Developing a new diagnostic test for rheumatic fever

With support from Cure Kids, Dr Nikki Moreland is investigating antibody-based biomarkers for rheumatic fever. If one (or more) of these biomarkers are validated through this process, it would represent a significant discovery in the fight against rheumatic fever and RHD in New Zealand and worldwide.

Dr Nikki Moreland

University of Auckland

Rheumatic fever is an autoimmune disease that develops after a Group A Streptococcus infection (commonly known as a strep infection). Rheumatic fever is most common in children aged 5-15 years old. It is a major cause of health inequality in New Zealand, occurring at unacceptably high rates in Maori and Pacific children, as well as children from lower socioeconomic environments. Each year, between 100-200 children are newly diagnosed and hospitalised with rheumatic fever in New Zealand.

Rheumatic fever can lead to inflammation of the heart, as well as the brain, skin and other organs. It is the inflammation of the heart that can lead to permanent scarring of the heart valves, known as rheumatic heart disease (RHD), resulting in severe complications, including stroke and premature death.

Tragically, there are 160 deaths attributed to RHD every year in New Zealand, despite being entirely preventable with appropriate care and treatment. RHD has been eliminated in almost all other developed countries in the world.

Investigating a unique biomarker for rheumatic fever

The lack of an accurate laboratory test means that a rapid diagnosis of rheumatic fever is often not possible, and misdiagnoses still occur. The important first step to developing a diagnostic test is to identify the unique biomarker(s) common to all cases of the disease; something that has not previously been possible.

With support from Cure Kids, Dr Nikki Moreland and her team from the University of Auckland are investigating antibody-based biomarkers for rheumatic fever. Their research involves complex approaches to comparing the antibodies of children with rheumatic fever to the antibodies of children without rheumatic fever.

Promising biomarkers identified

In a small number of samples, promising biomarkers have been identified. Further testing is required in larger numbers of samples, and in different populations, to see if the biomarkers are accurate indicators of rheumatic fever. If one (or more) of these biomarkers are validated through this process, it would represent a significant discovery in the fight against rheumatic fever and RHD in New Zealand and worldwide.