[The diagnostic and prognostic significance of the indices of the immune response to streptococcal group A antigens in rheumatism].

Serum samples obtained from 33 patients with acute rheumatic fever (ARF), 60 patients with rheumatic heart disease (RHD) and 30 adult healthy persons have been studied. Antibodies to streptococcal A polysaccharide (SAP) and lypoteichoic acid (LTA) were examined by ELISA, to streptolysin O by standard technique. SAP antibodies in high titers persisted from 5 to 12 months in ARF and rheumatic carditis patients especially when RHD was developing. High titers of antibodies to LTA and SLO persisted for 3 months since ARF onset, then fell (p < 0.05). ELISA proved sensitive in determination of antibodies to SAP and LTA. Its combination with determination of the titers to SLO antigens confirmed Streptococcus A infection involvement in emergence of ARF in all the cases including insidious or late-onset carditis and chorea. High levels of antibodies to SAP and LTA were more frequently detected in patients with RHD than in healthy persons (p < 0.001). Correlation between frequency of high levels of antibodies to SAP and bicillin 5 or erythromycin administration, duration of RHD was not established.