Document Detail

Revisiting the pathogenesis of rheumatic fever and carditis.
MedLine Citation:
PMID:  23319102     Owner:  NLM     Status:  MEDLINE    
Rheumatic fever is one of the most-neglected ailments, and its pathogenesis remains poorly understood. The major thrust of research has been directed towards cross-reactivity between streptococcal M protein and myocardial α-helical coiled-coil proteins. M protein has also been the focus of vaccine development. The characteristic pathological findings suggest that the primary site of rheumatic-fever-related damage is subendothelial and perivascular connective tissue matrix and overlying endothelium. Over the past 5 years, a streptococcal M protein N-terminus domain has been shown to bind to the CB3 region in collagen type IV. This binding seems to initiate an antibody response to the collagen and result in ground substance inflammation. These antibodies do not cross-react with M proteins, and we believe that no failure of immune system and, possibly, no molecular mimicry occur in rheumatic fever. This alternative hypothesis shares similarity with collagen involvement in both Goodpasture syndrome and Alport syndrome.
Rajendra Tandon; Meenakshi Sharma; Y Chandrashekhar; Malak Kotb; Magdi H Yacoub; Jagat Narula
Publication Detail:
Type:  Journal Article     Date:  2013-01-15
Journal Detail:
Title:  Nature reviews. Cardiology     Volume:  10     ISSN:  1759-5010     ISO Abbreviation:  Nat Rev Cardiol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-22     Completed Date:  2013-07-15     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  101500075     Medline TA:  Nat Rev Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  171-7     Citation Subset:  IM    
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MeSH Terms
Antigens, Bacterial / immunology
Autoantibodies / biosynthesis
Bacterial Outer Membrane Proteins / immunology
Carrier Proteins / immunology
Child, Preschool
Collagen Type IV / immunology
Endothelium, Vascular / immunology,  microbiology,  pathology
Myocarditis / immunology,  microbiology*,  pathology
Myocardium / immunology,  pathology
Protein Binding
Rheumatic Fever / immunology,  microbiology*,  pathology
Streptococcus pyogenes / immunology,  pathogenicity*
Reg. No./Substance:
0/Antigens, Bacterial; 0/Autoantibodies; 0/Bacterial Outer Membrane Proteins; 0/Carrier Proteins; 0/Collagen Type IV; 0/streptococcal M protein
Comment In:
Nat Rev Cardiol. 2014 Feb;11(2):123   [PMID:  24419260 ]

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