Robust COX-2-mediated prostaglandin response may drive arthralgia and bone destruction in patients with chronic inflammation post-chikungunya

PLoS Negl Trop Dis. 2021 Feb 17;15(2):e0009115. doi: 10.1371/journal.pntd.0009115. eCollection 2021 Feb.

Abstract

Patients following infection by chikungunya virus (CHIKV) can suffer for months to years from arthralgia and arthritis. Interestingly, methotrexate (MTX) a major immune-regulatory drug has proved to be of clinical benefit. We have previously shown that CHIKV can persist in the joint of one patient 18 months post-infection and plausibly driving chronic joint inflammation but through ill-characterized mechanisms. We have pursued our investigations and report novel histological and in vitro data arguing for a plausible role of a COX-2-mediated inflammatory response post-CHIKV. In the joint, we found a robust COX-2 staining on endothelial cells, synovial fibroblasts and more prominently on multinucleated giant cells identified as CD11c+ osteoclasts known to be involved in bone destruction. The joint tissue was also strongly stained for CD3, CD8, CD45, CD14, CD68, CD31, CD34, MMP2, and VEGF (but not for NO synthase and two B cell markers). Dendritic cells were rarely detected. Primary human synovial fibroblasts were infected with CHIKV or stimulated either by the synthetic molecule polyriboinosinic:polyribocytidylic acid (PIC) to mimic chronic viral infection or cytokines. First, we found that PIC and CHIKV enhanced mRNA expression of COX-2. We further found that PIC but not CHIKV increased the mRNA levels of cPLA2α and of mPGES-1, two other central enzymes in PGE2 production. IFNβ upregulated cPLA2α and COX-2 transcription levels but failed to modulated mPGES-1 mRNA expression. Moreover, PIC, CHIKV and IFNβ decreased mRNA expression of the PGE2 degrading enzyme 15-PGDH. Interestingly, MTX failed to control the expression of all these enzymes. In sharp contrast, dexamethasone was able to control the capacity of pro-inflammatory cytokines, IL-1β as well as TNFα, to stimulate mRNA levels of cPLA2α, COX-2 and mPGES-1. These original data argue for a concerted action of CHIKV (including viral RNA) and cytokines plausibly released from recruited leukocytes to drive a major COX-2-mediated PGE2 proinflammatory responses to induce viral arthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthralgia / metabolism*
  • Arthralgia / pathology
  • Arthralgia / virology
  • Arthritis / virology
  • Chikungunya Fever / metabolism*
  • Chikungunya Fever / pathology
  • Chikungunya virus
  • Cyclooxygenase 2 / metabolism*
  • Cytokines / metabolism
  • Dinoprostone / metabolism
  • Endothelial Cells / metabolism
  • Fibroblasts / metabolism
  • Humans
  • Inflammation / metabolism*
  • Interleukin-1beta
  • Methotrexate
  • Prostaglandins / metabolism*
  • RNA, Messenger / metabolism
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Cytokines
  • IL1B protein, human
  • Interleukin-1beta
  • Prostaglandins
  • RNA, Messenger
  • TNF protein, human
  • Tumor Necrosis Factor-alpha
  • Cyclooxygenase 2
  • Dinoprostone
  • Methotrexate

Grants and funding

YB is a fellow of the Regional Council of La Reunion (ref 234277) (https://regionreunion.com). This study was funded by the Regional Council of la Réunion, Europe and the French state through the Viropam research program reference D2017024696, POE FEDER (https://regionreunion.com/sites/feder/). 2014-2020 1.09, Grant number: GURDTI 2017-1198-0002583, N° Synergie RE0002583 to PGu and JS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.