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Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that induces in humans a disease characterized by fever, rash, and pain in muscles and joints. The recent emergence or reemergence of CHIKV in the Indian Ocean Islands and India has stressed the need to better understand the pathogenesis of this disease. Previous CHIKV disease models have used young or immunodeficient mice, but these do not recapitulate human disease patterns and are unsuitable for testing immune-based therapies. Herein, we describe what we believe to be a new model for CHIKV infection in adult, immunocompetent cynomolgus macaques. CHIKV infection in these animals recapitulated the viral, clinical, and pathological features observed in human disease. In the macaques, long-term CHIKV infection was observed in joints, muscles, lymphoid organs, and liver, which could explain the long-lasting CHIKV disease symptoms observed in humans. In addition, the study identified macrophages as the main cellular reservoirs during the late stages of CHIKV infection in vivo. This model of CHIKV physiopathology should allow the development of new therapeutic and/or prophylactic strategies.

Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic and no antiviral drug or vaccine is yet available for the treatment of this disease 1-3. Several clinical studies are ongoing to evaluate the efficacy of repurposed drugs that have demonstrated antiviral efficacy in vitro. Among these candidates, hydroxychloroquine (HCQ) has been given to thousands of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-the virus that causes COVID-19-worldwide but there is no definitive evidence that HCQ is effective for treating COVID-19 4-7. Here we evaluated the antiviral activity of HCQ both in vitro and in SARS-CoV-2-infected macaques. HCQ showed antiviral activity in African green monkey kidney cells (Vero E6) but not in a model of reconstituted human airway epithelium. In macaques, we tested different treatment strategies in comparison to a placebo treatment, before and after peak viral load, alone or in combination with azithromycin (AZTH). Neither HCQ nor the combination of HCQ and AZTH showed a significant effect on viral load in any of the analysed tissues. When the drug was used as a pre-exposure prophylaxis treatment, HCQ did not confer protection against infection with SARS-CoV-2. Our findings do not support the use of HCQ, either alone or in combination with AZTH, as an antiviral drug for the treatment of COVID-19 in humans. Infection with SARS-CoV-2 is characterized by initial mild disease associated with respiratory symptoms at the peak of viral replication 1,8. In some patients, a late severe immunological syndrome occurs 6-14 days after the onset of symptoms that may require intensive care and is responsible for most of the fatalities 1-3. HCQ has well-documented in vitro activity against various viruses 4 and has emerged as an active compound against SARS-CoV-2 in different screening programmes, including a library of 1,520 Food and Drug Administration (FDA)-approved compounds 5. In Vero E6 cells, HCQ has a 50% maximal effective concentration (EC 50) 5,9,10 that varies between 0.7 and 4 μM. It may inhibit viral transport in endosomes by alkalinizing the intra-organelle compartment 10,11 and affect glycosylation, as reported for other viruses 12. The drug may also act as an immunomodulatory agent 13,14. In patients with lupus, HCQ decreases the level of inflammatory cytokines 11,15,16 , which may be relevant for the treatment of COVID-19 2. Furthermore, it has been proposed that AZTH, which displays in vitro antiviral activity against SARS-COV-2 5,17 , could potentiate the efficacy of HCQ 6. On the basis of these properties, HCQ has been considered for the treatment of COVID-19, alone or in combination with AZTH 6,7. We and others have set up non-human primate (NHP) models of SARS-CoV-2 infection 18-20. Here we used cynomolgus macaques (Macaca fascicularis) to test different treatment strategies with HCQ, alone or in combination with AZTH, before or after the peak of viral replication. We also tested HCQ administration as pre-exposure prophylaxis treatment...

