Why Some Children are Prone to Repeated Tonsil Infections

Highlights:

Some children are prone to repeated Streptococcal tonsil (throat) infections due to a combination of decreased immunity as well as a genetic predisposition to the illness that has been shown to run in families
Streptococcal throat infection affects nearly 600 million cases a year and is one of the most common reasons for absence from school.
Many children need surgery to remove the infected tonsils and in some children, the infection can result in damage to the heart
The findings of the study could pave the way for development of vaccines against streptococcal throat infections to prevent these infections and associated complications

A combination of genetic and immune-related factors may be causing recurrent streptococcal throat infections in certain children, according to a recent study at the La Jolla Institute for Immunology (LJI) led by Jennifer Dan, M.D., Ph.D., Clinical Associate at LJI.

The findings of the study appear in the journal Science Translational Medicine.

‘Recurrent tonsillitis (RT) is likely to be due to a combination of reduced immunity and inherited predisposition to the infection. In certain children, this can cause long-term damage to the heart. The findings can help in the development of vaccines for Streptococcal infections that prevent the occurrence of these repeated infections and the complications.’
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Finding Out Why Some Children Have a Frequent Sore Throat

The authors of the study hoped to find out why certain children have frequent throat infections and complications, a question that has puzzled scientists for a long time.

The team obtained samples of tonsillar tissue from a total of 146 children between 5 to 18 years old, who had undergone tonsillectomies (removal of tonsil) for either repeated throat infections or sleep apnea
On analyzing the tonsillar tissue microscopically, it was found that the part referred to as ‘germinal center’ (which is the site where the B lymphocytes and T lymphocytes work together to form antibodies to fight the infection) was smaller in children with recurrent throat infections
Also, the blood of these children demonstrated fewer antibodies against the streptococcal pyrogenic exotoxin, SpeA. However, kids in the control group showed high levels of anti-SpeA antibody titers, suggesting they had been exposed to the bacteria but did not develop infection due to good immunity and ability to fight the organism
Additionally, the study team identified two human leukocyte antigen gene variants that were associated with a higher risk of recurrent tonsillitis (RT), suggesting that some children may have an inherited predisposition as the illness tends to run in families

The findings of the study, therefore, suggest that a combination of immunological and genetic factors may be responsible for recurrent tonsillitis (RT) or throat infections in some children.

Tonsil Adenoid Removal Reduces Asthma Symptoms
Kids with asthma who have their tonsils and adenoids removed may experience less asthma symptoms, say researchers.

Could Vaccine Be the Answer to Prevent Recurrent Streptococcal Sore Throats?

The authors of the study feel that the findings of the study could pave the way for research in the development of vaccines to prevent throat infections which could help to avoid invasive surgeries, costly and costly antibiotics with potential side effects and the huge burden on the health care system.

Shane Crotty, senior author, Ph.D., a professor in the Division of Vaccine Discovery said: "We have 100+ years of experience with this disease but there really wasn’t any good explanation why some kids suffer from recurrent strep throat. We think that this is the first solid evidence that there is an important immunological component as well as a genetic one which together contributes to recurrent strep throat. Let’s try and build on it."

Antibiotic Use Reduced by Nearly a Third in Patients with Sore Throat Thanks to New Test
Research appearing in the British Medical Journal shows that a new 'clinical score' test for patients with sore throats could reduce the amount of antibiotics prescribed.

What is Streptococcal Throat Infection?

Streptococcal throat infection is one of several infections caused by the bacterium Streptococcus pyogenes, also referred to as group A Streptococcus (GAS). Other serious infections include pneumonia, impetigo, scarlet fever and necrotizing fasciitis, the feared flesh-eating disease.

Streptococcal throat infection is easily treated with antibiotics but recurrent infections can be troublesome. Also, undiagnosed or untreated streptococcal throat infections can lead to serious complications later including damage to the heart and rheumatic heart disease.

Tonsils and Adenoids Cause Sleep Problems in Kids
Adenotonsillectomy is the surgical treatment of swollen tonsils and adenoids and is the chief cure for sleep apnea.

Summary

Recurrent streptococcal throat infections in some children are due to a combination of immunological and genetic factors. It can result in serious late complications including heart damage. Development of an effective vaccine could potentially prevent recurrent streptococcal throat infections and associated complications.

References:

Recurrent group A Streptococcus tonsillitis is an immunosusceptibility disease involving antibody deficiency and aberrant TFH cells - (http://stm.sciencemag.org/content/11/478/eaau3776)
Why your kid’s strep throat keeps coming back - (http://dx.doi.org/10.1126/scitranslmed.eaau3776)

Source-Medindia