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Rheumatic Heart Disease: Pathogenesis and Vaccine
L Guilherme1,2, S Freschi de Barros1,2, K F Kohler1,2
1Heart Institute (InCor), Department of Clinical Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Current Protein & Peptide Science
|July 27, 2017
Summary
Rheumatic fever and rheumatic heart disease stem from untreated S. pyogenes infections in genetically susceptible children, triggering autoimmune responses. This review explores susceptibility genes, molecular mimicry, and potential vaccine strategies.
Area of Science:
- Immunology
- Genetics
- Cardiology
Background:
- Rheumatic fever (RF) and rheumatic heart disease (RHD) are serious sequelae of untreated Group A Streptococcus (S. pyogenes) throat infections.
- Genetic predisposition plays a crucial role in the development of autoimmune reactions following S. pyogenes infection.
Purpose of the Study:
- To review the genetic factors conferring susceptibility to RF and RHD.
- To elucidate the autoimmune mechanisms, particularly molecular mimicry between human proteins and streptococcal M protein.
- To discuss current perspectives on vaccine development for disease prevention.
Main Methods:
- Literature review focusing on genetic susceptibility and autoimmune mechanisms in RF/RHD.
- Analysis of molecular mimicry between S. pyogenes M protein and human tissue antigens.
- Exploration of vaccine development strategies.
Main Results:
- Specific genes are associated with increased risk of developing RF and RHD.
- Molecular mimicry involving streptococcal M protein is a key driver of autoimmune responses.
- Clinical manifestations include polyarthritis, carditis, severe valve damage, and Sydenham's chorea.
Conclusions:
- Understanding genetic susceptibility and autoimmune pathways is critical for preventing RF and RHD.
- Vaccine development targeting S. pyogenes holds promise for primary prevention of these debilitating diseases.
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