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In Search of the Holy Grail: A Specific Diagnostic Test for Rheumatic Fever
David J McMillan1,2, Rukshan A M Rafeek2, Robert E Norton2,3,4
1School of Science and Technology, Engineering and Genecology Research Centre, University of the Sunshine Coast, Maroochydore, QLD, Australia.
Frontiers in Cardiovascular Medicine
|May 31, 2021
Summary
Developing a specific diagnostic test for Acute Rheumatic Fever and Rheumatic Heart Disease (ARF/RHD) is possible by identifying pathogen-associated peptides. This approach could lead to more accurate diagnosis and safer vaccine development for streptococcal infections.
Area of Science:
- Immunology
- Microbiology
- Cardiovascular Medicine
Background:
- Current Acute Rheumatic Fever and Rheumatic Heart Disease (ARF/RHD) diagnosis relies on non-specific clinical and laboratory markers.
- Existing laboratory tests detect general streptococcal infection evidence or inflammation, lacking specificity for ARF/RHD.
Purpose of the Study:
- To propose a novel strategy for developing a specific diagnostic test for ARF/RHD.
- To leverage current understanding of streptococcal biology and immunopathology for diagnostic advancements.
Main Methods:
- Utilizing antibody array technology and/or T-cell tetramers to identify pathogen-associated peptides specific to ARF/RHD.
- Collaborating to share well-characterized patient samples for peptide identification.
- Employing an appropriate animal model to validate pathognomonic peptides.
Main Results:
- The study contends that sufficient knowledge exists to identify specific streptococcal peptides for ARF/RHD diagnosis using current technologies.
- Proposed peptides can be incorporated into affordable point-of-care diagnostic devices.
Conclusions:
- Identification of pathogen-associated peptides offers a pathway to a specific ARF/RHD diagnostic test.
- This approach will also aid in evaluating the safety of anti-streptococcal vaccines, preventing adverse outcomes.
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