The Immunomodulatory Role of Microbiota in Rheumatic Heart Disease: What Do We Know and What Can We Learn from Other Rheumatic Diseases?

Rheumatic heart disease (RHD) represents a serious cardiac sequela of acute rheumatic fever, occurring in 30–45% of patients. RHD is multifactorial, with a strong familial predisposition and known environmental risk factors that drive loss of immunological tolerance. The gut and oral microbiome have...

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Bibliographic Details
Main Authors: Amira Kohil, Wafa Abdalla, Wisam N. Ibrahim, Khalid M. Al-Harbi, Amal Al-Haidose, Maha Al-Asmakh, Atiyeh M. Abdallah
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/59/9/1629
Description
Summary:Rheumatic heart disease (RHD) represents a serious cardiac sequela of acute rheumatic fever, occurring in 30–45% of patients. RHD is multifactorial, with a strong familial predisposition and known environmental risk factors that drive loss of immunological tolerance. The gut and oral microbiome have recently been implicated in the pathogenesis of RHD. Disruption of the delicate balance of the microbiome, or dysbiosis, is thought to lead to autoimmune responses through several different mechanisms including molecular mimicry, epitope spreading, and bystander activation. However, data on the microbiomes of RHD patients are scarce. Therefore, in this comprehensive review, we explore the various dimensions of the intricate relationship between the microbiome and the immune system in RHD and other rheumatic diseases to explore the potential effect of microbiota on RHD and opportunities for diagnosis and treatment.
ISSN:1010-660X
1648-9144