Chronic tonsillitis. The role of probiotics in the treatment of inflammation
- Authors: Lavrenova G.V.1, Zhamakochyan K.T.1
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Affiliations:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- Issue: Vol 30, No 3 (2024)
- Pages: 200-208
- Section: Review
- Submitted: 27.10.2024
- URL: https://journals.eco-vector.com/2310-3825/article/view/639943
- DOI: https://doi.org/10.33848/fopr639943
- ID: 639943
Cite item
Abstract
The problem of treatment of chronic tonsillitis is always relevant. The disruption of the protective mechanisms of palatal tonsils, pharyngeal mucosa and other immunocompetent organs contributes to the chronicity and exacerbation of inflammation. Tonsillectomy and antibacterial treatment involves the removal of palatal tonsils damaged by inflammation and alteration of microflora, but also reduces or suppresses the protective functions of the associated tissues. There are various initial etiopathogenetic factors of chronic inflammation of palatine tonsils, but the main one is persistent pharyngeal dysbiosis, which hinders the resolution of inflammation. Therefore, cleaning of the palatal tonsils should be supplemented by creating conditions for local and systematic restoration of the microbiocenosis. However, this issue is often overlooked and treatments to stabilize the microflora are not prescribed during antibiotic therapy. In recent years, several studies have evaluated the association between gastrointestinal disorders and palatal tonsil inflammation. Based on the general literature on intestinal disorders, microbiota and immunity, it was concluded that there may be direct correlation between the disruption of the protective functions of the intestine and palatal tonsils in patients with chronic tonsillitis with inflammatory and functional intestinal disorders, especially with intestinal dysbiosis.
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About the authors
Galina V. Lavrenova
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: lavrenovagv@yandex.ru
ORCID iD: 0000-0002-3537-0226
SPIN-code: 2440-5103
MD, Dr. Sci. (Medicine)
Russian Federation, Saint PetersburgKristina Ts. Zhamakochyan
Academician I.P. Pavlov First St. Petersburg State Medical University
Author for correspondence.
Email: kristina.voita@mail.ru
ORCID iD: 0000-0003-3120-4906
Russian Federation, Saint Petersburg
References
- Mikhailova IV, Mikhailov YuKh, Orlova YuYu. Topical issues in treatment of chronic tonsillitis. In: Proceedings of the Interregional Scientific and Practical Conference “Antibacterial Therapy in Otolaryngology”; Cheboksary, March 28, 2019. Cheboksary; 2019. P. 81–85. (In Russ.) EDN: ZZVTFV
- Maltseva GS, Ryazantsev SV. Systemic antibacterial therapy for chronic tonsillitis. Russian Otolaryngology. 2009;(3(40)):149–156. (In Russ.) EDN: MHWPFX
- Goffman VV, Dvoryanchikov VV. Bacteriologic and immunologic status in patients with chronic tonsillitis current position. Russian Otolaryngology. 2014;(2(69)):19–23. EDN: RYYUIL
- Dvoryanchikov VV, Gofman VR, Podsvirov VI. Cliniko-morphological and microbiological parallels between lymphoid tissue of the tonsills and appendix. Russian Otolaryngology. 2015;(4(77)):40–42. EDN: UHCMVR
- Pirogov NN, Portenko EG, Stolyarov DI. A question of microbiota’s role in the etiopathogenesis of chronic pharyngotonsillitis. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2016;22(3):63–71. EDN: WJJSGP
- Karpishchenko SA, Lavrenova GV, Muratova EI. Violation of the microecological status of the palatine tonsils and intestines as a single mechanism for the formation of chronic tonsillitis. Modern medicine: a peer-reviewed scientific and practical journal. 2019;(3(15)):87–89. (In Russ.)
- Zakharova IN, Dmitrieva YuA. Intestinal microbiota and the use of probiotics from the perspective of evidence-based medicine. Consilium Medicum. 2016;(4):24–28. EDN XXXAPP
- Ardatskaya MD. Probiotics, prebiotics and metabiotics in the correction of intestinal microecological disorders. Medical Council. 2015;(13):94–99. EDN: UNSZJJ
- Karpishchenko SA, Lavrenova GV, Muratova EI. Modern trends in the treatment of chronic tonsillitis associated with intestinal pathology. Practical Medicine. 2018;16(5):76–80. EDN: VADUKF
- Kolesnikova OM, Karpishchenko SA, Legkova YuV. Anti-inflammatory therapy of pharyngeal diseases. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2019;25(3):53–59. EDN: BVHASM doi: 10.33848/foliorl23103825-2019-25-3-53-59
- Berezhnoy VV, Kramarev SA, Shunko EE. Human microflora and the role of modern probiotics in its regulation. Women’s Health. 2004;(1(17)):134–139. (In Russ.)
- Muratova EI, Lavrenova GV. Treatment of chronic tonsillitis in patients with lactase deficiency: results of a clinical study. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2021;27(3):85–93. EDN: LUHUSA doi: 10.33848/foliorl23103825-2021-27-3-85-93
- Grafskaya NA. Prevention of exacerbations of chronic pharyngitis in gastroenterological patients. Russian Otolaryngology. 2003;(1):46–47. (In Russ.)
