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Challenges to developing effective streptococcal vaccines to prevent rheumatic fever and rheumatic heart disease

Authors Sharma A, Nitsche-Schmitz D

Received 22 January 2014

Accepted for publication 10 March 2014

Published 2 May 2014 Volume 2014:4 Pages 39—54

DOI https://doi.org/10.2147/VDT.S45037

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4


Abhinay Sharma, D Patric Nitsche-Schmitz

Department of Medical Microbiology, Helmholtz Center for Infection Research, Braunschweig, Germany

Abstract: Acute rheumatic fever is a sequela of Streptococcus pyogenes and potentially of Streptococcus dysgalactiae subsp. equisimilis infections. Acute rheumatic fever is caused by destructive autoimmunity and inflammation in the extracellular matrix and can lead to rheumatic heart disease, which is the most frequent cardiologic disease that is acquired in youth. Although effective treatments are available, acute rheumatic fever and rheumatic heart disease remain serious threats to human health, which affect millions and cause high economic losses. This has motivated the search for a vaccine that prevents the causative streptococcal infections. A variety of potential vaccine candidates have been identified and investigated in the past. Today, new approaches are applied to find alternative candidates. Nevertheless, several obstacles lie in the way of an approved S. pyogenes vaccine for use in humans. Herein, a subjective selection of promising vaccine candidates with respect to the prevention of acute rheumatic fever/rheumatic heart disease and safety regarding immunological side effects is discussed.

Keywords: autoimmune disease, side effects, M protein vaccine, molecular mimicry, coiled-coil, collagen binding, PARF

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