Some of the People, Some of the Time Susceptibility to Acute Rheumatic Fever

• Published in: Circulation (New York, N.Y.) Vol. 119; no. 5; pp. 742 - 753
• Main Authors: Bryant, Penelope A., Robins-Browne, Roy, Carapetis, Jonathan R., Curtis, Nigel
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 10.02.2009
• Subjects: Acute Disease; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Genetic Predisposition to Disease - epidemiology; Global Health; Humans; Medical sciences; Neuropharmacology; Neuroprotective agent; Pharmacology. Drug treatments; Prevalence; Rheumatic Fever - epidemiology; Rheumatic Fever - genetics; Rheumatic Fever - immunology; Rheumatic Heart Disease - epidemiology; Rheumatic Heart Disease - genetics; Rheumatic Heart Disease - immunology; Infection; Immunology; genetics; susceptibility; Streptococcal infection; Heart disease; rheumatic heart disease; Diseases of the osteoarticular system; Bacteriosis; Cardiovascular disease; antigens; Rheumatic fever
• ISSN: 0009-7322; 1524-4539; 1524-4539
• 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.