The role of tonsillectomy in psoriasis treatment

Simões, João; Ribeiro, João Carlos; Ferreira, Bárbara Roque; Paiva, Sandra

doi:10.1136/bcr-2014-206899

Cited by 16 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the clinical setting, it is well established that streptococcal throat infection is the major triggering factor of guttate psoriasis and that IL-36γ is abundantly expressed in the outermost skin layers of psoriatic individuals ( D’Erme et al., 2015 ; Telfer et al., 1992 ). In some patients the connection between streptococcal infection and psoriasis flare is so strong that guidelines recommend tonsillectomy ( Simões et al., 2015 ). As streptococcal SpeB is the most highly secreted protein produced during infection and is known to interact with host proteins with both pro- and anti-inflammatory consequences, the data presented here may well provide a mechanistic link between the proteolytic activation of IL-36γ by S. pyogenes SpeB and the initiation of guttate psoriasis ( Nelson et al., 2011 ; Elliott, 1945 ).…”

Section: Discussionmentioning

confidence: 99%

The Proinflammatory Cytokine IL-36γ Is a Global Discriminator of Harmless Microbes and Invasive Pathogens within Epithelial Tissues

et al. 2020

View full text Add to dashboard Cite

Summary Epithelial tissues represent vital interfaces between organisms and their environment. As they are constantly exposed to harmful pathogens, innocuous commensals, and environmental microbes, it is essential they sense and elicit appropriate responses toward these different types of microbes. Here, we demonstrate that the epithelial cytokine interleukin-36γ (IL-36γ) acts as a global discriminator of pathogenic and harmless microbes via cell damage and proteolytic activation. We show that intracellular pro-IL-36γ is upregulated by both fungal and bacterial epithelial microbes; yet, it is only liberated from cells, and subsequently processed to its mature, potent, proinflammatory form, by pathogen-mediated cell damage and pathogen-derived proteases. This work demonstrates that IL-36γ senses pathogen-induced cell damage and proteolytic activity and is a key initiator of immune responses and pathological inflammation within epithelial tissues. As an apically located epithelial proinflammatory cytokine, we therefore propose that IL-36γ is critical as the initial discriminator of harmless microbes and invasive pathogens within epithelial tissues.

show abstract

Section: Discussionmentioning

confidence: 99%

The Proinflammatory Cytokine IL-36γ Is a Global Discriminator of Harmless Microbes and Invasive Pathogens within Epithelial Tissues

et al. 2020

View full text Add to dashboard Cite

show abstract

“…RAT and PTA or some therapy-refractory systemic diseases, for example, certain forms of psoriasis or IgA-nephropathy 10 , 11 , are common indications for tonsillectomies. Indeed, tonsillectomy is one of the most common surgical procedures in young adults and infants (e.g.…”

