Improvement of psoriasis after tonsillectomy is associated with a decrease in the frequency of circulating T cells that recognize streptococcal determinants and homologous skin determinants.

• Published in: The Journal of Immunology
• Main Authors: Thorleifsdottir, Ragna Hlin, Sigurdardottir, Sigrun Laufey, Sigurgeirsson, Bardur, Olafsson, Jon Hjaltalin, Sigurdsson, Martin Ingi, Petersen, Hannes, Arnadottir, Sigurlaug, Gudjonsson, Johann Eli, Johnston, Andrew, Valdimarsson, Helgi
• Other Authors: Department of Immunology, Landspitali University Hospital, 101 Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: American Association of Immunologists 2012
• Subjects: Adolescent; Adult; Antigens; Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Cell Movement; Child; Preschool; Chronic Disease; Epitopes; T-Lymphocyte; Female; Humans; Keratins; Lymphopenia; Male; Middle Aged; Palatine Tonsil; Prospective Studies; Psoriasis; Skin; T-Lymphocyte Subsets; Tonsillectomy; Young Adult; Iceland
• Online Access: http://hdl.handle.net/2336/239051; https://doi.org/10.4049/jimmunol.1102834

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Exacerbation of chronic psoriasis can be associated with streptococcal throat infections, and T cells that respond to peptide sequences common to streptococcal M proteins and skin keratins have been detected in patients' blood. To our knowledge, we have conducted the first blinded, prospective study to assess the impact of tonsillectomy on psoriasis. Twenty-nine patients with chronic psoriasis and history of exacerbation after sore throat were randomly assigned to tonsillectomy (n = 15) or control (n = 14) groups and monitored for 2 y clinically and by enumeration of circulating skin homing T cells that respond to short homologous M protein or keratin peptides. Thirteen patients (86%) showed sustained improvement after tonsillectomy ranging from 30 to 90% reduction in disease severity. Furthermore, there was a close correlation between the degree of clinical improvement in individual patients and reduction in the frequency of peptide-reactive skin-homing T cells in their circulation. No corresponding clinical or immunologic changes were observed among the controls. These findings indicate that tonsillectomy may have a beneficial effect on chronic psoriasis because the palatine tonsils generate effector T cells that recognize keratin determinants in the skin. Icelandic Research Fund, Icelandic Research Fund for Graduate Students, University of Iceland, National University Hospital in Iceland