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High Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic Streptococci

Journal article
Authors Susann Skovbjerg
Kristian Roos
Sigvard Olofsson
Magnus Lindh
Annika Ljung
Lars Hynsjö
Stig Holm
Ingegerd Adlerberth
Agnes E Wold
Published in Journal of Interferon and Cytokine Research
Volume 35
Issue 9
Pages 682-689
ISSN 1079-9907
Publication year 2015
Published at Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine
Institute of Biomedicine, Department of Microbiology and Immunology
Institute of Biomedicine, Department of Infectious Medicine
Pages 682-689
Language en
Keywords epstein-barr-virus, acute pharyngotonsillitis, surface secretion, middle-ear, children, bacteria, cells, pharyngitis, infections, chemokines, Biochemistry & Molecular Biology, Cell Biology, Immunology
Subject categories Immunology in the medical area


Acute pharyngotonsillitis denotes tonsillar inflammation caused by bacteria or viruses. Here, we investigated if beta-hemolytic streptococci (beta-HS) tonsillitis would differ in inflammatory mediator response from tonsillitis of other causes. Tonsillar secretions were obtained from 36 acute pharyngotonsillitis patients and 16 controls. Bacteria were cultured quantitatively and 18 different viruses were quantified by real-time polymerase chain reaction. Cytokine and prostaglandin E-2 (PGE(2)) levels were determined by enzyme-linked immunosorbent assays. Almost half of the patients' tonsillar secretions yielded high counts of beta-HS, and most samples contained viruses, irrespective of whether beta-HS were present or not. The Epstein-Barr virus (EBV) was the most common virus (patients 62% and controls 13%). Compared to controls, patients' secretions had higher levels of interleukin (IL)-1 beta, IL-6, IL-8, tumor necrosis factor (TNF), and PGE(2), while few samples contained IL-12, IL-10, or interferon-gamma (IFN-gamma). The presence of beta-HS in tonsillitis secretions could not be distinguished by any of the measured mediators, while the presence of EBV DNA tended to be associated with enhanced levels of IL-1 beta and IL-8. The results suggest a common inflammatory response in acute pharyngotonsillitis, regardless of causative agent. The suggested correlation between intense inflammation and the presence of EBV DNA in tonsillitis secretions may be due to reactivation of the virus and/or the EBV-containing B cells.

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