Rheumatic heart disease breakthrough

Six newly identified proteins, implicated in rheumatic heart disease, could herald a change in the way the condition is treated and diagnosed in the developing world, researchers say.

A study, undertaken by the University of Manchester, UK, and the University of Cape Town, South Africa, used proteomics to identify the disease’s biomarker signature.

Writing in *Clinical Proteomics*, the authors say their findings show, for the first time, ongoing inflammation activity in 215 patients with severe RHD from 10 African countries.

The team took blood samples from participating RHD patients in the RHDGen Consortium, which is led by Dr Mark Engel and the late Prof Bongani Mayosi at the University of Cape Town.

They analysed about 2,500 proteins implicated in RHS and when they used machine learning to proteomic data, they identified six that gave a 90% discrimination rate.

RHD is caused by one or several episodes of rheumatic fever, caused by Streptococcus pyogenes. Although it is the only cardiovascular disease of global impact that is completely preventable, developing countries have poor access to echocardiography to diagnose it early enough to treat it.

The research team say identifying the biomarker signature could help in the development of simple test kits that could be used in the home and clinic and they add that existing anti-inflammatory treatments have the potential to be repurposed, to be taken prophylactically to combat persistent inflammation and prevent disease progression.

Joint senior author Bernard Keavney, clinical professor of cardiovascular medicine at The University of Manchester and consultant cardiologist at Manchester University NHS Foundation trust, said: “Rheumatic heart disease is a major source of morbidity and mortality in developing countries.

“Almost 300,000 people die from this disease every year and 40 million people are profoundly affected by it. That’s a tragedy as it is essentially preventable if diagnosed early enough.

“But by providing a deeper insight into the mechanisms underlying RHD we hope now to be opening the door to new opportunities for drug repurposing, prophylaxis, and development of easy to use diagnostics.”

Taariq Salie M, Yang J, Ramírez Medina CR et al. Data independent acquisition mass spectrometry in severe Rheumatic Heart Disease (RHD) identifies a proteomic signature showing ongoing inflammation and effectively classifying RHD cases. *Clinical Proteomics* 22 March 2022

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