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Rheumatic Fever: A Model of Autoimmune Disease due to Molecular Mimicry between Human and Pathogen Proteins

Jorge Kalil1, Luiza Guilherme1

  • 1Department of Clinical Medicine, Clinical Hospital and Heart Institute (InCor), School of Medicine, University of São Paulo; Heart Institute (InCor), School of Medicine, University of São Paulo; Institute for Immunology Investigation, Millennium Institute, São Paulo.

Critical Reviews in Immunology
|January 19, 2021
PubMed

Insights

Acute rheumatic fever (ARF) is an autoimmune condition triggered by Streptococcus pyogenes infection. This review details how ARF leads to rheumatic heart disease (RHD), causing heart failure and early death.

Area of Science:

  • Immunology
  • Cardiology
  • Infectious Diseases

Background:

  • Acute rheumatic fever (ARF) is an autoimmune disease following Streptococcus pyogenes infection.
  • Rheumatic heart disease (RHD) is a major complication, leading to heart failure and mortality.
  • Both humoral and cellular immune responses mediate ARF and RHD pathogenesis.

Purpose of the Study:

  • To review the key events triggering cardiac lesions in ARF.
  • To elucidate the autoimmune mechanisms underlying RHD development.

Main Methods:

  • Literature review of studies on ARF and RHD.
  • Analysis of immune responses involved in heart lesion formation.

Main Results:

  • Identified specific Streptococcus pyogenes strains as triggers.
  • Detailed the autoimmune cascade leading to valvular damage.
  • Highlighted the role of genetic susceptibility in disease development.

Conclusions:

  • Understanding ARF pathogenesis is crucial for RHD prevention.
  • Targeting autoimmune responses may offer therapeutic strategies.
  • Further research into genetic factors can improve risk prediction.

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