Towards developing a vaccine for rheumatic heart disease

Abstract

Rheumatic heart disease (RHD) is the most serious manifestations of rheumatic fever, which is caused by group A Streptococcus (GAS or Streptococcus pyogenes) infection. RHD is an auto immune sequelae of GAS pharyngitis, rather than the direct bacterial infection of the heart, which leads to chronic heart valve damage. Although antibiotics like penicillin are effective against GAS infection, improper medical care such as poor patient compliance, overcrowding, poverty, and repeated exposure to GAS, leads to acute rheumatic fever and RHD. Thus, efforts have been put forth towards developing a vaccine. However, a potential global vaccine is yet to be identified due to the widespread diversity of S. pyogenes strains and cross reactivity of streptococcal proteins with host tissues. In this review, we discuss the available vaccine targets of S. pyogenes and the significance of in silico approaches in designing a vaccine for RHD.

Figure 1.. Types of inflammations caused by S. pyogenes infection.

Figure 2.. Common characteristics of a potential vaccine candidate.

Figure 3.. Reverse vaccinology.

The procedure of reverse vaccinology starts with the study of entire genome sequence of the pathogen with the help of bioinformatics to identify all the proteins encoded by the pathogen. Novel protein targets identified through this in silico approach can be expressed, purified and subsequently tested for immunogenicity.

Figure 4.. Different types of in silico approaches for identifying potential targets for vaccine development.