Why Tonsillitis Keeps Coming Back

doctor looking down throat of a child

Do your kids keep getting tonsillitis?

Some kids get tonsillitis, or infected tonsils, again and again. A new study found that strep, a germ that causes tonsillitis, can trick the body’s immune system. Because of the trick, the body’s immune cells kill each other, rather than the germ. But this only happens in certain people who are vulnerable.

Your tonsils are the bumps of tissue at the back of your throat. They help prevent infections in the body by trapping germs that come in through your nose and mouth. When tonsils get infected, they can swell and become painful. Children who get tonsillitis over and over may need to have their tonsils removed.

Researchers compared tonsils removed from children who had repeated bouts of tonsillitis with those from children who had them removed for other reasons, such as a sleep disorder.

Kids with repeated tonsillitis had more of certain immune cells (a type of TFH cell). These cells help another immune cell, called B cells, make antibodies to fight the germ. But the kids with repeated tonsillitis had fewer B cells and antibodies that guard against strep.

The team found that strep makes a certain toxin that, in kids with repeated tonsillitis, causes certain TFH cells to destroy B cells instead of helping them. These kids had genetic differences that made them more vulnerable to this effect.

The results suggest there may be a way to make a vaccine that trains the immune system to prevent recurring bouts of tonsillitis, says Dr. Shane Crotty, who led the study at the La Jolla Institute for Immunology.

Written by NIH Office of Communications and Public Liaison

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