Closing the gap between viral and noninfectious arthritis.

Abstract

Worldwide, mosquito-borne alphaviruses are a major cause of infectious arthritis-like disease, but this has not yet significantly impacted the Americas (1). The arthritogenic alphaviruses include Ross River virus (RRV), chikungunya virus (CHIKV), Sindbis-like viruses (SINV), Barmah Forest virus (BFV), Mayaro virus (MAYV), and o’nyong-nyong virus (ONNV), which are typically found from Europe to central Africa, southern Asia, and in portions of northern South America (2). Infection with these viruses begins as a febrile illness, which in a high percentage of cases, can progress to rheumatic disease, which has been described as polyyarthralgia and/or polyarthritis and can be chronic, flaring, and potentially debilitating (2). In PNAS, Chen et al. (3) present evidence that joint pain and associated symptoms of arthritogenic alphavirus infection (in this case a mouse model of RRV) are strikingly similar to a classical arthritis manifestation, exhibiting cytokine induction profiles reminiscent of rheumatoid arthritis and disruption of osteoblast/osteoclast homeostasis, leading to bone loss.