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

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 mec...

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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
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ISSN	0009-7322 1524-4539 1524-4539
DOI	10.1161/CIRCULATIONAHA.108.792135

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Abstract	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.
AbstractList	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. 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.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.
Author	Bryant, Penelope A. Carapetis, Jonathan R. Robins-Browne, Roy Curtis, Nigel
Author_xml	– sequence: 1 givenname: Penelope A. surname: Bryant fullname: Bryant, Penelope A. organization: From the Departments of Paediatrics (P.A.B., N.C.), and Microbiology and Immunology (R.R.-B.), University of Melbourne, Parkville, Australia; Infectious Diseases Unit, Department of General Medicine (P.A.B., N.C.), and Infection, Immunity and Environment Theme, Murdoch Children’s Research Institute (P.A.B., R.R.-B., N.C.), Royal Children’s Hospital Melbourne, Parkville, Australia; and Menzies School of Health Research (J.R.C.), Charles Darwin University, Casuarina, Australia – sequence: 2 givenname: Roy surname: Robins-Browne fullname: Robins-Browne, Roy organization: From the Departments of Paediatrics (P.A.B., N.C.), and Microbiology and Immunology (R.R.-B.), University of Melbourne, Parkville, Australia; Infectious Diseases Unit, Department of General Medicine (P.A.B., N.C.), and Infection, Immunity and Environment Theme, Murdoch Children’s Research Institute (P.A.B., R.R.-B., N.C.), Royal Children’s Hospital Melbourne, Parkville, Australia; and Menzies School of Health Research (J.R.C.), Charles Darwin University, Casuarina, Australia – sequence: 3 givenname: Jonathan R. surname: Carapetis fullname: Carapetis, Jonathan R. organization: From the Departments of Paediatrics (P.A.B., N.C.), and Microbiology and Immunology (R.R.-B.), University of Melbourne, Parkville, Australia; Infectious Diseases Unit, Department of General Medicine (P.A.B., N.C.), and Infection, Immunity and Environment Theme, Murdoch Children’s Research Institute (P.A.B., R.R.-B., N.C.), Royal Children’s Hospital Melbourne, Parkville, Australia; and Menzies School of Health Research (J.R.C.), Charles Darwin University, Casuarina, Australia – sequence: 4 givenname: Nigel surname: Curtis fullname: Curtis, Nigel organization: From the Departments of Paediatrics (P.A.B., N.C.), and Microbiology and Immunology (R.R.-B.), University of Melbourne, Parkville, Australia; Infectious Diseases Unit, Department of General Medicine (P.A.B., N.C.), and Infection, Immunity and Environment Theme, Murdoch Children’s Research Institute (P.A.B., R.R.-B., N.C.), Royal Children’s Hospital Melbourne, Parkville, Australia; and Menzies School of Health Research (J.R.C.), Charles Darwin University, Casuarina, Australia
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Keywords	Infection Immunology genetics susceptibility Streptococcal infection Heart disease rheumatic heart disease Diseases of the osteoarticular system Bacteriosis Cardiovascular disease antigens Rheumatic fever
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Snippet	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...
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SubjectTerms	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
Subtitle	Susceptibility to Acute Rheumatic Fever
Title	Some of the People, Some of the Time
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