Publication:
In Search of the Holy Grail: A Specific Diagnostic Test for Rheumatic Fever

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dc.contributor.authorMcMillan, David Jen
dc.contributor.authorRafeek, Rukshan A Men
dc.contributor.authorNorton, Robert Een
dc.contributor.authorGood, Michael Fen
dc.contributor.authorSriprakash, Kadaba Sen
dc.contributor.authorKetheesan, Natkunamen
dc.date.accessioned2022-03-07T00:47:34Z
dc.date.available2022-03-07T00:47:34Z
dc.date.issued2021-05-14
dc.description.abstractCurrent diagnosis of Acute Rheumatic Fever and Rheumatic Heart Disease (ARF/RHD) relies on a battery of clinical observations aided by technologically advanced diagnostic tools and non-specific laboratory tests. The laboratory-based assays fall into two categories: those that (1) detect "evidence of preceding streptococcal infections" (ASOT, anti-DNAse B, isolation of the Group A <i>Streptococcus</i> from a throat swab) and (2) those that detect an ongoing inflammatory process (ESR and CRP). These laboratory tests are positive during any streptococcal infection and are non-specific for the diagnosis of ARF/RHD. Over the last few decades, we have accumulated considerable knowledge about streptococcal biology and the immunopathological mechanisms that contribute to the development, progression and exacerbation of ARF/RHD. Although our knowledge is incomplete and many more years will be devoted to understanding the exact molecular and cellular mechanisms involved in the spectrum of clinical manifestations of ARF/RHD, in this commentary we contend that there is sufficient understanding of the disease process that using currently available technologies it is possible to identify pathogen associated peptides and develop a specific test for ARF/RHD. It is our view that with collaboration and sharing of well-characterised serial blood samples from patients with ARF/RHD from different regions, antibody array technology and/or T-cell tetramers could be used to identify streptococcal peptides specific to ARF/RHD. The availability of an appropriate animal model for this uniquely human disease can further facilitate the determination as to whether these peptides are pathognomonic. Identification of such peptides will also facilitate testing of potential anti-streptococcal vaccines for safety and avoid potential candidates that may pre-dispose potential vaccine recipients to adverse outcomes. Such peptides can also be readily incorporated into a universally affordable point of care device for both primary and tertiary care.en
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dc.identifier.citationFrontiers in Cardiovascular Medicine, v.8, p. 1-8en
dc.identifier.doi10.3389/fcvm.2021.674805en
dc.identifier.issn2297-055Xen
dc.identifier.pmid34055941en
dc.identifier.staffune-id:dmcmil21en
dc.identifier.staffune-id:rmohame3en
dc.identifier.staffune-id:rnorton4en
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dc.identifier.staffune-id:ssripraken
dc.identifier.staffune-id:nketheesen
dc.identifier.urihttps://hdl.handle.net/1959.11/46961
dc.languageenen
dc.publisherFrontiers Research Foundationen
dc.relation.ispartofFrontiers in Cardiovascular Medicineen
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleIn Search of the Holy Grail: A Specific Diagnostic Test for Rheumatic Feveren
dc.typeJournal Articleen
dcterms.accessRightsUNE Greenen
dspace.entity.typePublication
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local.atsiresearchNoen
local.contributor.firstnameDavid Jen
local.contributor.firstnameRukshan A Men
local.contributor.firstnameRobert Een
local.contributor.firstnameMichael Fen
local.contributor.firstnameKadaba Sen
local.contributor.firstnameNatkunamen
local.contributor.lastnameMcMillanen
local.contributor.lastnameRafeeken
local.contributor.lastnameNortonen
local.contributor.lastnameGooden
local.contributor.lastnameSriprakashen
local.contributor.lastnameKetheesanen
local.fileurl.openhttps://rune.une.edu.au/web/retrieve/078e9da5-7863-4740-8591-40fd802600bcen
local.fileurl.openpublishedhttps://rune.une.edu.au/web/retrieve/078e9da5-7863-4740-8591-40fd802600bcen
local.format.endpage8en
local.format.startpage1en
local.identifier.runningnumber674805en
local.identifier.unepublicationidune:1959.11/46961en
local.identifier.volume8en
local.identifier.wosid000655369000001en
local.open.fileurlhttps://rune.une.edu.au/web/retrieve/078e9da5-7863-4740-8591-40fd802600bcen
local.output.categoryC1en
local.output.categorydescriptionC1 Refereed Article in a Scholarly Journalen
local.peerreviewedYesen
local.profile.emaildmcmil21@une.edu.auen
local.profile.emailrmohame2@myune.edu.auen
local.profile.emailrnorton4@une.edu.auen
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local.profile.emailssriprak@une.edu.auen
local.profile.emailnkethees@une.edu.auen
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local.profile.schoolSchool of Science and Technologyen
local.profile.schoolSchool of Science and Technologyen
local.profile.schoolSchool of Rural Medicineen
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local.profile.schoolSchool of Science and Technologyen
local.profile.schoolSchool of Science and Technologyen
local.publisher.placeSwitzerlanden
local.record.institutionUniversity of New Englanden
local.record.placeauen
local.relation.fundingsourcenoteMG is a recipient of an Australian National Health and Medical Research Council Investigator Fellowship and RAMR an Australian International Post-graduate Research Award.en
local.search.authorMcMillan, David Jen
local.search.authorRafeek, Rukshan A Men
local.search.authorNorton, Robert Een
local.search.authorGood, Michael Fen
local.search.authorSriprakash, Kadaba Sen
local.search.authorKetheesan, Natkunamen
local.sensitive.culturalNoen
local.sourceriskNoen
local.subject.for2020320211 Infectious diseasesen
local.subject.for2020320701 Medical bacteriologyen
local.subject.seo2020200104 Prevention of human diseases and conditionsen
local.title.maintitleIn Search of the Holy Grailen
local.title.subtitleA Specific Diagnostic Test for Rheumatic Feveren
local.uneassociationYesen
local.year.published2021en
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