Envolvimento do VCAM-1 com artrite em pacientes com Chikungunya crônica

Abstract

The chronic phase of chikungunya is characterized by prolonged joint manifestations, whose underlying mechanisms remain poorly understood. Among the investigated biomarkers, Vascular Cell Adhesion Molecule-1 (VCAM-1) stands out for its role in endothelial activation and leukocyte recruitment in inflammatory processes. This study aimed to evaluate the relationship between serum levels of the adhesion molecule VCAM-1 and the presence of arthralgia in patients with chronic chikungunya. A cross-sectional observational study was conducted with 34 patients diagnosed with chronic chikungunya monitored in a basic health unit. Data were collected through structured interviews, medical record review, and VCAM-1 measurement via ELISA. Sociodemographic, clinical, laboratory, and pain intensity variables were analyzed. The main findings indicated a high frequency of persistent symptoms, such as arthralgia (64.7%), fatigue (44.1%), and paresthesia (41.2%). A statistically significant association was found between arthralgia and symptoms such as edema (p < 0.001), as well as higher scores on the numeric pain scale and EQ-5D-3L (p = 0.007 and p = 0.016, respectively). Notably, VCAM-1 levels were significantly lower in the group with arthralgia (median 514.4 ng/mL) compared to those without joint pain (829.4 ng/mL), with p = 0.021. This finding suggests a lesser involvement of the VCAM-dependent leukocyte adhesion pathway in cases of persistent pain, highlighting the potential involvement of other inflammatory pathways. It is concluded that simple clinical manifestations, such as edema and pain intensity, may be useful for identifying patients at risk of chronic progression. Furthermore, VCAM-1 may serve as a differential biomarker for distinct inflammatory phenotypes. Further studies with larger samples and multiple biomarkers are recommended to deepen understanding of the immunoinflammatory mechanisms of chronic chikungunya.