Pathogenesis of Acute Rheumatic Fever
Mechanisms besides M protein molecular mimicry in ARF pathogenesis
Alternatively, a direct pathogenic binding effect of GAS M-proteins themselves to collagens may initiate a local immune reaction. Anti-Group A carbohydrates, including those to rhamnose-N-acetylglucosamine, can also cross-react with the glycosides of heart valves. So-called heart-reactive antibodies are found in higher titers in 33% to 85% of patients with RHD than in patients without RHD. Notably, they may play a role in the pathogenesis of chorea.
