Ultrastructure of lesions of rheumatic carditis

Streptococcal Rheumatic Carditis.

“…Some of these components include somatic antigens such as M-protein (13-16, 19-22, 37, 45, 57, 68-70, 83, 102, 110, 114, 116, 119, 135, 145, 172, 198, 201, 205, 222, 230, 242, 285, 287, 288, 299, 301), C-polysaccharide complexes of mucopeptide and polysaccharide (6, 27, 37, 50, 63, 131, 135, 188, 215, 216, 233-235, 237, 240, 245), mucopeptide (1,84,132,167,223,224,236,302), cell wall components (2,50,82,85,86,148,238,244,271), and antigens cross-reactive with tissues (118, 119, 126, 129, 210, 249, 273, 2%, 298,299). Others include the cell membrane (43,71,84,274) and L-forms (19,43,91,103,113,166,215,244,263,297,298).…”

“…McEwan (169) lists the suggested origins of fixed connective tissue cells. The two major theories are that (i) the Aschoff cells are nonmyogenic mesenchymal cells (9,15,139,148,187,199,243,259,276,279) and (ii) they are myogenetic in origin (5,18,174,180,182,183,277). According to Becker and Murphy (18), Aschoff bodies are central to the pathology of rheumatic heart disease, which is in opposition to Stollerman's (249,250) opinion that Aschoff lesions cannot account for the serious myocardial failure of severe rheumatic carditis.…”

“…Later, investigators forwarded evidence to prove that fibrinoid is a complex mixture of substances including fibrin, gamma globulin (immunoglobulins G, M, and A), and other constituents such as complement (Cl) (87,148,180,275,279).…”

Streptococcal rheumatic carditis.

“…Various streptococcal antigens have been studied in an effort to find out which one(s) played a major part in the pathogenesis of rheumatic fever. Some of these components include somatic antigens such as M-protein (13-16, 19-22, 37, 45, 57, 68-70, 83, 102, 110, 114, 116, 119, 135, 145, 172, 198, 201, 205, 222, 230, 242, 285, 287, 288, 299, 301), C-polysaccharide complexes of mucopeptide and polysaccharide (6, 27, 37, 50, 63, 131, 135, 188, 215, 216, 233-235, 237, 240, 245), mucopeptide (1,84,132,167,223,224,236,302), cell wall components (2,50,82,85,86,148,238,244,271), and antigens cross-reactive with tissues (118, 119, 126, 129, 210, 249, 273, 2%, 298,299). Others include the cell membrane (43,71,84,274) and L-forms (19,43,91,103,113,166,215,244,263,297,298).…”

“…McEwan (169) lists the suggested origins of fixed connective tissue cells. The two major theories are that (i) the Aschoff cells are nonmyogenic mesenchymal cells (9,15,139,148,187,199,243,259,276,279) and (ii) they are myogenetic in origin (5,18,174,180,182,183,277). According to Becker and Murphy 18, Aschoff bodies are central to the pathology of rheumatic heart disease, which is in opposition to Stollerman's (249, 250) opinion that Aschoff lesions cannot account for the serious myocardial failure of severe rheumatic carditis.…”