Abstract
The sera of patients with acute rheumatic fever, uncomplicated streptococcal infections and post-streptococcal glomerulonephritis contain a heart-reactive antibody which binds to the sarcolemmal membrane of myofibrils of heart muscle as well as to other mammalian muscle tissue. The sera of patients with acute rheumatic fever have about four times as much of this antibody as is found in sera of patients convalescent from uncomplicated streptococcal infections or acute post-streptococcal glomerulonephritis. This antibody is not present in a number of other diseases, including idiopathic myocardiopathies, lupus erythematosus, rheumatoid arthritis, multiple myeloma, and sarcoidosis. The titre of heart-reactive antibody declines slowly over a period of 2–3 years following acute rheumatic fever but reappears with subsequent rheumatic recrudescences. Following cardiotomy a heart-reactive antibody also is demonstrable in the serum but is differentiated from that antibody which follows acute rheumatic fever. While streptococcal-induced antibody is absorbed with streptococcal membrane, heart-reactive antibody following cardiotomy is absorbed only with cardiac tissue. The presence in the sera of patients with acute rheumatic fever of high titres of heart-reactive antibody, absorbable by streptococcal membrane, provides an additional laboratory tool for the differential diagnosis of rheumatic fever and may be of value in the long-term management of this disease.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ANDERSON H. C., McCARTY M. Determination of C-reactive protein in the blood as a measure of the activity of the disease process in acute rheumatic fever. Am J Med. 1950 Apr;8(4):445–455. doi: 10.1016/0002-9343(50)90226-9. [DOI] [PubMed] [Google Scholar]
- HESS E. V., FINK C. W., TARANTA A., ZIFF M. HEART MUSCLE ANTIBODIES IN RHEUMATIC FEVER AND OTHER DISEASES. J Clin Invest. 1964 May;43:886–893. doi: 10.1172/JCI104974. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KAPLAN M. H., DALLENBACH F. D. Immunologic studies of heart tissue. III. Occurrence of bound gamma globulin in auricular appendages from rheumatic hearts. Relationship to certain histopathologic features of rheumatic heart disease. J Exp Med. 1961 Jan 1;113:1–16. doi: 10.1084/jem.113.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KAPLAN M. H. IMMUNOLOGIC RELATION OF STREPTOCOCCAL AND TISSUE ANTIGENS. I. PROPERTIES OF AN ANTIGEN IN CERTAIN STRAINS OF GROUP A STREPTOCOCCI EXHIBITING AN IMMUNOLOGIC CROSS-REACTION WITH HUMAN HEART TISSUE. J Immunol. 1963 Apr;90:595–606. [PubMed] [Google Scholar]
- KAPLAN M. H., MEYESERIAN M. An immunological cross-reaction between group-A streptococcal cells and human heart tissue. Lancet. 1962 Apr 7;1(7232):706–710. doi: 10.1016/s0140-6736(62)91653-7. [DOI] [PubMed] [Google Scholar]
- KAPLAN M. H., MEYESERIAN M., KUSHNER I. Immunologic studies of heart tissue. IV. Serologic reactions with human heart tissue as revealed by immunofluorescent methods: isoimmune, Wassermann, and autoimmune reactions. J Exp Med. 1961 Jan 1;113:17–36. doi: 10.1084/jem.113.1.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KAPLAN M. H., SVEC K. H. IMMUNOLOGIC RELATION OF STREPTOCOCCAL AND TISSUE ANTIGENS. III. PRESENCE IN HUMAN SERA OF STREPTOCOCCAL ANTIBODY CROSS-REACTIVE WITH HEART TISSUE. ASSOCIATION WITH STREPTOCOCCAL INFECTION, RHEUMATIC FEVER, AND GLOMERULONEPHRITIS. J Exp Med. 1964 Apr 1;119:651–666. doi: 10.1084/jem.119.4.651. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Markowitz M., Gordis L. A mail-in technique for detecting penicillin in urine: application to the study of maintenance of prophylaxis in rheumatic fever patients. Pediatrics. 1968 Jan;41(1):151–153. [PubMed] [Google Scholar]
- STRAUSS A. J., KEMP P. G., Jr, VANNIER W. E., GOODMAN H. C. PURIFICATION OF HUMAN SERUM GAMMA-GLOBULIN FOR IMMUNOLOGIC STUDIES: GAMMA-GLOBULIN FRAGMENTATION AFTER SULFATE PRECIPITATION AND PROLONGED DIALYSIS. J Immunol. 1964 Jul;93:24–34. [PubMed] [Google Scholar]
- VAN DER GELD H. ANTI-HEART ANTIBODIES IN THE POSTPERICARDIOTOMY AND THE POSTMYOCARDIAL-INFARCTION SYNDROMES. Lancet. 1964 Sep 19;2(7360):617–621. doi: 10.1016/s0140-6736(64)90512-4. [DOI] [PubMed] [Google Scholar]
- Zabriskie J. B., Freimer E. H. An immunological relationship between the group. A streptococcus and mammalian muscle. J Exp Med. 1966 Oct 1;124(4):661–678. doi: 10.1084/jem.124.4.661. [DOI] [PMC free article] [PubMed] [Google Scholar]