TNF and rheumatic fever: The role of autoimmune reactions in the pathogenesis of acute rheumatic fever was demonstrated when antibodies against group A streptococcus cross-recognize to a series of cardiac proteins such as cardiac myosin, tropomyosin, keratin, laminin and vimentin, and multiple cytokines including IL-1, IL-6, and TNF-α exerted inflammatory effects on cardiomyocytes.