Abstract
The present study was conducted on the implication of apoptosis and some factors that may control it, in the pathogenesis of rheumatic heart disease. The study included: (a) 35 unrelated subjects diagnosed as acute rheumatic carditis (10 severe and 25 mild to moderate grade) admitted to the hospital, treated and after improvement, were discharged to be followed up in the outpatient cardiology clinic; (b) the thirty five patients during their follow up and after 6 months from completion of treatment were investigated; (c) fifty subjects of matched age and sex as control. All the subjects were subjected to (a) routine clinical and laboratory investigations and acute phase reactants (ASO, ESR, CRP) and throat culture; (b) measurement of CD95 (sFas); (c) detection of apoptotic cells by PI, geimsa, AO stains and assessment of apoptotic index; (d) DNA fragmentation detection of mRNA and its grade and serum levels in pg/ml for IL-1alpha IL-1Beta, TNF-alpha and IFN-gamma. These investigations were repeated after 6 months from completion of treatment. The results in the acute stage (ARHD) revealed significant decrease in the level of CD95 and percentage of apoptotic cells by the three stains, significant increase of mRNA expression and serum levels of IL-1 alpha, TNF-alpha (P