Rheumatic Fever: From Sore Throat to Autoimmune Heart Lesions

Guilherme, Luiza; Kalil, Jorge

doi:10.1159/000077915

Cited by 50 publications

(31 citation statements)

References 31 publications

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“…As a result, it is possible that viral infections may serve to exacerbate lupus through TLR stimulation. While molecular mimicry has long been linked to autoimmune responses such as rheumatic carditis (70), where a streptococcal protein has some homology to a host protein, it may also be the case that viral nucleic acids may provide a "nonspecific" activation of TLRs that serves to potentiate autoimmune responses. There are, however, some studies that challenge the hypothesis linking infection to autoimmunity (reviewed in Ref.…”

Section: Discussionmentioning

confidence: 99%

Nucleic Acid-Sensing TLRs as Modifiers of Autoimmunity

Deane

Bolland

2006

The Journal of Immunology

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The immune system requires precise regulation of activating and inhibitory signals so that it can mount effective responses against pathogens while ensuring tolerance to self-components. Some of the most potent activation signals are triggered by innate immune molecules, particularly those in the TLR family. Recent studies have shown that engagement of TLRs plays a significant role in both innate and adaptive immunity. This review focuses on the ways that TLR function might contribute to the etiology of lupus-like syndromes in the context of an autoimmune-prone environment. By considering the sources, localization, and expression of both nucleic acids and the molecules that bind them, we discuss several ways that innate immunity can play a role in the development of systemic autoimmunity.

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Section: Discussionmentioning

confidence: 99%

Nucleic Acid-Sensing TLRs as Modifiers of Autoimmunity

Deane

Bolland

2006

The Journal of Immunology

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“…Rheumatic Fever (RF) is an auto-immune disease mediated by humoral and cellular autoimmune responses to Streptococcus pyogenes infections [1]. In RF patients, antibody production to the streptococcal infection is cross-reactive with other cells or proteins within the host.…”

Section: Mechanism Of Diseasementioning

confidence: 99%

“…Rheumatic fever (RF) is an auto-immune disease mediated by humoral and cellular auto-immune responses to Streptococcus pyogenes infections [1,2]. Initial RF episodes can produce either mild or severe symptoms and damage, however milder outcomes are more common with an initial presentation (e.g., endocarditis, heart valve damage, Sydenham's chorea, rheumatoid arthritis, and potentially depression and obsessive compulsive disorder) [3].…”

Section: Introductionmentioning

confidence: 99%

Complications of physician misdiagnosis/treatment of rheumatic fever in the United States

Peterson¹

2013

ABB

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Rheumatic fever is an auto-immune disease caused by exposure to Streptococcus pyogenes. Over the last 50 years, reports of rheumatic fever within the United States have diminished. The decrease was attributed to the advent of penicillin in the treatment of streptococcus infections. We propose that current diagnostic and treatment methodologies may adversely increase the morbidity rate of rheumatic fever within the United States. Publication rates and interest in rheumatic fever has diminished over the last 30 years. Because of this decline, many physicians are only vaguely aware of the disorder. Additionally, the fear of antibiotic resistance has influenced the Center of Disease Control to suggest a significant decrease in the use of antibiotics by physicians. Although extremely valid for the future health and well-being of the population, such policies must be examined for each individual case carefully. The American Heart Association prescribes long-term antibiotic prophylaxis as the only current treatment; however literature reviews indicate that such therapy is rarely used. Therefore individuals diagnosed with rheumatic fever are not being treated. Additionally, because many physicians are not routinely testing for streptococcus or early signs of endocarditis, it is likely that cases of rheumatic fever will increase in the future, and many individuals may not be diagnosed until sever damage or morbidity occurs. Physician education and clear revised guide-lines are necessary to ensure adequate treatment of individuals with rheumatic fever. Misunderstandings of the disease and how it should be treated by first responders (i.e. primary care providers and pediatricians) are discussed.

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“…Rheumatic valve diseases are still common in developing countries 3 . For this reason, many patients undergo surgery very early in life 4 , and frequently require reoperations during the natural history of the disease.…”

Section: Introductionmentioning

confidence: 99%