Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Mar 31;2017(1):e201704.
doi: 10.21542/gcsp.2017.4.

Towards developing a vaccine for rheumatic heart disease

Geethanjali Devadoss Gandhi  1   2 , Navaneethakrishnan Krishnamoorthy  1   2   3 , Ussama M Abdel Motal  1 , Magdi Yacoub  1   3
Affiliations
Review

Towards developing a vaccine for rheumatic heart disease

Geethanjali Devadoss Gandhi et al. Glob Cardiol Sci Pract. .

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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Types of inflammations caused by S. pyogenes infection.
Figure 2.
Figure 2.. Common characteristics of a potential vaccine candidate.
Figure 3.
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.
Figure 4.. Different types of in silico approaches for identifying potential targets for vaccine development.
See this image and copyright information in PMC

References

    1. Remenyi B, Wilson N, Steer A, Ferreira B, Kado J, Kumar K, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease–an evidence-based guideline. Nat Rev Cardiol. 2012;9(5):297–309. - PMC - PubMed
    1. Cunningham MW. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev. 2000;13(3):470–511. - PMC - PubMed
    1. Stollerman GH. Rheumatic and heritable connective tissue diseases of the cardiovascular system, vol. 11. Sanders, WB; Philadelphia: 1988.
    1. Guilherme L, Kalil J, Cunningham M. Molecular mimicry in the autoimmune pathogenesis of rheumatic heart disease. Autoimmunity. 2006;39(1):31–39. - PubMed
    1. Chang C. Cutting edge issues in rheumatic fever. Clin Rev Allergy Immunol. 2012;42(2):213–237. - PubMed