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.
Keywords: Rheumatic fever, rheumatic heart disease, M protein, genes, cytokines, T and B lymphocytes, heart-tissue proteins,
anti-S. pyogenes vaccine.
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