- Dyukov LA, Shulga IA. Some effects of probiotic therapy in chronic tonsillitis. Vyatka Medical Bulletin. 2008;(2):58–61. (In Russ.) EDN: PCEQMZ
- Zakharchenko SM, Suvorov AN. Antibiotics, probiotics, prebiotics: friends or enemies? Consilium Medicum. 2009;11(8):47–51. (In Russ.) EDN: RBEKXT
- Zakharchenko SM, Sigidaev AS. The state of intestinal microflora in patients with chronic tonsillitis during complex etiotropic therapy. Lechenie i profilaktika. 2015;(4):36–42. EDN: VJFRXT
- Andreeva IV. Potential possibilities of using probiotics in clinical practice. Clinical Microbiology and Antimicrobial Chemotherapy. 2006;8(2):151–172. EDN: TKGKWR
- Lilly DM, Stilwell RH. Probiotics: growth promoting factors produced by microorganisms. Science. 1965;147(3659):747–748. doi: 10.1126/science.147.3659.747.
- Hoesl CE, Altwein JE. The probiotic approach: an alternative treatment option in urology. Eur Urol. 2005;47(3):288–296. doi: 10.1016/j.eururo.2004.09.011
- Tsapieva AN, Suvorov AN. Investigation of antagonistic activity properties of lactobacilli isolated from fermented milk products and probiotics. Preventive and clinical medicine. 2010;(3–4):156–160. EDN: SBJWGX
- Shulga EI, Shulga IA, Smolyagin AI, et al. Experience of conservative treatment of chronic tonsillitis with the probiotic “Bion-3”. Russian Otolaryngology. 2016;(3(82)):160–163. EDN: WAADBD doi: 10.18692/1810-4800-2016-3-160-163
- Bondarchuk IE. Experience of “lactoflor kiddy” use in conservative treatment of children with chronic tonsillitis. Medical news. 2019;(1(292)):65–68. EDN: YXRYTJ
- Rizzo A, Paolillo R, Guida L, et al. Effect of metronidazole and modulation of cytokine production on human periodontal ligament cells. Int Immunopharmacol. 2010;10(7):744–750. doi: 10.1016/j.intimp.2010.04.004
- Metchnikoff E. Lactic acid as inhibiting intestinal putrefaction. In: Chalmers Mitchell P, ed. The prolongation of life: optimistic studies. London: Heinemann; 1907. P. 161–183.
- Vorobyov AA, Bondarenko NM, Lykova EA, et al. The micro-ecological disorders in a clinical pathology and their correction by probiotics. Annals of the Russian Academy of Medical Sciences. 2004;(2):13–17. EDN: OIVZRT
- Kaibysheva VO, Nikonov EL. Probiotics from the standpoint of evidence-based medicine. Russian journal of Evidence-based gastroenterology. 2019;8(3):45–54. EDN: LFBVJW doi: 10.17116/dokgastro2019803145
- Erdes SI, Mukhametova EM, Revyakina SA. Combined enterosorbents in pediatric practice: possibilities of use and mechanisms of action (review). Effective pharmacotherapy. 2012;(16):26–31. (In Russ.) EDN: SJFGYH
- Khramtsov AG, Ryabtseva SA, Budkevich RO, et al. Prebiotics as functional food ingredients: terminology, choice and comparative evaluation criteria, classification. Problems of nutrition. 2018;87(1):5–17. EDN: YRZCFH doi: 10.24411/0042-8833-2018-10001
- Wang Y, Li X, Ge T, et al. Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016;95(31):e4509. doi: 10.1097/MD.0000000000004509
- Meskina ER, Galkina LA. Correction of microflora of pharynx in children with acute tonsillitis. Lechenie i profilaktika. 2014;(4):67–72. EDN: THZVYD
- Gao L, Xu T, Huang G, et al. Oral microbiomes: more and more importance in oral cavity and whole body. Protein Сell. 2018;9(5):488–500. doi: 10.1007/s13238-018-0548-1
- Fiorini G, Cimminiello C, Chianese R, et al. Bacillus subtilis selectively stimulates the synthesis of membrane bound and secreted IgA. Chemioterapia. 1985;4(4):310–312.
- Lefevre M, Racedo SM, Ripert G, et al. Probiotic strain Bacillus subtilis CU1 stimulates the immune system of the elderly during common infectious disease period: a randomized, double-blind placebo-controlled study. Immun Ageing. 2015;12:24. doi: 10.1186/s12979-015-0051-y
- Kryuchko TA, Tkachenko OYa. Clinical experience of Streptococcus salivarius k12 use for the prevention of pharyngotonsillitis and respiratory infections in children. Child health. 2018;13(7):629–634. EDN: YQZQPR doi: 10.22141/2224-0551.13.7.2018.148915
- Vertakova OV, Kiselev AB, Chaukina VA, et al. A new approach to the treatment of chronic foci of oropharyngeal infection in individuals with a polymorbid background. Russian Otolaryngology. 2017;(1(86)):21–26. EDN: YHHQVJ
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