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Rheumatic fever and rubella immunity
M el-Kholy1, M Helmy, M Shaker
1Pediatric Department, Ain Shams University, Cairo, Egypt.
Insights
Children with rheumatic fever had significantly lower rubella IgG antibody titers compared to healthy controls. This suggests lower rubella immunity may increase susceptibility to rheumatic fever, warranting investigation into rubella vaccination for prevention.
Area of Science:
- Immunology
- Pediatrics
- Rheumatology
Background:
- Rheumatic fever is a significant childhood illness.
- The etiology of rheumatic fever remains incompletely understood.
- Rubella virus has been investigated as a potential contributing factor.
Purpose of the Study:
- To investigate the association between anti-rubella IgG antibody titers and rheumatic fever in children.
- To compare rubella IgG levels in children with acute rheumatic fever, a history of rheumatic fever, or rheumatic heart disease with healthy controls.
Main Methods:
- Quantification of anti-rubella IgG antibody titers using enzyme-linked immunosorbent assay (ELISA).
- Comparison of IgG titers between a cohort of 106 children with rheumatic conditions and 35 healthy controls.
- Statistical analysis to determine significant differences in antibody levels.
Main Results:
- Children with rheumatic conditions exhibited significantly lower rubella IgG titers (521.2 +/- 3.0) compared to controls (1066.5 +/- 8.3) (p < 0.001).
- No significant differences in rubella IgG titers were observed between acute rheumatic fever cases and those with a history of rheumatic fever or rheumatic heart disease.
- No significant gender-based differences in rubella IgG titers were found in either cases or controls.
Conclusions:
- Lower rubella IgG levels in children with rheumatic fever may indicate increased susceptibility.
- Elevated rubella immunity might confer protection against rheumatic fever, potentially by cross-immunity to a related agent.
- Rubella vaccination could be a potential strategy for preventing rheumatic fever.
Abstract:
Anti-rubella IgG titer was estimated in 106 children: sixty five had acute rheumatic fever and 41 had either a history of rheumatic fever or a definite rheumatic heart disease. Their ages ranged from 6 to 16 years old (11.4 +/- 2.7 years). Sixty two were females and 44 were males. They were compared with 35 control normal subjects of both sexes with no history of rheumatic affection, aged 5 to 14 years (10.2 +/- 3.6 years). The results obtained showed a significantly (p less than 0.001) higher rubella IgG titer level in the controls (1066.5 +/- 8.3) as compared to the rheumatic cases (521.2 +/- 3.0). No differences were found in the rubella antibody titer between cases of acute rheumatic fever and those with history of rheumatic fever or rheumatic heart disease, nor between males and females in either cases or controls. We suggested that the low rubella IgG levels encountered in the rheumatic cases, make them more susceptible to rheumatic fever affection. In other words, a high immunity level against rubella might also produce an immunity against an agent, possibly related to rubella virus, with a specific role in the development of rheumatic fever. Vaccination against rubella could be worth a trial, for prevention of rheumatic fever.