title: High Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic Streptococci.
abstract: Acute pharyngotonsillitis denotes tonsillar inflammation caused by bacteria or viruses. Here, we investigated if beta-hemolytic streptococci (β-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 E2 (PGE2) levels were determined by enzyme-linked immunosorbent assays. Almost half of the patients' tonsillar secretions yielded high counts of β-HS, and most samples contained viruses, irrespective of whether β-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)-1β, IL-6, IL-8, tumor necrosis factor (TNF), and PGE2, while few samples contained IL-12, IL-10, or interferon-gamma (IFN-γ). The presence of β-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-1β 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.
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Susann
authors.initials: S
authors.lastname: Skovbjerg
authors.affiliation: 3 ENT Department, Capio Lundby Hospital , Gothenburg, Sweden .
authors.forename: Kristian
authors.initials: K
authors.lastname: Roos
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Sigvard
authors.initials: S
authors.lastname: Olofsson
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindh
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Annika
authors.initials: A
authors.lastname: Ljung
authors.affiliation: 4 Department of Clinical Chemistry and Transfusion Medicine, University of Gothenburg , Gothenburg, Sweden .|5 Clinical Chemistry, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Lars
authors.initials: L
authors.lastname: Hynsjö
authors.affiliation: 6 Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden .
authors.forename: Stig E
authors.initials: SE
authors.lastname: Holm
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Adlerberth
authors.affiliation: 1 Department of Infectious Diseases, University of Gothenburg , Gothenburg, Sweden .|2 Clinical Microbiology, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Agnes E
authors.initials: AE
authors.lastname: Wold
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000276:immunology*; D004279:DNA, Viral / Q000235:genetics; D015232:Dinoprostone / Q000276:immunology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000382:microbiology / Q000821:virology; D007371:Interferon-gamma / Q000276:immunology; D007378:Interleukins / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013291:Streptococcus / Q000276:immunology*; D014069:Tonsillitis / Q000276:immunology* / Q000382:microbiology* / Q000821:virology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D055815:Young Adult
chemical_list: D016207:Cytokines; D004279:DNA, Viral; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D015232:Dinoprostone