Although the etiology of RHD is not completely understood, studies have shown that RHD is mediated by humoral and cellular autoimmune responses4 and associated with cytokine activities.8 T helper 17 (Th17) cells have been recently identified preferential producers of IL-17, IL-17A, IL-17F, IL-21, and IL-22. Here, IL22 is linked to rheumatic heart disease.