USA: A study published in the journal Cell Host & Microbe revealed that the chikungunya virus, responsible for more than 10 million cases recorded in around 125 countries over the past 20 years since its arrival, is capable of spreading through the blood, reaching multiple organs and crossing the blood-brain barrier, which protects the central nervous system.
The mechanism by which chikungunya virus can lead to death typically involves severe complications such as encephalitis, severe dehydration from persistent fever and vomiting, or exacerbation of underlying health conditions in individuals. While fatalities directly caused by chikungunya are rare, severe cases can result in systemic complications that contribute to mortality.
The study analyzed data from 32 deceased patients and included test results for the presence of CHIKV in the body, as well as laboratory and autopsy information. Histopathology, quantification of cytokines, metabolomics, proteomics, and viral genomic analysis, as well as real-time reverse transcription-polymerase chain reaction, were performed in samples of blood serum, cerebrospinal fluid, and other tissues. The scientists also evaluated samples and tests from two other groups, one consisting of 39 survivors of acute CHIKV infection and the other consisting of 15 blood donors.
The results showed the presence of CHIKV in cerebrospinal fluid samples, indicating its ability to cross the blood-brain barrier, the physical layer that protects the central nervous system and normally prevents pathogens from entering.
The findings indicated that the invasion of the chikungunya virus occurs through two mechanisms: first, the virus infects CD14+ and CD16+ monocytes and, in the presence of high levels of CCL-2 it migrates across the barrier and is transported to the brain; second, the infection affects proteins that are important for holding the epithelial cells of the blood-brain barrier together.
“This shows that CHIKV is not only responsible for arthralgia, which causes fever, muscle pain and joint swelling, but leads to neurological damage,” explained William Marciel de Souza, professor at the University of Kentucky (United States) and lead author of the study. “In the blood, we observed a severe alteration in the coagulation cascade, with a decrease in some key proteins, as well as hemodynamic damage in the organs, i.e. excess fluid. In the immune system, the levels of cytokines associated with inflammation were higher than those observed in chikungunya patients who survived.”
Reference: William M. de Souza, Marcilio J. Fumagalli, Shirlene T.S. de Lima, Pierina L. Parise, Deyse C.M. Carvalho, Cristian Hernandez, Ronaldo de Jesus, Jeany Delafiori, Darlan S. Candido, Victor C. Carregari, Stefanie P. Muraro, Gabriela F. Souza, Leda M. Simões Mello, Ingra M. Claro, Yamilka Día, Rodrigo B. Kato, Lucas N. Trentin, Clauber H.S. Costa, Ana Carolina B.M. Maximo, Karene F. Cavalcante,Scott C. Weaver; Journal: Cell Host & Microbe; DOI: 10.1016/j.chom.2024.02.011
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