COMBINED IMPACT OF STREPTOCOCCUS PYOGENES INFECTION, ANTI-STREPTOLYSIN O RESPONSE, AND IL-10/TNF-Α GENE POLYMORPHISMS ON SUSCEPTIBILITY TO RECURRENT TONSILLITIS



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Objective: The aim of the study was to examine bacteriological profile of recurrent tonsillitis, and assess the association between Streptococcus pyogenes infection, anti-streptolysin O (ASO) levels, and cytokine gene polymorphisms (IL-10 and TNF-a).Methods: This study involved 100 participants, i.e., 50 patients with recurrent tonsillitis and 50 healthy controls. Bacteriological culture and identification were done on throat swab samples. Serum ASO was determined serologically by standard procedures. Genotype of IL -10 ( -1082 G/A) and TNF- ( -308 G/A) was done by molecular methods. These were statistically analyzed to compare the groups and evaluate correlations between the variables. Results: Bacteriological tests showed that 76% of the patient samples were culture-positive, and Streptococcus pyogenes was the most common isolate (63.2%). The level of ASO was markedly elevated in the patient group as compared to the control group with mean levels of 356.8 ± 120.5 IU/mL and 112.4 ± 48.7 IU/mL respectively (p < 0.05).Genetic analysis showed that there was increased prevalence of IL-10 AA genotype (low producer) and TNF- alpha AA genotype (high producer) in patients. Strong correlation between TNF-alpha polymorphism and disease susceptibility was found whereby there was an increased prevalence of the A allele of TNF-a in the patients. Correlation analysis revealed that TNF-alpha polymorphism was positively associated with ASO levels (r = +0.46) and IL-10 polymorphism was negatively associated with ASO levels (r = -0.39) and both these were statistically significant (p < 0.05).Conclusion: Recurrent tonsillitis is clearly linked to persistent infection with Streptococcus pyogenes, high levels of anti-streptolysin O (ASO) as well as to polymorphisms of the genes coding for cytokines. The results indicate that, the allelic variation in immune-response genes might be associated with susceptibility to recurrent tonsillitis and the immune response to streptococcal infection, because these are more common in patients. These results point to the need to consider bacteriological, immunological and genetic parameters in explaining the mechanisms of recurrent tonsillitis and could help to develop novel diagnostic and therapeutic strategies.

About the authors

Rana Talib Mohsen

University of Anbar, Iraq

Author for correspondence.
Email: Ranamohsen2011@gmail.com

assistant professor

Iraq

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