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Lymphocyte surface markers in acute rheumatic fever and post-streptococcal acute glomerulonephritis
Insights
Children with acute rheumatic fever (ARF) and acute post-streptococcal glomerulonephritis (AGN) show distinct lymphocyte cell-surface marker changes. These immune cell alterations may help differentiate ARF and AGN in pediatric patients.
Area of Science:
- Immunology
- Pediatrics
- Rheumatology
Background:
- Acute rheumatic fever (ARF) and acute post-streptococcal glomerulonephritis (AGN) are post-infectious sequelae.
- Understanding immune system involvement is crucial for diagnosis and management.
Purpose of the Study:
- To investigate lymphocyte cell-surface marker profiles in children with ARF and AGN.
- To compare these profiles with healthy controls.
Main Methods:
- Flow cytometry analysis of lymphocyte subsets.
- Evaluation of surface immunoglobulin (Ig), Fc receptors, and T-cell rosettes.
- Assessment of streptococcal antigen-binding cells.
Main Results:
- Elevated proportions of cells with surface Ig and Fc receptors in AGN patients.
- Increased active T-cell rosettes in ARF patients with carditis or chorea.
- Elevated streptococcal antigen-binding cells in both ARF and AGN acute phases, predominantly B cells.
Conclusions:
- Distinct lymphocyte marker patterns are observed in pediatric ARF and AGN.
- These findings may aid in differentiating these conditions.
- Immune cell profiling offers insights into the pathogenesis of these post-streptococcal diseases.
Abstract:
Lymphocyte cell-surface markers were examined in forty children with acute rheumatic fever (ARF) and twelve with acute post-streptococal glomerulonephritis (AGN) and compared to thirty-six normal controls of similar age. Cell-surface-marker studies included surface Ig using fluorescein-labelled F(ab)2 anti-F(AB')2, IgG aggregate binding cells, and EAC rosettes. T cells were identified both as 'active' rosettes and total E-binding cells. Proportions and absolute numbers of cells bearing surface Ig and Fc receptors were elevated in subjects with AGN (Pless than0-01-0-5), whereas proportions of cells producing EAC rosettes were diminished. Patients with acute rheumatic carditis or chorea showed a substantial elevation in proportions and numbers of active T-cell rosettes (Pless than0-01). Streptococcal antigen binding cells capable of forming rosettes with autologous cells coated with group A streptococcal membranes were elevated in the acute phase of both rheumatic fever and acute glomerulonephritis(Pless than0-01). The majority of such cells were removed by passage over insolubilized Ig-anti-IgG columns and appeared to be B cells.