The Rheumatology Research Foundation recently awarded Aileen Y. Chang, M.D., M.S.P.H., a $75,000 pilot grant to fund her research in rheumatology for a project entitled, “A Pilot Study of the Pathogenesis of Chikungunya Arthritis in the Americas.”
“Chikungunya is a virus spread by mosquitos, the same ones that cause dengue and Zika,” said Chang, assistant professor of medicine at the George Washington University School of Medicine and Health Sciences (SMHS). “It causes chronic arthritis, and for some patients, it can last from months to years. I am interested in finding out what causes the arthritis.”
In the United States, physicians treat severe arthritis pain with immune-modulating medications that inhibit the immune system. Previous studies found evidence of the chikungunya virus in the joints of monkeys six months after contracting the virus. If this trend were to occur in humans as well, physicians would have to alter treatment plans as medications inhibiting the immune system while still housing a virus can be dangerous. Pulling synovial fluid from a cohort of 50 patients, Chang found there was no viral RNA in the joints, meaning there was not persistent virus in the joints, suggesting the safety of current medications.
This discovery led to the next step in her research, with Chang studying the causes behind persistent arthritis. One possibility is that the chikungunya virus may be altering its hosts’ micro-RNA expression, leading to pathways that cause arthritis. Another are altered DNA methylation patterns in CHIKV associated arthritis.
“I think we are really close to finding a new and more appropriate form of treatment, in keeping with efforts at personalized medicine,” said Chang.
Chang is one of 85 rheumatology trainees and professionals who recently received awards from the Foundation. The recipients, ranging from medical students and residents to experienced investigators and rheumatologists, will receive funding for essential education and training, as well as innovative research projects. Their applications were closely examined by experts in different areas of the field through an extensive peer review process. Pilot grants encourage established investigators to begin tests of novel research ideas into arthritis and related inflammatory diseases by providing seed funds to gather preliminary data.
Chang is mentored by Gary Simon, M.D., director of the Division of Infectious Disease and vice chairman of the Department of Medicine, and Jeffrey Bethony, Ph.D., professor of microbiology, immunology, and tropical medicine, both at SMHS.
“Dr. Chang is a talented young investigator whose studies will help elucidate the mechanism of the persistent arthritis that may follow acute infection with chikungunya virus,” said Simon. “This arthritis can last for months or even years and can be very debilitating. Her studies include epidemiology, virology, and immunology and will help lead to appropriate therapies for this condition.”
“Dr. Chang is an excellent translation researcher combining the best elements of clinical and patient based research, with the state of the art next-generation laboratory technologies,” said Bethony. “She is a model translation researcher at GW, bringing excellent skills to the Department of Microbiology, Immunology, and Tropical Medicine. We need more like Dr. Chang.”
Visit the Rheumatology Research Foundation for more information.
