Bryant Penelope A, Robins-Browne Roy, Carapetis Jonathan R, Curtis Nigel
Department of Paediatrics, University of Melbourne, Parkville, Australia.
Circulation. 2009 Feb 10;119(5):742-53. doi: 10.1161/CIRCULATIONAHA.108.792135.
Acute rheumatic fever is a major cause of heart disease in large parts of the world, but it remains unknown why only a small fraction of those who are infected with rheumatogenic group A streptococci develop an abnormal immune response that leads to acute rheumatic fever. An understanding of the mechanisms underlying host susceptibility can provide important insights into pathogenesis that in turn can inform new treatments. Extensive searches for susceptibility factors have been undertaken, including human leukocyte antigens, B-cell alloantigens, and cytokine genes. Although significant associations have been found between genetic factors and acute rheumatic fever, study results often conflict with each other. This review explores current understanding about host susceptibility to acute rheumatic fever and provides an overall perspective to the number of studies that have recently addressed this subject.
急性风湿热是世界上大部分地区心脏病的主要病因，但仍不清楚为什么只有一小部分感染致风湿性A组链球菌的人会产生异常免疫反应，进而导致急性风湿热。了解宿主易感性的潜在机制可以为发病机制提供重要见解，从而为新的治疗方法提供依据。人们已经对易感性因素进行了广泛研究，包括人类白细胞抗原、B细胞同种异体抗原和细胞因子基因。虽然已经发现遗传因素与急性风湿热之间存在显著关联，但研究结果往往相互矛盾。本综述探讨了目前对宿主易感性急性风湿热的理解，并对最近涉及该主题的众多研究提供了一个总体视角。
