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Markers of susceptibility to acute rheumatic fever: the B-cell antigen D8/17 is not robust as a marker in South Africa

Published online by Cambridge University Press:  08 February 2011

Kathleen G. Walker ,
Margaret Cooper ,
Karin McCabe ,
Jane Hughes ,
Wendy Mathiassen ,
John Lawrenson  and
Jo M. Wilmshurst
Kathleen G. Walker*
Affiliation:
Department of Paediatric Cardiology, Rheumatic Fever Clinic, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa Department of Paediatric Neurology, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
Margaret Cooper
Affiliation:
Department of Paediatrics, Institute of Child Health Research Laboratory, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
Karin McCabe
Affiliation:
Department of Paediatrics, Institute of Child Health Research Laboratory, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
Jane Hughes
Affiliation:
Department of Paediatrics, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
Wendy Mathiassen
Affiliation:
Department of Paediatric Cardiology, Rheumatic Fever Clinic, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa Department of Paediatric Neurology, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
John Lawrenson
Affiliation:
Department of Paediatric Cardiology, Rheumatic Fever Clinic, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa Paediatric Cardiology Service of the Western Cape, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
Jo M. Wilmshurst
Affiliation:
Department of Paediatric Neurology, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
*
Correspondence to: Dr K. Walker MBCHB DCH, S25/26 Medical Out Patients’ Department, University of Cape Town, Red Cross Children's Hospital, Klipfontein Road, Rondebosch 7700, Cape Town, Western Cape, Republic of South Africa. Tel: +27 21 658 5111; Fax: +27 21 689 1287; E-mail: buley@iafrica.com
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Abstract

Background

Acute rheumatic fever and its chronic sequelae, rheumatic cardiac disease, and neuropsychiatric movement disorders, remain major public health problems in South Africa. Early identification and treatment of streptococcal pharyngitis in susceptible individuals would prevent rheumatic cardiac disease. The B-cell antigen D8/17 is a marker of susceptibility to rheumatic fever in some populations.

Methods and results

We assessed the significance of the D8/17 marker in a group of South Africans. Blood was collected from 107 individuals; 40 patients had previous confirmed rheumatic fever, 20 were first-degree relatives, and 47 were controls. The expression of D8/17 in each sample was analysed by flow cytometry. The mean proportion of B-cells that were D8/17 positive was 0.5% in the index cases, 0.47% in their relatives, and 0.27% in the controls. There was a significant difference between the index cases and the controls, p = 0.03, but the mean percentage positive in each group was very low.

Conclusions

Patients with a history of rheumatic fever had statistically increased expression of the D8/17 marker. However, the actual percentages in this observational study were markedly lower than in other populations, ranging from 0.14%–1.53% compared to 11.6%–39.3%. The D8/17 marker would be an impractical screening tool in the South African population.

Keywords

Preventionrheumatic cardiac diseasegenetics
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 3 , June 2011 , pp. 328 - 333
Copyright
Copyright © Cambridge University Press 2011

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