الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Development of rheumatic fever, which is known to depend on igeNetic-environmental interaction (Hafez et al., 1984), is generally thought ,to entail reaction of the immune system with group A streptococci or their The production and role of anti-antibodies in the pathogenesis of rheumatic carditis was supported by the finding of circulating antibodies to cardiac tissue (Zabriskie et al., 1971). Cytokines are known to have an important role in inflammation and autoimmune reactions (Remick, 1997). In rheumatic fever, the irnmuno¬inflammatory response is triggered by a streptococcl antigen. The antigen is presented by APC to B lymphocytes. T -cells may be helper or suppressive and responsible with the macrophages for the reaction of cytokines. The objectives of this work are to investigate the gene expression by determination of mRNA and estimation of serum levels of IL-12 and IFNy, also to study the possible genetic tendency. The study included 146 children, out of them 89 were patients with RF, 7 suffering from streptococcal pharyngitis (SP), and 50 healthy children taken as control group. The rheumatic children were taken up consecutively from the cardiology unit of the University Children Hospital at Mansoura. All subjects were enrolled into the following groups: group 1. 29 with active rheumatic heart disease (ARHD). group!: 8 with active rheumatic fever arthritis (ARFA).