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The influence of tonsillectomy on allergic diseases in pediatric patients

Urara Funakoshi1, Syuji Yonekura1, Tomohisa Iinuma1

  • 1Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

International Journal of Pediatric Otorhinolaryngology
|November 23, 2020
PubMed

Insights

Tonsillectomy improved symptoms of allergic airway diseases like perennial allergic rhinitis and bronchial asthma in children. While not altering allergy mechanisms, it reduced infection risk and airway obstruction, leading to symptom relief.

Area of Science:

  • Immunology
  • Pediatric Allergy
  • Otolaryngology

Background:

  • The impact of tonsillectomy on pediatric allergic airway diseases remains unclear.
  • Investigating tonsillectomy's effect on perennial allergic rhinitis (PAR) and bronchial asthma (BA) is crucial.

Purpose of the Study:

  • To prospectively evaluate the influence of tonsillectomy on PAR and BA in children.
  • To analyze immunological changes following tonsillectomy in pediatric patients.

Main Methods:

  • Prospective study comparing a tonsillectomy group with an age-matched control group.
  • Inclusion of immunological analyses, including flow cytometry and IgE level measurements.
  • Clinical assessment of PAR and BA symptoms in both groups.

Main Results:

  • Tonsillar cells produced allergen-specific Th2 cells upon in vitro stimulation.
  • Increased effector regulatory T cells (Tregs) were found in tonsils compared to peripheral blood.
  • Surgery group showed improved PAR and BA symptoms, lower total IgE, and increased Der f-specific IgE in sensitized subjects.

Conclusions:

  • Tonsillectomy improved symptoms of allergic airway diseases in children, likely due to reduced infection risk and airway obstruction.
  • The procedure did not alter the fundamental immunological mechanisms of allergy.
  • Clinical benefits observed suggest tonsillectomy as a potential intervention for symptom management.
Abstract

Keywords:
Allergic rhinitisBronchial asthmaPediatric subjectsRegulatory T cellsTonsillectomy

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