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Streptococcal pharyngitis and rheumatic heart disease: the superantigen hypothesis revisited. 2018

Jacklyn R Hurst, and Katherine J Kasper, and Akshay N Sule, and John K McCormick
Department of Microbiology and Immunology, Western University, London, Canada.

Streptococcus pyogenes is a human-specific and globally prominent bacterial pathogen that despite causing numerous human infections, this bacterium is normally found in an asymptomatic carrier state. This review provides an overview of both bacterial and human factors that likely play an important role in nasopharyngeal colonization and pharyngitis, as well as the development of acute rheumatic fever and rheumatic heart disease. Here we highlight a recently described role for bacterial superantigens in promoting acute nasopharyngeal infection, and discuss how these immune system activating toxins could be crucial to initiate the autoimmune process in rheumatic heart disease.

UI MeSH Term Description Entries
D009305 Nasopharynx The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function. Rhinopharynx,Choanae,Nasopharynges,Nasopharynxes,Rhinopharynges,Rhinopharynxes
D010612 Pharyngitis Inflammation of the throat (PHARYNX). Sore Throat,Pharyngitides,Sore Throats,Throat, Sore
D002353 Carrier State The condition of harboring an infective organism without manifesting symptoms of infection. The organism must be readily transmissible to another susceptible host. Asymptomatic Carrier State,Asymptomatic Infection Carrier,Inapparent Infection Carrier,Presymptomatic Carrier State,Presymptomatic Infection Carrier,Super-spreader Carrier,Superspreader Carrier,Asymptomatic Carrier States,Asymptomatic Infection Carriers,Carrier State, Asymptomatic,Carrier State, Presymptomatic,Carrier States,Carrier, Super-spreader,Carrier, Superspreader,Carriers, Super-spreader,Carriers, Superspreader,Inapparent Infection Carriers,Infection Carrier, Asymptomatic,Infection Carrier, Inapparent,Infection Carrier, Presymptomatic,Presymptomatic Carrier States,Presymptomatic Infection Carriers,Super spreader Carrier,Super-spreader Carriers,Superspreader Carriers
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012213 Rheumatic Fever A febrile disease occurring as a delayed sequela of infections with STREPTOCOCCUS PYOGENES. It is characterized by multiple focal inflammatory lesions of the connective tissue structures, such as the heart, blood vessels, and joints (POLYARTHRITIS) and brain, and by the presence of ASCHOFF BODIES in the myocardium and skin. Acute Rheumatic Fever,Arthritis, Rheumatic, Acute,Rheumatism, Articular, Acute,Arthritis, Acute Rheumatic,Inflammatory Rheumatism,Polyarthritis Rheumatica,Rheumatic Arthritis,Rheumatism, Acute Articular,Acute Articular Rheumatism,Acute Articular Rheumatisms,Acute Rheumatic Arthritides,Acute Rheumatic Arthritis,Acute Rheumatic Fevers,Arthritis, Rheumatic,Articular Rheumatism, Acute,Fever, Acute Rheumatic,Fever, Rheumatic,Fevers, Acute Rheumatic,Inflammatory Rheumatisms,Polyarthritis Rheumaticas,Rheumatic Arthritides,Rheumatic Arthritis, Acute,Rheumatic Fever, Acute,Rheumatic Fevers,Rheumatism, Inflammatory
D013290 Streptococcal Infections Infections with bacteria of the genus STREPTOCOCCUS. Group A Strep Infection,Group A Streptococcal Infection,Group A Streptococcal Infections,Group B Strep Infection,Group B Streptococcal Infection,Group B Streptococcal Infections,Infections, Streptococcal,Infection, Streptococcal,Streptococcal Infection
D013297 Streptococcus pyogenes A species of gram-positive, coccoid bacteria isolated from skin lesions, blood, inflammatory exudates, and the upper respiratory tract of humans. It is a group A hemolytic Streptococcus that can cause SCARLET FEVER and RHEUMATIC FEVER. Flesh-Eating Bacteria,Streptococcus Group A,Bacteria, Flesh-Eating
D018089 Superantigens Microbial antigens that have in common an extremely potent activating effect on T-cells that bear a specific variable region. Superantigens cross-link the variable region with class II MHC proteins regardless of the peptide binding in the T-cell receptor's pocket. The result is a transient expansion and subsequent death and anergy of the T-cells with the appropriate variable regions. Superantigen

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