title: Persistent arthralgia induced by Chikungunya virus infection is associated with interleukin-6 and granulocyte macrophage colony-stimulating factor.
abstract: BACKGROUND
  Chikungunya virus (CHIKV) infection induces arthralgia. The involvement of inflammatory cytokines and chemokines has been suggested, but very little is known about their secretion profile in CHIKV-infected patients.
  
  
  METHODS
  A case-control longitudinal study was performed that involved 30 adult patients with laboratory-confirmed Chikungunya fever. Their profiles of clinical disease, viral load, and immune mediators were investigated.
  
  
  RESULTS
  When patients were segregated into high viral load and low viral load groups during the acute phase, those with high viremia had lymphopenia, lower levels of monocytes, neutrophilia, and signs of inflammation. The high viral load group was also characterized by a higher production of pro-inflammatory cytokines, such as interferon-α and interleukin (IL)-6, during the acute phase. As the disease progressed to the chronic phase, IL-17 became detectable. However, persistent arthralgia was associated with higher levels of IL-6 and granulocyte macrophage colony-stimulating factor, whereas patients who recovered fully had high levels of Eotaxin and hepatocyte growth factor.
  
  
  CONCLUSIONS
  The level of CHIKV viremia during the acute phase determined specific patterns of pro-inflammatory cytokines, which were associated with disease severity. At the chronic phase, levels of IL-6, and granulocyte macrophage colony-stimulating factor found to be associated with persistent arthralgia provide a possible explanation for the etiology of arthralgia that plagues numerous CHIKV-infected patients.
authors.affiliation: Communicable Disease Centre, Singapore.
authors.forename: Angela
authors.initials: A
authors.lastname: Chow
authors.forename: Zhisheng
authors.initials: Z
authors.lastname: Her
authors.forename: Edward K S
authors.initials: EK
authors.lastname: Ong
authors.forename: Jin-miao
authors.initials: JM
authors.lastname: Chen
authors.forename: Frederico
authors.initials: F
authors.lastname: Dimatatac
authors.forename: Dyan J C
authors.initials: DJ
authors.lastname: Kwek
authors.forename: Timothy
authors.initials: T
authors.lastname: Barkham
authors.forename: Henry
authors.initials: H
authors.lastname: Yang
authors.forename: Laurent
authors.initials: L
authors.lastname: Rénia
authors.forename: Yee-Sin
authors.initials: YS
authors.lastname: Leo
authors.forename: Lisa F P
authors.initials: LF
authors.lastname: Ng
mesh_terms: D000328:Adult; D000368:Aged; D018354:Alphavirus Infections / Q000276:immunology / Q000473:pathology; D018771:Arthralgia / Q000209:etiology*; D001168:Arthritis / Q000276:immunology / Q000473:pathology / Q000821:virology*; D001769:Blood / Q000276:immunology / Q000821:virology; D016022:Case-Control Studies; D065632:Chikungunya Fever; D002646:Chikungunya virus / Q000276:immunology* / Q000472:pathogenicity*; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019562:Viral Load
chemical_list: D016207:Cytokines