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Streptococcal Immunology: Protection Versus Injury

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Department of Medicine, College of Medicine, University of Tennessee Center for the Health Sciences; Memphis, Tennessee

Ann Intern Med. 1978;88(3):422-423. doi:10.7326/0003-4819-88-3-422
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The pathogenesis of rheumatic fever and rheumatic carditis is still obscure despite a voluminous literature on group A streptococcal immunology (1). The popular notion, however, that rheumatic inflammation may be due to cross-reactivity between streptococcal antigens and cardiac tissues has loomed as a formidable deterrence to attempts to prepare a streptococcal vaccine. Several recent studies have opened up new technical approaches to the clean separation of the type-specific M protein determinants from the streptococcal antigens responsible for cross-reactions with heart and other tissues. These studies offer fresh approaches toward solving the riddle of rheumatic carditis and they offer some new


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