No compelling evidence that vaccination with streptococcus pyogenes group A carbohydrate elicits cross-reactive rheumatic fever autoantibodies

We reviewed 70 years of research defining the specificity of anti-group A carbohydrate (GAC) monoclonal and polyclonal antibodies and antibodies raised against other S. pyogenes components reacting with GAC. While some rheumatic fever associated autoantibodies react with N-Acetyl-β-D-glucosamine sidechains of GAC and cross-react with tissues, these appear to be a consequence, not the cause, of autoimmunity. We propose GAC be considered further as a broadly protective group A streptococcal vaccine. (70 words).