Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190.
Microbiol Spectr. 2019 Jul;7(4). doi: 10.1128/microbiolspec.GPP3-0045-2018.
The group A streptococci are associated with a group of diseases affecting the heart, brain, and joints that are collectively referred to as acute rheumatic fever. The streptococcal immune-mediated sequelae, including acute rheumatic fever, are due to antibody and cellular immune responses that target antigens in the heart and brain as well as the group A streptococcal cross-reactive antigens as reviewed in this article. The pathogenesis of acute rheumatic fever, rheumatic heart disease, Sydenham chorea, and other autoimmune sequelae is related to autoantibodies that are characteristic of autoimmune diseases and result from the immune responses against group A streptococcal infection by the host. The sharing of host and streptococcal epitopes leads to molecular mimicry between the streptococcal and host antigens that are recognized by the autoantibodies during the host response. This article elaborates on the discoveries that led to a better understanding of the pathogenesis of disease and provides an overview of the history and the most current thought about the immune responses against the host and streptococcal cross-reactive antigens in group A streptococcal sequelae.
A 组链球菌与一组影响心脏、大脑和关节的疾病有关，这些疾病统称为急性风湿热。正如本文所综述的那样，链球菌免疫介导的后遗症，包括急性风湿热，是由于针对心脏和大脑以及 A 组链球菌交叉反应性抗原的抗体和细胞免疫反应引起的。急性风湿热、风湿性心脏病、风湿性舞蹈病和其他自身免疫后遗症的发病机制与自身抗体有关，这些自身抗体是自身免疫性疾病的特征，是由宿主针对 A 组链球菌感染的免疫反应引起的。宿主和链球菌表位的共享导致链球菌和宿主抗原之间的分子模拟，这些抗原在宿主反应中被自身抗体识别。本文详细阐述了导致对疾病发病机制更好理解的发现，并概述了针对 A 组链球菌后遗症中宿主和链球菌交叉反应性抗原的免疫反应的历史和最新观点。
