Home' Trinidad and Tobago Guardian : February 14th 2017 Contents response, causing the tissue damage that
patients perceive as arthritis.
The researchers found a similar pattern in
the mice treated with the drug combination:
By four weeks after infection, live virus was
no longer present in the animals' joints, but
viral genetic material remained, suggest-
ing that the drugs had not eliminated the
chronic phase of the disease.
It is possible that a treatment that reduces
arthritis symptoms in the first weeks after
infection could lower the chance that the
disease becomes chronic, but no data has
yet been published for or
even if short-
lived, would be
a boon for chikun- gunya
patients, who currently have no proven
treatment options. Lenschow has discussed
beginning a human study with colleagues
in Brazil, but plans are not yet finalised.
(Washington University School of Medicine)
A24 body & soul
guardian.co.tt Tuesday, February 14, 2017
Combining a drug for rheumatoid arthritis
with one that targets the chikungunya virus can
eliminate the signs of chikungunya arthritis in
mice in the disease's earliest stage, according to
researchers at Washington University School of
Medicine in St Louis.
The findings could lead to a drug therapy for the
painful, debilitating condition for which there cur-
rently is no treatment.
"We found that combining these two drugs could
abolish the signs of arthritis in mice during the acute
phase," said Deborah Lenschow, MD, PhD, an associ-
ate professor of medicine and the study's co-senior
author, referring to the phase in the first weeks after
infection. The study was published on February 1, in
Science Translational Medicine.
Until about a decade ago, chikungunya virus, which
is transmitted by mosquitoes, mainly was restricted
to East Africa and South Asia. But in recent years
the virus has spread around the world. The first case
originating in the Western Hemisphere was reported
in late 2013, and by the end of 2015, the virus had in-
fected an estimated 1.8 million people in the Americas.
Chikungunya infection causes fever and severe
joint pain, as well as rash, muscle pain and fatigue.
The majority of patients continue to experience joint
pain six months after infection, and for some, the
arthritis continues for years.
"We were seeing people at our rheumatology clinic
whose signs and symptoms really mimicked rheuma-
toid arthritis but who had been infected with chi-
kungunya," Lenschow said. "This raised the question
in our minds, 'Would therapeutics we use to treat
rheumatoid arthritis be of any benefit to patients
with chikungunya arthritis?'"
To find out, Lenschow, co-senior author Michael
Diamond, MD, PhD, and colleagues tested a panel of
six rheumatoid arthritis drugs---all approved by the
Food and Drug Administration for use in patients---on
mice infected with chikungunya virus.
All six drugs work by suppressing the activity of the
immune system. Although different in many ways,
rheumatoid arthritis and chikungunya arthritis both
involve out-of-control immune activity in the joints.
The researchers injected seven groups of mice with
the virus and three days later administered one of the
six arthritis drugs or a placebo to each group of mice.
A week after infection---when the mice's arthritis
signs were at their peak---the researchers measured
the amount of swelling around the joints as well as
the numbers of immune cells and molecules in the
Two of the drugs---abatacept and tofacitinib---
significantly reduced the swelling and the levels of
immune cells and molecules. Importantly, the levels
of live virus did not increase in the animals given the
immunosuppressive arthritis drugs.
"There was a significant concern that administer-
ing any immunosuppressive drug would allow the
virus to escape from immune control, leading to
worse outcomes in the long-term," said Diamond,
the Herbert S Gasser Professor of Medicine. "We've
seen that with other viruses, but in this case, none of
the drugs seemed to exacerbate viral replication. This
raises the possibility that these drugs can be safely
investigated in humans."
The treatment was only partially successful at re-
solving the arthritis, however, which led the research-
ers to test whether adding a human antibody against
chikungunya virus could improve the effectiveness.
Each drug individually reduced joint swelling a week
after infection. But when abatacept and the antiviral
drug were used together, the joint swelling and the
infectious virus in the animals' joints were eliminated.
"We saw real improvement in the acute phase, but
unfortunately, the drug interventions we tried failed
to correct the chronic phase," Diamond said.
In humans, the chronic phase of chikungunya ar-
thritis starts three weeks after initial infection and
lasts as long as the patient continues to experience
joint pain, which can be three or four years. During the
chronic phase, infectious virus is no longer detect-
able in the joints, but viral genetic material persists
and may be sufficient to trigger an ongoing immune
Although different in many ways,
rheumatoid arthritis and chikungunya
arthritis both involve out-of-control
immune activity in the joints.
Drug combo works against chikungunya arthritis in mice
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