From rheumatic fever to Libman-Sacks endocarditis: is there any possible pathogenetic link?

The heart lesions of rheumatic fever and the heart involvement in antiphospholipid syndrome (APS), have different clinical pictures. Yet, there are several common characteristics linking both diseases: 1) central nervous system (CNS) and heart involvement; 2) molecular mimicry between the a pathogen...

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Bibliographic Details
Published in:Lupus 2005-01, Vol.14 (9), p.697-701
Main Authors: Blank, M, Aron-Maor, A, Shoenfeld, Y
Format: Article
Language:English
Subjects:
Antibodies
Antigens
Antiphospholipid Syndrome - immunology
Antiphospholipid Syndrome - pathology
Antiphospholipid Syndrome - physiopathology
Arthritis
Autoantibodies - immunology
Cells
Cloning
Cytokines
Endocarditis
Endocarditis - etiology
Endocarditis - immunology
Endocarditis - pathology
Endocarditis - physiopathology
Endothelium
Heart
Heart Valves - pathology
Humans
Internal medicine
Lupus
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - immunology
Lupus Erythematosus, Systemic - pathology
Lupus Erythematosus, Systemic - physiopathology
Lymphocytes
Medicine
Pathogenesis
Pathogens
Peptides
Proteins
Rheumatic fever
Rheumatic Fever - immunology
Rheumatic Fever - pathology
Rheumatic Fever - physiopathology
Streptococcus
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Summary:The heart lesions of rheumatic fever and the heart involvement in antiphospholipid syndrome (APS), have different clinical pictures. Yet, there are several common characteristics linking both diseases: 1) central nervous system (CNS) and heart involvement; 2) molecular mimicry between the a pathogen and the origin of the disease; 3) cross reacting antibodies between the pathogen and self molecules; 4) endothelial cell activation in the ‘crime-area’ i.e., the valves; 5) some of the patients with RF have circulating antiphospholipid antibodies, while APS may be associated with streptococcal infection; and 6) recently, a cross-reactivity between antibodies directed to the streptococcal M-protein and its synthetic derivative in rheumatic fever (RF) and antibodies derived from APS patients targeting the beta-2-glycoprotein-I (β2GPI) and a β2GPI related synthetic peptide. In the current paper, we summarize the possible links between the heart involvement in RF and APS.
ISSN:0961-2033
1477-0962
DOI:10.1191/0961203305lu2203oa