Guilherme L, de Barros S Freschi, Kohler K F, Santos S R, Ferreira F Morais, Silva W R, Alencar R, Postol E, Kalil J
Heart Institute (InCor), Department of Clinical Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Institute for Investigation in Immunology, Department of Clinical Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Curr Protein Pept Sci. 2018;19(9):900-908. doi: 10.2174/1389203718666170725115855.
Rheumatic fever (RF) and rheumatic heart disease (RHD) follow untreated S. pyogenes throat infections in children who present susceptible genes that favor the development of autoimmune reactions. In this review, we focus on the genes that confer susceptibility and on the autoimmune reactions that occur due to molecular mimicry between human-tissue proteins and streptococcal M protein. Polyarthritis is the initial manifestation, which can evolve to carditis and severe valve damage; these culminate in rheumatic heart disease (RHD) or Sydenham's chorea, which affects the central nervous system. A perspective on vaccine development to prevent the disease is also discussed.
风湿热（RF）和风湿性心脏病（RHD）发生于患有易引发自身免疫反应易感基因的儿童，这些儿童的化脓性链球菌咽喉感染未得到治疗。在本综述中，我们重点关注那些赋予易感性的基因，以及由于人体组织蛋白与链球菌M蛋白之间的分子模拟而发生的自身免疫反应。多关节炎是最初的表现，可发展为心脏炎和严重的瓣膜损害；这些最终会导致风湿性心脏病（RHD）或影响中枢神经系统的 Sydenham 舞蹈病。本文还讨论了预防该疾病的疫苗开发前景。
