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The persistence of elevated levels of antibody to the streptococcal group A polysaccharide (A-antibody) in patients with chronic rheumatic valvular heart disease was previously reported. Other studies have shown that valvular glycoproteins share common antigenic determinants with the streptococcal polysaccharide. The possibility that valvular damage per se contributes to the elevated antibody levels was examined in the present study by measuring the levels of A-autibody in the serum of patients with congenital heart disease and in patients with chronic rheumatic valvular heart disease. The results show that in the absence of evidence for antecedent group A streptococcal infection, the levels of the A-antibody in patients with congenital heart disease are normal, in contrast to the elevated levels found in patients with rheumatic heart disease. To test whether acute valvular damage would affect the A-antibody levels, similar determinations were performed on patients with bacterial endocarditis superimposed on rheumatic or congenital heart disease. The A-antibody levels obtained on these two groups of patients with bacterial endocarditis were not significantly different from the values obtained for the corresponding group of patients without endocarditis. These findings suggest that valvular damage does not contribute to the elevated A-antibody levels in patients with chronic rheumatic valvular disease.
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Accepted: June 9, 1970
Received: March 17, 1970
☆This study was supported by a research grant from the National Institutes of Health, No. AI 08539-03, United States Public Health Service, and the Developmental Physiology Training Grant, National Institutes of Health, No. T1-HD0054.
© 1970 Published by Elsevier Inc.