{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:46:06Z","timestamp":1790682366225,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1\u2010TR\u2010001876"],"award-info":[{"award-number":["UL1\u2010TR\u2010001876"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2\u2010TR\u2010001877"],"award-info":[{"award-number":["KL2\u2010TR\u2010001877"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if chikungunya virus persists in synovial fluid after infection, potentially acting as a causative mechanism of persistent arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross\u2010sectional study of 38 Colombian participants with clinical chikungunya virus infection during the 2014\u20132015 epidemic who reported chronic arthritis and 10 location\u2010matched controls without chikungunya virus or arthritis. Prior chikungunya virus infection status was serologically confirmed, and the presence of synovial fluid chikungunya virus, viral\n                      <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content>\n                      , and viral proteins was determined by viral culture, quantitative reverse transcription\u2013polymerase chain reaction (\n                      <jats:styled-content style=\"fixed-case\">qRT<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      ), and mass spectrometry, respectively. Biomarkers were assessed by multiplex analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with serologically confirmed chikungunya arthritis (33 of 38 [87%]) were predominantly female (82%) and African Colombian (55%) or white Colombian (33%), with moderate disease activity (mean \u00b1\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      Disease Activity Score in 28 joints 4.52 \u00b1 0.77) a median of 22 months after infection (interquartile range 21\u201323 months). Initial symptoms of chikungunya virus infection included joint pain (97%), swelling (97%), stiffness (91%), and fever (91%). The most commonly affected joints were the knees (87%), elbows (76%), wrists (75%), ankles (56%), fingers (56%), and toes (56%). Synovial fluid samples from all patients with chikungunya arthritis were negative for chikungunya virus on\n                      <jats:styled-content style=\"fixed-case\">qRT<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      , showed no viral proteins on mass spectrometry, and cultures were negative. Case and control plasma cytokine and chemokine concentrations did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is one of the largest observational studies involving analysis of the synovial fluid of chikungunya arthritis patients. Synovial fluid analysis revealed no detectable chikungunya virus. This finding suggests that chikungunya virus may cause arthritis through induction of potential host autoimmunity, suggesting a role for immunomodulating agents in the treatment of chikungunya arthritis, or that low\u2010level viral persistence exists in synovial tissue only and is undetectable in synovial fluid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.40383","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T00:04:04Z","timestamp":1513728244000},"page":"585-593","source":"Crossref","is-referenced-by-count":84,"title":["Chikungunya Arthritis Mechanisms in the Americas"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7410-9867","authenticated-orcid":false,"given":"Aileen Y.","family":"Chang","sequence":"first","affiliation":[{"name":"The George Washington University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A. 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