On Getting Arthritis:"Welcome to the Club"

As a Manhattanite who loves to walk and takes the subway a great deal, it was a lousy morning indeed when I awoke with a terrible pain in my left knee that seemed to drag into it all the muscles of my left leg and making walking so painful as to be almost impossible for about a week.

Diagnosis: "Garden variety arthritis" ( which I already had in my right wrist following its healing from break three years ago) and a delay in getting imaging done because of the arctic vortex weather changing my doctor's schedule ( which was just getting interrupted anyway).

My cousin's wife, who worked for 40 years in an Orthopedic group practice office before retiring recently, sent me emails about ordinary treatments and tossed off the remark, " as Bette Davis said,'growing old is not for sissies."

Or, as a doctor quipped, "growing old sucks." 

Every day I merrily had walked passed a myriad of people on the sidewalk with all their different kinds of canes, limps and walking sticks and to tell you the truth I often wondered how longer I would be spared joining them.

I also discovered (and remembered) that when it came to knee pain, I was one of the few people I knew who didn't have some already ( my best friend in NYC, Jesus -- by the way, it seems so strange to write for other people " as my friend Jesus was telling me the other day"-- well anyway about a year ago he could hardly walk).

I talked to him on the phone and found without doing anything special he had been relatively pain free for months now. Go figure.

(In regards to Jesus, another friend of mine could not resist adding, " whatever you do next, ask yourself, 'What would Jesus do'?").

Another recent article suggested most knee surgery for common knee arthritis was a waste of time compared to other therapies.

Comes now the newest research on the affliction, introducing us to the wonderful new world of "large mimiviruses,"-- well, read on

Gigantic oddball virus triggers arthritis in mice

• 11:44 20 January 2014 by Andy Coghlan

Five times bigger than normal viruses, gigantic mimiviruses have long been a curiosity. Now, for the first time, they have been linked to a disease that humans get.

Rather than the viruses causing infection directly, it is the proteins they make that seem to be the culprit, triggering an immune response that led to arthritis in mice.

Meanwhile, blood tests from a small group of people with arthritis suggest they are more likely than healthy people to carry antibodies to a particular mimivirus protein that is of the type that comes under attack in the condition.

Though bigger studies in people are now needed, the findings suggest mimiviruses could trigger some human cases of rheumatoid arthritis, which is caused by the body's immune system attacking itself.

Discovered more than a decade ago in a cooling tower in Bradford, UK, mimiviruses get their name because their size mimics that of bacteria rather than other viruses. They are known to infect and kill amoebas, but no link to disease in humans had previously been found.

Protein injections

While trawling through publically available gene libraries, Thierry Hennet of the University of Zurich, Switzerland, noticed that mimiviruses make proteins called collagens that are very similar to those made by humans.

Hennet's main research focus is how arthritis is affected by collagens. These are the basic structural proteins in animals, which break down in rheumatoid arthritis – and have never been seen in viruses before.

He wondered whether people coming into contact with mimiviruses, through exposure to contaminated sea or lake water for example, might make antibodies against the mimivirus collagen. These antibodies might then go on to attack human collagen because it's so similar, eventually leading to arthritis.

To investigate, his team injected mice with a mixture of 60 proteins that had been extracted from mimiviruses bred in the lab, including several collagens. They also injected a second group of mice with just one of these collagens, L71, and a third group with just cow collagen, already known to trigger arthritis in mice.

The group that received the cow collagen developed the most severe cases of arthritis, as expected. But all the mice that received protein injections were more likely to develop arthritis than control mice who received none.

Mimiviruses everywhere

Later, Hennet tested the blood of 100 people with arthritis and 100 without. He found antibodies against L71 in 22 of the people with arthritis, compared with just six in the healthy group, suggesting that mimivirus might play a role in human arthritis too.

"This is fascinating research, and certainly worth following," says David Scott, chief medical adviser to the UK National Arthritis Society. "The numbers from the patients are small, so the link to rheumatoid arthritis is weak, but very new and exciting."

The blood tests also suggested that people do come into contact with mimiviruses – but that they alone don't cause arthritis. Around a third of samples in both those with arthritis and healthy controls had antibodies to L425, a major mimivirus coat protein, suggesting that the same number of people from both groups had been exposed to the virus.

Hennet also found mimiviruses in two of 10 random water samples from Lake Zurich. "They are everywhere, and we can't escape contact with them," he says.

He stresses that more research is needed to explore the link further. "My message is that these complex viruses are not directly pathogenic, but may still contribute to development of autoimmune disorders such as rheumatoid arthritis in the long term," he says.

Journal reference: Journal of Virology, doi.org/qvm