Is It Time to Reconsider the Group A Streptococcal Rheumatogenic Concept?

The Limitations of the Rheumatogenic Concept for Group A Streptococcus: Systematic Review and Genetic Analysis Gabrielle de Crombrugghe; Noemie Baroux; Anne Botteaux ; Nicole J Moreland; Deborah A Williamson ... Wide genetic distribution of group A streptococcus emm types was associated with acute rheumatic fever. Rheumatogenic motifs were infrequent. Microbiology studies on rheumatic fever pathogenesis should also examine previously called nonrheumatogenic emm types. Vaccine development should aim for broad strain coverage.

Is It Time to Reconsider the Group A Streptococcal Rheumatogenic Concept? Anna Norrby-Teglund; Nikolai Siemens Acute rheumatic fever (ARF) and related rheumatic heart disease (RHD) are major causes of morbidity and mortality worldwide with >33 million estimated cases and >319 000 deaths in 2015 [1]. ARF is the result of an autoimmune response to pharyngitis, and likely also impetigo, caused by Streptococcus pyogenes (group A Streptococcus [GAS]) [2, 3]. Although most of the clinical features will resolve with treatment within 2–3 weeks, the active inflammation of the heart tissue, particularly inflammation of the mitral and aortic valves can lead to chronic damage (ie, RHD)....