Chikungunya virus (CHIKV) and related arboviruses have been responsible for large epidemic outbreaks with serious economic and social impact. The immune mechanisms, which control viral multiplication and dissemination, are not yet known. Here, we studied the antibody response against the CHIKV surface antigens in infected patients. With plasma samples obtained during the early convalescent phase, we showed that the naturally-acquired IgG response is dominated by IgG3 antibodies specific mostly for a single linear epitope ‘E2EP3’. E2EP3 is located at the N-terminus of the E2 glycoprotein and prominently exposed on the viral envelope. E2EP3-specific antibodies are neutralizing and their removal from the plasma reduced the CHIKV-specific antibody titer by up to 80%. Screening of E2EP3 across different patient cohorts and in non-human primates demonstrated the value of this epitope as a good serology detection marker for CHIKV infection already at an early stage. Mice vaccinated by E2EP3 peptides were protected against CHIKV with reduced viremia and joint inflammation, providing a pre-clinical basis for the design of effective vaccine against arthralgia-inducing CHIKV and other alphaviruses.

IntroductionVectors derived from retroviruses offer particularly flexible properties in gene transfer applications given the numerous possible associations of various viral surface glycoproteins (GPs; determining cell tropism) with different types of viral cores (determining genome replication and integration). 1 For example, association of the vesicular stomatitis virus G (VSV-G) GP with viral cores derived from lentiviruses results in vector pseudotypes that have broad tropism and can integrate into nonproliferating target cells. 2 They have proved useful for the transduction of several cell types ex vivo and in vivo. [3][4][5][6][7] Yet there is considerable interest in exploring the properties of lentiviral vectors pseudotyped with alternative viral GPs. [8][9][10][11][12][13][14] This parameter is likely to modulate the physicochemical properties of the vectors, their interaction with the host immune system, and their host range. Several studies have indeed shown that the transduction efficiency of target cells is dependent on the type of GP used to coat retroviral vectors. [15][16][17][18][19][20] Additionally, some in vivo gene transfer applications will require vectors that are targeted for specific cell entry or gene expression (or both) after systemic administration. 21 Due to the wide distribution of its receptor, a lipid component of the plasma membrane, 22 VSV-G pseudotypes may bind to the surface of all cells encountered after inoculation before reaching the target cells. Moreover, VSV-Gpseudotyped vectors are rapidly inactivated by human serum 23 and this might impose a limitation on the use of VSV-G as a GP to pseudotype vectors for systemic gene delivery.Lentiviral vectors derived from simian immunodeficiency virus (SIV) have been generated in several laboratories, 1 including our own. 24 Characterization of these vectors has indicated that they are similar to those derived from human immunodeficiency virus 1 (HIV-1) with respect to the insertion of transgenes in nonproliferating cells, although SIV vectors perform better than HIV-1 vectors in simian cells. 24 Here, we report the properties of SIVmac-derived vectors pseudotyped with a panel of GPs derived from different membrane-enveloped viruses. In particular, we examined stability in human or macaque sera and gene transfer in primary hematopoietic cells including peripheral blood lymphocytes (PBLs) and CD34 ϩ cells. Materials and methods CellsThe 293T human embryo kidney cell line (American Type Culture Collection, Rockville, MD, CRL-1573) and the TE671 human rhabdomyosarcoma cell line (ATCC CRL-8805) were grown in Dulbecco modified Eagle medium (DMEM; Life Technologies, Cergy-Pontoise, France) supplemented with 10% fetal calf serum (FCS).Human and cynomolgus macaque (Macaca fascicularis) CD34 ϩ cells were obtained according to the institutional guidelines of the ethic commission from mobilized blood and bone marrow samples, respectively, as described previously. 25-27 CD34 ϩ cells were recovered after Ficoll-Paque (Amersham-Pharmacia Biot...

