Pathogenesis of Acute Rheumatic Fever

Abstract

Abstract Acute rheumatic fever is a multiorgan inflammatory disorder affecting the heart, joints, brain, and skin. The pathogenic mechanism of molecular mimicry involves autoantibodies and T\xa0cells directed against group A streptococcal cell wall components and heart or brain antigens that have been extensively investigated. Autoantibodies and T-cell responses in rheumatic heart disease and Sydenham chorea induce valve disease with heart murmurs and movement and behavioral disturbances, respectively. In carditis, autoantibodies and T\xa0cells target valve proteins while in Sydenham chorea the autoantibodies deposit in the brain and target the basal ganglia and dopaminergic neurons.