DIAGNOSTIC AND PROGNOSTIC-SIGNIFICANCE OF IMMUNE-RESPONSE TO STREPTOCOCCUS-A ANTIGENS IN RHEUMATIC-FEVER

Serum samples obtained from 33 patients with acute rheumatic fever (AR F), 60 patients with rheumatic heart disease (RHD) and 30 adult health y persons have been studied. Antibodies to streptococcal A polysacchar ide (SAP) and lypoteichoic acid (LTA) were examined by ELIZA, to strep tolysin O by standard technique. SAP antibodies in high titers persist ed from 5 to 12 months in ARF and rheumatic carditis patients especial ly when RHD was developing. High titers of antibodies to LTA and SLO p ersisted for 3 months since ARF onset, then fell (p<0.05). ELIZA prove d sensitive in determination of antibodies to SAP and LTA. Its combina tion with determination of the titers to SLO antigens confirmed Strept ococcus A infection involvement in emergence of ARF in all tile cases including insidious or late-onset carditis and chorea. High levels of antibodies to SAP and LTA were more frequently detected in patients wi th RHD than in healthy persons (p<0.001). Correlation between frequenc y of high levels of antibodies to SAP and bicillin 5 or erythromycin a dministration duration Of RHD was not established.