Cell surfaces of some peripheral blood cells from individuals with a history of
rheumatic fever/
rheumatic heart disease (RHD) have been demonstrated by the use of
monoclonal antibodies to be antigenically distinct from the majority of the population. Our study examines the distribution of cells bearing these "rheumatic"
antigens in 23 subjects with
rheumatic fever/RHD of Maori, Polynesian and Caucasian ancestry and 182 members of their families (
rheumatic fever/RHD families) as well as in 46 members of families in which no member had been demonstrated to have had
rheumatic fever/RHD (control families). Mononuclear cells from the blood of all cooperating family members were prepared and non-T cells isolated by sheep red blood cell rosette depletion. The binding of
monoclonal antibodies 83S19.23 and D8103 to non-T cells was measured using an immunoperoxidase technique. Subjects with
rheumatic fever/RHD had a significantly higher proportion of cells binding the
antibodies than the unaffected members of all families. Unaffected members of
rheumatic fever/RHD families had significantly higher levels of such rheumatic cells than control families. An increase in the proportion of rheumatic cells with age was noted in unaffected members of
rheumatic fever/RHD families but not in
rheumatic fever/RHD subjects of control families. A level of 13% 83S19.23 positive non-T cells optimally discriminated between rheumatic and nonrheumatic individuals. The relative risk for
rheumatic fever/RHD with 13% or greater positive cells was 9.48. The negative predictive value of having less than 13% positive cells was 98.3%. In the population studied, 83S19.23 seems especially capable of identifying those with low risk for
rheumatic fever/RHD.