Diagnosis, therapy and prevention of Psoriasis vulgaris and other poststreptococcal long term consequences

Proteins of the Lancefield group A haemolytic streptococci (Streptococcus pyogenes) share amino-acid sequence homologies with various human proteins. As a result, a protective immune response against group A haemolytic streptococci may cross-react against organ-specific homologous epitopes and turn into a pathogenic autoimmune response due to molecular mimicry. This may result in chronic inflammation and autoimmune tissue damage and promote several post-streptococcal sequelae, which include psoriasis vulgaris, poststreptococcal glomerulonephritis, rheumatic fever, and the group of Paediatric Neuropsychatric Disorders Associated with Streptococcal infection (PANDAS). Currently, no specific diagnostic markers are available for these diseases.

Four proteins have been identified as autoantigens for the poststreptococcal cross-reactive autoimmune response (Ezrin, SerpinB5, Peroxiredoxin-2, heat shock protein beta-1). These proteins can be used as diagnostic markers for poststreptococcal diseases and are also potential targets for their therapy or preventive vaccination. The proteins identified could be used in serologic tests such as ELISA or Dip-stick test to support a specific diagnosis, which would allow for a better disease classification, define early treatment indications and thus improve the prognosis of those diseases.

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