanding chikungunya disease mechanisms, this Review will instead focus on other arthritogenic alphaviruses that have been identified globally and provide a comprehensive appraisal of present and future research directions.
蚊媒病毒（或虫媒病毒）在传染病领域已经存在了几个世纪，通常（但并非绝对）存在于世界的赤道和亚热带地区。在过去的二十年中，引起关节炎的甲病毒（一种虫媒病毒属）重新出现，该属包括几种引起严重关节炎疾病的成员。最近的疫情爆发进一步突显了这些病毒给公众健康带来的巨大负担。关节炎型甲病毒常被报道为特定地区（如加勒比海、东南亚和印度洋）集中爆发的情况，并导致使人衰弱的急性疾病，感染后数年可能发展为慢性表现。这些病毒被分类为几种抗原复合物，跨越一系列宿主和蚊子媒介，可沿特定地理位置分布。在这篇综述中，我们强调了已知会引起人类关节炎的甲病毒的关键特征，并概述了目前与分类、免疫原性、发病机制和旨在限制疾病表现的实验方法相关的发现。尽管过去 15 年中最突出的甲病毒疫情是基孔肯雅热病毒，但大量的工作致力于了解基孔肯雅热的发病机制，但本综述将重点关注在全球范围内发现的其他关节炎型甲病毒，并对当前和未来的研究方向进行全面评估。
