Manifestations chroniques rhumatologiques post-infection à virus chikungunya: Description clinique et orientations thérapeutiques

National audienceThe chikungunya virus epidemic that occurred on Reunion Island from May 2005 to the end of 2006 affected 30% of the population (more than 250 000 people). As a result of its major clinical impact, this outbreak allowed better documentation of the acute phase of the disease. The disease generally has a slowly self-limiting course over a period of several months with rheumatic manifestations. For practitioners, these symptoms raise numerous questions at several levels, i.e., i) role of the virus in pain, ii) most appropriate treatment, and iii) prevention of development of chronic symptoms. This study in two patient cohorts on Reunion Island was carried out in an attempt to improve understanding and management of chronic rheumatic manifestations following chikungunya virus infection. Findings in 360 patients presenting painful manifestations following chikungunya virus infection showed that the risk of developing inflammatory polyarthritis was higher if the initial acute phase lasted longer than 3 weeks. Based on this observation, it is recommended that these patients undergo rheumatologic evaluation at 3 months to assess the need for possible immunosuppressor treatment (methotrexate).L'affection à virus chikungunya qui a sévi à l'Ile de la Réunion de mai 2005 à fin 2006, a atteint 30 % de la population (plus de 250 000 personnes). Le retentissement précoce majeur clinique a permis de mieux décrire la phase aiguë de la maladie. L'évolution est généralement lentement favorable chez un grand nombre de patients avec, sur plusieurs mois, l'expression de manifestations rhumatologiques, interrogeant sur plusieurs plans les praticiens quant à: i) la responsabilité de l'infection à virus chikungunya dans l'expression des manifestations douloureuses, ii) les thérapeutiques à proposer, iii) la possibilité d'enrayer l'évolution chronique. L'observation de deux cohortes de patients à la Réunion tente d'apporter une réponse à la compréhension et à l'amélioration de la prise en charge des manifestations chroniques « post-chikungunya ». L'observation de 360 patients souffrant de manifestations douloureuses post-infection à virus chikungunya fait ressortir le risque majoré de développement d'une polyarthrite inflammatoire lorsque l'atteinte aiguë initiale dure plus de 3 semaines avec la proposition pour ces patients d'une évaluation rhumatologique à 3 mois pour traitement par immunosupresseur (méthotrexate)

Osteoblastic cell response on high-rough titanium coatings by cold spray

Highly rough and porous commercially pure titanium coatings have been directly produced for first time by the cold spray technology, which is a promising technology in front of the vacuum plasma spray for oxygen sensitive materials. The wettability properties as well as the biocompatibility evaluation have been compared to a simply sand blasted Ti6Al4V alloy substrate. Surface topographies were analysed using confocal microscopy. Next, osteoblast morphology (Phalloidin staining), proliferation (MTS assay), and differentiation (alkaline phosphatase activity) were examined along 1, 7 and 14 days of cell culture on the different surfaces. Finally, mineralization by alizarin red staining was quantified at 28 days of cell culture. The contact angle values showed an increased hydrophilic behaviour on the as-sprayed surface with a good correlation to the biological response. A higher cell viability, proliferation and differentiation were obtained for highly rough commercial pure titanium coatings in comparison with sand blasted substrates. Cell morphology was similar in all coatings tested; at 14 days both samples showed extended filopodia. A higher amount of calcium-rich deposits was detected on highly rough surfaces. In summary, in-vitro results showed an increase of biological properties when surface roughness increases.The authors want to thank the Spanish MINECO for financial support through project MAT2013-46755-R and the Generalitat de Catalunya for the project 2014 SGR 1558, and University of Barcelona for the award of a scholarship that has helped the development of this research. This work was also supported by the Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF; RD12/0043/0022), the Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES; CB16/10/00245) and FEDER funds

A three-dimensional block structure consisting exclusively of carbon nanotubes serving as bone regeneration scaffold and as bone defect filler

Many recent studies have been conducted to assess the ability of composite materials containing carbon nanotubes (CNTs) with high bone affinity to serve as scaffolds in bone regenerative medicine. These studies have demonstrated that CNTs can effectively induce bone formation. However, no studies have investigated the usefulness of scaffolds consisting exclusively of CNTs in bone regenerative medicine. We built a three-dimensional block entity with maximized mechanical strength from multi-walled CNTs (MWCNT blocks) and evaluated their efficacy as scaffold material for bone repair. When MWCNT blocks containing recombinant human bone morphogenetic protein-2 (rhBMP-2) were implanted in mouse muscle, ectopic bone was formed in direct contact with the blocks. Their bone marrow densities were comparable to those of PET-reinforced collagen sheets with rhBMP-2. On day 1 and day 3, MC3T3-E1 preosteoblasts were attached to the scaffold surface of MWCNT blocks than that of PET-reinforced collagen sheets. They also showed a maximum compression strength comparable to that of cortical bone. Our MWCNT blocks are expected to serve as bone defect filler and scaffold material for bone regeneration