Rheumatic fever: From pathogenesis to vaccine perspectives

Rheumatic fever (RF) is considered a model of autoimmune disease due to untreated throat infection by S. pyogenes that affects children and teenagers. The autoimmune process is believed to be the basis of all of the clinical manifestations; for instance, arthritis by immune complex deposition, chorea by antibody binding to neuronal cells, skin and subcutaneous manifestations that are mediated by a delayed hypersensitivity reaction, and carditis that is caused by cross-reactive antibodies and T cells. This chapter presents an overview of the mechanisms leading to the tissue lesions, treatment, and future possibilities of a vaccine against S. pyogenes.