Doctors may be one step closer to solving the mystery of why some children develop recurrent strep throat, a painful sore throat if left untreated that can lead to infectious skin ulcers, kidney problems and rheumatic heart disease.
new Research published in February 2019 in the journal Translational Medicine Sciences He found that both genetics and poor immune responses may be a reason why some children will tolerate recurrent bouts of the bacteria while others may never have it. Discovering the causes of this infection could bring researchers closer to developing a vaccine for group A streptococci, the most common type of streptococci, which infects more than 600 million people each year.
to test the theory, Jennifer Dunn, MD, PhDOne of the study authors and an infectious disease specialist at UC San Diego Health examined the surgically removed tonsils of 65 children: 26 had their tonsils removed due to repeated episodes of tonsillitis, and 39 were removed for an unrelated condition, such as sleep apnea.
Dr. Dunn and colleagues found that children who had their tonsils removed due to recurrent infections had smaller germ centers in the tonsils. Germinal centers live inside the lymph nodes and help produce antibodies, which are special proteins that fight infection. The antibodies recognize and inactivate the bacteria, and usually should be able to clear the infection before it strikes again.
“If these germinal centers are smaller, they may not be able to respond as well as the immune response,” Dunn says.
Children with recurrent tonsillitis were more likely to have family members who had tonsillectomy, suggesting a genetic predisposition to impaired immune response.
Knowing why staph infections recur is also one of the keys to developing a vaccine. Matthew Briger, MD, MPHStudy co-author and chief of otolaryngology at Rady Children’s Hospital in San Diego, says the vaccine will not only treat streptococcal and other infections such as tonsillitis, but will also reduce the need for surgeries like tonsillectomy.
“The surgery is very common and many children have it, but it usually involves a week of school absenteeism and there is a risk of bleeding, and it’s one of the most painful surgeries we have,” he says. “We do this surgery all the time, but we still don’t have a particularly good understanding of why some kids get it. [tonsillectomies] Others do not. “
This month, the American Academy of Otolaryngology Update its instructions To perform tonsillectomy surgery in children – something that has not been done since 2011. Tonsillectomy has been a very popular procedure, with More than 500,000 children Under the age of 15 had a tonsillectomy in 2009. That number has been cut by nearly half, the most recent National Health Statistics Report Show less than 300,000.
Marie Frances Musso, DoThe two main reasons for tonsillectomy in children are sleep apnea and frequent infections, says a pediatric otolaryngologist at Texas Children’s Hospital. With updated guidelines, Musso can still recommend surgery, but only if a child has had at least seven injuries in one year. Even with surgery, some children will still have sore throats.
A vaccine may be out of reach, but Dr. Musso says the latest study provides new clues to the causes of recurring staph infections, which would be a critical first step in developing a vaccine.
“This is the first time I’ve actually heard of someone mentioning the possibility of finding a group A vaccine,” she says. “What they are saying has the potential to work. If they can develop a vaccine, it could be effective and reduce the rate of infection.”