Discussion
Which of the following cross-reacts with cell wall carbohydrate of Streptococcus pyogenes?
Answer: A
Correct answer: Cardiac valves
The group A carbohydrate of the cell wall shares antigenic determinants with glycoproteins of the cardiac valves, so antibody raised against the organism attacks the valve tissue as well. This is the molecular mimicry that produces the valvular damage of rheumatic heart disease. The M protein cross-reacts with a different tissue, the myocardium.
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