Two of the crucial aspects of human immunodeficiency virus (HIV) infection are (i) viral persistence in reservoirs (precluding viral eradication) and (ii) chronic inflammation (directly associated with all-cause morbidities in antiretroviral therapy (ART)-controlled HIV-infected patients). The objective of the present study was to assess the potential involvement of adipose tissue in these two aspects. Adipose tissue is composed of adipocytes and the stromal vascular fraction (SVF); the latter comprises immune cells such as CD4+ T cells and macrophages (both of which are important target cells for HIV). The inflammatory potential of adipose tissue has been extensively described in the context of obesity. During HIV infection, the inflammatory profile of adipose tissue has been revealed by the occurrence of lipodystrophies (primarily related to ART). Data on the impact of HIV on the SVF (especially in individuals not receiving ART) are scarce. We first analyzed the impact of simian immunodeficiency virus (SIV) infection on abdominal subcutaneous and visceral adipose tissues in SIVmac251 infected macaques and found that both adipocytes and adipose tissue immune cells were affected. The adipocyte density was elevated, and adipose tissue immune cells presented enhanced immune activation and/or inflammatory profiles. We detected cell-associated SIV DNA and RNA in the SVF and in sorted CD4+ T cells and macrophages from adipose tissue. We demonstrated that SVF cells (including CD4+ T cells) are infected in ART-controlled HIV-infected patients. Importantly, the production of HIV RNA was detected by in situ hybridization, and after the in vitro reactivation of sorted CD4+ T cells from adipose tissue. We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection. These observations open up new therapeutic strategies for limiting the size of the viral reservoir and decreasing low-grade chronic inflammation via the modulation of adipose tissue-related pathways.

Chikungunya virus (CHIKV) is an arthritogenic alphavirus causing epidemics of acute and chronic arthritic disease. Herein we describe a comprehensive RNA-Seq analysis of feet and lymph nodes at peak viraemia (day 2 post infection), acute arthritis (day 7) and chronic disease (day 30) in the CHIKV adult wild-type mouse model. Genes previously shown to be up-regulated in CHIKV patients were also up-regulated in the mouse model. CHIKV sequence information was also obtained with up to ≈8% of the reads mapping to the viral genome; however, no adaptive viral genome changes were apparent. Although day 2, 7 and 30 represent distinct stages of infection and disease, there was a pronounced overlap in up-regulated host genes and pathways. Type I interferon response genes (IRGs) represented up to ≈50% of up-regulated genes, even after loss of type I interferon induction on days 7 and 30. Bioinformatic analyses suggested a number of interferon response factors were primarily responsible for maintaining type I IRG induction. A group of genes prominent in the RNA-Seq analysis and hitherto unexplored in viral arthropathies were granzymes A, B and K. Granzyme A-/- and to a lesser extent granzyme K-/-, but not granzyme B-/-, mice showed a pronounced reduction in foot swelling and arthritis, with analysis of granzyme A-/- mice showing no reductions in viral loads but reduced NK and T cell infiltrates post CHIKV infection. Treatment with Serpinb6b, a granzyme A inhibitor, also reduced arthritic inflammation in wild-type mice. In non-human primates circulating granzyme A levels were elevated after CHIKV infection, with the increase correlating with viral load. Elevated granzyme A levels were also seen in a small cohort of human CHIKV patients. Taken together these results suggest granzyme A is an important driver of arthritic inflammation and a potential target for therapy.Trial Registration: ClinicalTrials.gov NCT00281294

At the end of 2005, an outbreak of fever associated with joint pain occurred in La Réunion. The causal agent, chikungunya virus (CHIKV), has been known for 50 years and could thus be readily identified. This arbovirus is present worldwide, particularly in India, but also in Europe, with new variants returning to Africa. In humans, it causes a disease characterized by a typical acute infection, sometimes followed by persistent arthralgia and myalgia lasting months or years. Investigations in the La Réunion cohort and studies in a macaque model of chikungunya implicated monocytes-macrophages in viral persistence. In this Review, we consider the relationship between CHIKV and the immune response and discuss predictive factors for chronic arthralgia and myalgia by providing an overview of current knowledge on chikungunya pathogenesis. Comparisons of data from animal models of the acute and chronic phases of infection, and data from clinical series, provide information about the mechanisms of CHIKV infection–associated inflammation, viral persistence in monocytes-macrophages, and their link to chronic signs.