Tonsillitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Tonsillitis is associated with infection, it is currently unknown if the swelling and other symptoms are caused by the infectious agents themselves, or by the host immune response to these agents. Tonsillitis may be a result of aberrant immune responses to the normal bacterial flora of the nasopharynx.
Pathophysiology
- Under normal circumstances, as viruses and bacteria enter the body through the nose and mouth, they are filtered in the tonsils.[1][2]
- Acute tonsillitis may occur as a result of a Streptococcus pyogenes infection.
- S. pyogenes may be identified within the mucous layer that covers the tonsils as well as the surface of epithelial cells.
- The progression of the infection begins with penetration of infectious bacteria into the mucous barrier.
- Further progression results in the attachment of the infectious bacteria to the surfaces of epithelial cells. .
- Infection may then spread from cell to cell with the appearance of long chains of coccus-bacteria, encroaching on the border of the epithelial cells.
- Spread of infection may lead to the penetration of infectious bacteria into the outermost layers of epithelial cells - resulting in inflammation of the tonsils.
- Within the tonsils, white blood cells of the immune system mount an attack that helps destroy the viruses or bacteria by producing inflammatory cytokines like Phospholipase A2, [3] which also lead to fever.[1][2]
- Infection also provokes the production of cytokines and the activation of a complement immune response - both of which contribute to the overall inflammation of the tonsils.
References
- ↑ 1.0 1.1 van Kempen MJ, Rijkers GT, Van Cauwenberge PB (2000). "The immune response in adenoids and tonsils". Int. Arch. Allergy Immunol. 122 (1): 8–19. doi:10.1159/000024354. PMID 10859465. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Perry M, Whyte A (1998). "Immunology of the tonsils". Immunology Today. 19 (9): 414–21. doi:10.1016/S0167-5699(98)01307-3. PMID 9745205. Unknown parameter
|month=ignored (help) - ↑ "Circulating phospholipase-A2 activity in obstructive sleep apnea". International Journal of Pediatric Otorhinolaryngology. 2012. doi:10.1016/j.ijporl.2011.12.026. PMID 22297210.
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