Section: Introductionmentioning

confidence: 99%

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

Geißler

Weigel

Schubert

et al. 2020

Sci Rep

View full text Add to dashboard Cite

the aim of this study was to examine t cell function in tonsils of patients with recurrent acute tonsillitis (RAT) or peritonsillar abscess (PTA) by analyzing the cytokine production following T cell receptor (TCR) and co-receptor stimulation with a combination of anti-CD3 and anti-CD28 antibodies. The release of IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 and IL-17A from isolated, stimulated T cells of 27 palatine tonsils (10 RAT, 7 PTA, 10 tonsils without inflammation) was measured via a bead-based flow cytometric analysis. The results were compared with the cytokine release of isolated peripheral T cells in a subset of the same patients (6 PTA, 4 patients without signs of inflammation in the blood). tcR stimulation increased the concentration of released cytokines in tonsil and blood as well as in different forms of inflammation and tissue with no inflammation. Stimulation increased the proinflammatory cytokines TNF-α, IFN-γ, and IL-2 more than the anti-inflammatory cytokines IL-4 and IL-10 in tonsil and blood samples in RAT, PTA, and samples without inflammation. Blood of patients with PTA showed a higher pro-inflammatory cytokine level compared to the samples of patients without inflammation. T cells in tonsils are fully responsive and competent for antigen-induced cytokine production in RAT and PTA. One should be aware that tonsillectomy, if indicated, might remove a functioning immune organ. Tonsillotomy might be an alternative even in adults to maintain immunological function. The palatine tonsils as paired lymphatic organs are located at the beginning of the upper aerodigestive tract and are responsible for immune protection against ingested and inhaled pathogens. In this context, innate and adaptive immune reactions interact, whereby tonsillar T cells located primarily in the extra-follicular spaces, in particular, play a dominant role 1. Cytokines are produced in the context of inflammatory reactions by immunecompetent cells. A distinction is made between genuine pro-inflammatory, e. g. tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-6, IL17-A, and mostly anti-inflammatory cytokines like IL-4 and IL-10 2-4. Furthermore, depending on the inflammatory scenario, T-cells can differentiate into differently primed states, including Th1, Th2, and Th17. Briefly, Th1 helper cells produce large amounts of IFN-γ, IL-2, and TNF-β, which trigger macrophages and are important for cell-mediated immunity and phagocyte-dependent immune responses. Th2 cells produce IL-4, IL-5, IL-10, and IL-13, which promote antibody production, eosinophil activation, and inhibition of several macrophage functions 5. Th17 cells and their effector cytokines IL-17A, IL-17F, IL-21, and IL-22 mediate host defense mechanisms to a variety of infections, especially of bacterial origin, and are furthermore involved in the pathogenesis of many autoimmune diseases 6. Recurrent acute tonsillitis (RAT) is a common chronic inflammation of the palatine tonsils, which often needs surgical excision 7 .

show abstract

“…Recently, tonsillectomy has been reported to be extremely effective for palmoplantar pustulosis, pustulotic arthro‐osteitis, and IgAN, and the tonsil has been established as the focus of these diseases. In addition, there are a large number of reports that tonsillectomies are also effective for psoriatic diseases, and IgA vasculitis, reactive arthritis, periodic fever, aphthous stomatitis, and pharyngitis and cervical adenitis syndrome …”

Section: Histological Backgrounds Of Tiasmentioning

confidence: 99%

Recent advances in the immunological understanding of association between tonsil and immunoglobulin A nephropathy as a tonsil‐induced autoimmune/inflammatory syndrome

Harabuchi

Takahara

2019

Immunity Inflam & Disease

View full text Add to dashboard Cite

Introduction Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. It is well known that upper respiratory tract infections, particularly acute tonsillitis, often worsen IgAN. Recent many clinical studies clearly show that tonsillectomy with steroid pulse therapy is the effective treatments for IgAN patients. Recently, the immunological evidence of association between tonsil and IgAN has been reported. Methods In this review, the mechanism underlying the onset of IgAN, as a tonsil‐induced autoimmune/inflammatory syndrome (TIAS), is outlined with the main focus on the authors' research results. Results In the tonsils of patients with IgAN, hyperimmune response to the unmethylated deoxycytidyl‐deoxyguanosine oligodeoxynucleotides (CpG‐ODN) take place, resulting in hyperproduction of interferon‐γ. The hyperproduction is followed by both overproduction of mutated IgA via B‐cell activating factor (BAFF)/a proliferation‐inducing ligand (APRIL)‐mediated pathways and overexpression of T‐cell receptor Vβ6, CXCR3, and CX3CR1 on tonsillar T cells. These IgA and T cells home to the kidney via the systemic circulation, resulting in nephritis of IgAN. Conclusions Scientific evidence supporting the use of tonsillectomy has gradually accumulated. We hope that many additional researchers will publish new evidence linking the tonsils and kidneys in the future.

show abstract

The role of tonsillectomy in psoriasis treatment

Cited by 16 publications

References 7 publications

The Proinflammatory Cytokine IL-36γ Is a Global Discriminator of Harmless Microbes and Invasive Pathogens within Epithelial Tissues

The Proinflammatory Cytokine IL-36γ Is a Global Discriminator of Harmless Microbes and Invasive Pathogens within Epithelial Tissues

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

Recent advances in the immunological understanding of association between tonsil and immunoglobulin A nephropathy as a tonsil‐induced autoimmune/inflammatory syndrome

Contact Info

Product

Resources

About