Streptococcus and rheumatic fever

MW Cunningham - Current opinion in rheumatology, 2012 - journals.lww.com
MW Cunningham
Current opinion in rheumatology, 2012journals.lww.com
To summarize, pathogenic mechanisms of crossreactive autoantibodies which target the
valve in rheumatic heart disease and the neuronal cell in Sydenham chorea share a
common streptococcal epitope GlcNAc and target intracellular biomarkers of disease
including cardiac myosin in the myocardium and tubulin, a protein abundant in the brain.
However, intracellular antigens are not believed to be the basis for disease. The theme of
molecular mimicry in streptococcal autoimmune sequelae is the recognition of targeted …
Summary
To summarize, pathogenic mechanisms of crossreactive autoantibodies which target the valve in rheumatic heart disease and the neuronal cell in Sydenham chorea share a common streptococcal epitope GlcNAc and target intracellular biomarkers of disease including cardiac myosin in the myocardium and tubulin, a protein abundant in the brain. However, intracellular antigens are not believed to be the basis for disease. The theme of molecular mimicry in streptococcal autoimmune sequelae is the recognition of targeted intracellular biomarker antigens such as cardiac myosin and brain tubulin, while targeting extracellular membrane antigens such as laminin on the valve surface endothelium or lysoganglioside and dopamine receptors in the brain. Antibody binding to these cell surface antigens may lead to valve damage in rheumatic heart disease or neuropsychiatric behaviors and involuntary movements in Sydenham chorea.
Lippincott Williams & Wilkins