| Rheumatic heart disease: mediation by complex immune events. | |
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MedLine Citation:
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PMID: 21404913 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Rheumatic fever (RF) is an autoimmune disease caused by the Gram-positive bacteria Streptococcus pyogenes following an untreated throat infection in susceptible children. Rheumatic heart disease (RHD), the most serious complication, occurs in 30-45% of RF patients and leads to chronic valvular lesions. Here, we focus on the genes that confer susceptibility for developing this disease. Molecular mimicry mediates the cross-reactions between streptococcal antigens and human proteins. Several autoantigens have been identified, including cardiac myosin epitopes, vimentin, and other intracellular proteins. In heart tissue, antigen-driven oligoclonal T cell expansions probably cause the rheumatic heart lesions. These cells are CD4+ and produce inflammatory cytokines (TNF alpha and IFN gamma). IL-4+ cells are found in the myocardium; however, these cells are very scarce in the valve lesions of RHD patients. IL-4 is a Th2-type cytokine and plays a regulatory role in the inflammatory response mediated by Th1 cytokines. Our findings indicate that the Th1/Th2 cytokine balance has a role in healing myocarditis while the low numbers of IL-4-producing cells in the valves probably induced the progressive and permanent valve damage. |
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Authors:
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L Guilherme; K F Köhler; J Kalil |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Advances in clinical chemistry Volume: 53 ISSN: 0065-2423 ISO Abbreviation: Adv Clin Chem Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2985173R Medline TA: Adv Clin Chem Country: United States |
Other Details:
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Languages: eng Pagination: 31-50 Citation Subset: IM |
Affiliation:
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Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil. luizagui@usp.br |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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