title: From rheumatic fever to Libman-Sacks endocarditis: is there any possible pathogenetic link?
abstract: The heart lesions of rheumatic fever and the heart involvement in antiphospholipid syndrome (APS), have different clinical pictures. Yet, there are several common characteristics linking both diseases: 1) central nervous system (CNS) and heart involvement; 2) molecular mimicry between the a pathogen and the origin of the disease; 3) cross reacting antibodies between the pathogen and self molecules; 4) endothelial cell activation in the 'crime-area' i.e., the valves; 5) some of the patients with RF have circulating antiphospholipid antibodies, while APS may be associated with streptococcal infection; and 6) recently, a cross-reactivity between antibodies directed to the streptococcal M-protein and its synthetic derivative in rheumatic fever (RF) and antibodies derived from APS patients targeting the beta-2-glycoprotein-I (beta2GPI) and a beta2GPI related synthetic peptide. In the current paper, we summarize the possible links between the heart involvement in RF and APS.
authors.affiliation: Department of Internal Medicine B, The Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Blank
authors.forename: A
authors.initials: A
authors.lastname: Aron-Maor
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D016736:Antiphospholipid Syndrome / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D001323:Autoantibodies / Q000276:immunology; D004696:Endocarditis / Q000209:etiology / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D006351:Heart Valves / Q000473:pathology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D012213:Rheumatic Fever / Q000276:immunology / Q000473:pathology / Q000503:physiopathology
chemical_list: D001323:Autoantibodies