Immunological aspects of tonsils and of tonsillitis

The human tonsils are responsible for the final antigen-induced differentiation of B-cells to plasma cells. Their main function could be the expansion of memory IgA-B-cells, allowing J-chain expression and final differentiation under secondary signals. IgA/J+-cells have been shown to migrate into mucosal membranes, allowing a protection against microorganisms. Recurrent tonsillitis obviously interferes with this complex immunological network, possibly resulting in a reduced mucosal protection by IgA. Furthermore, bacterial antigens can initiate the liberation of biochemical inflammatory mediators. Among these, arachidonic acid products can play a key role. They can induce epithelial damage and decreased ciliary function. Furthermore, they influence tonsillar immunological reactions.