The association of D8/17 and CD19 B cell typing with rheumatic heart disease of rheumatic carditis patients in malatya and neighbourhood

Aim: Acute rheumatic fever is a non-suppurative autoimmune complication of group A beta hemolytic streptococcal pharyngitis. Cardiac complications are significant in absence of secondary prophylaxis and lead to chronic and life threatening valvular heart disease. The chronic sequela of acute rheumatic fever, rheumatic heart disease is one of the leading causes of acquired heart diseases worldwide. Due to the association of HLA antigens with the autoimmune diseases, several studies investigating the association between the HLA antigens and the rheumatic fever/rheumatic heart disease have been performed. The aim of our study was to investigate the association of HLA antigens and a non HLA protein D8/17 with the rheumatic heart disease and its pattern of cardiac involvement.Material and method: A total of 35 children and 12 adult patients who have rheumatic heart disease and 35 healthy children and 12 healthy adult controls were included in our study. Medical history of rheumatic fever and follow-up were obtained from all patients and control group members. After physical examination, all patients and control group members were evaluated with 2D and colour coded echocardiography. Blood samples were taken from all patients and control group members and stored at -20 C0 for the DNA analysis. Another blood samples were taken and D8/17 expression of the B lymphocytes were examined via flow cytometry.Results: Percentage of the D8/17 expressing B lymphocytes of the case group were significantly higher than the control group (p=0,013). When compared with the control group, the HLA DRB5 (p=0,007) and HLA DRB1*15 (p=0,008) expression of the case group were significantly higher and the DRB4 expresssion of the case group was significantly lower.Discussion and Conclusion: Our findings support the association between HLA Class 2 subgroups and the rheumatic heart disease. Our findings showed the association between D8/17 expression and rheumatic heart disease. Further studies including higher number of patients and control group members should be performed for the confirmation of our results.Keywords: Rheumatic heart disease, HLA DR subgroups, D8/17, Flow cytometry