title: Disease exacerbation by etanercept in a mouse model of alphaviral arthritis and myositis.
abstract: OBJECTIVE
  Mosquito-borne alphaviruses such as chikungunya virus, o'nyong-nyong virus, and Ross River virus (RRV) cause sporadic, sometimes large, outbreaks of rheumatic disease worldwide. This study was designed to test the effect of treating RRV-induced arthritis using the anti-tumor necrosis factor (anti-TNF) drug etanercept in a mouse model of rheumatic disease.
  
  
  METHODS
  Mice were infected with RRV and treated with etanercept. Weight gain was measured, tissue viral titers were determined, and histologic changes in muscle and joint tissues were assessed.
  
  
  RESULTS
  RRV-infected mice treated with etanercept showed decreased weight gain, higher viral titers in muscle, joints, and blood, and more tissue damage and inflammatory cell recruitment than RRV-infected mice without treatment.
  
  
  CONCLUSIONS
  Anti-TNF therapy is unlikely to be useful in treating alphaviral arthritides. During alphaviral epidemics, careful monitoring of patients being treated with anti-TNF agents may be warranted.
authors.affiliation: University of Canberra, Canberra, Australian Capital Territory, Australia.
authors.forename: Ali
authors.initials: A
authors.lastname: Zaid
authors.forename: Nestor E
authors.initials: NE
authors.lastname: Rulli
authors.forename: Michael S
authors.initials: MS
authors.lastname: Rolph
authors.forename: Andreas
authors.initials: A
authors.lastname: Suhrbier
authors.forename: Suresh
authors.initials: S
authors.lastname: Mahalingam
mesh_terms: D000524:Alphavirus / Q000276:immunology; D018354:Alphavirus Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000818:Animals; D000843:Ankle Joint / Q000187:drug effects / Q000473:pathology / Q000821:virology; D001169:Arthritis, Experimental / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D004195:Disease Models, Animal; D000068800:Etanercept; D054884:Host-Pathogen Interactions / Q000276:immunology; D007074:Immunoglobulin G / Q000633:toxicity*; D007166:Immunosuppressive Agents / Q000633:toxicity*; D008136:Longevity / Q000187:drug effects; D051379:Mice; D008810:Mice, Inbred C57BL; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology / Q000821:virology; D009220:Myositis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D018124:Receptors, Tumor Necrosis Factor; D016896:Treatment Outcome; D019562:Viral Load; D015430:Weight Gain / Q000187:drug effects
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept