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dc.contributor.authorThorleifsdottir, Ragna Hlin
dc.contributor.authorSigurdardottir, Sigrun Laufey
dc.contributor.authorSigurgeirsson, Bardur
dc.contributor.authorOlafsson, Jon Hjaltalin
dc.contributor.authorSigurdsson, Martin Ingi
dc.contributor.authorPetersen, Hannes
dc.contributor.authorArnadottir, Sigurlaug
dc.contributor.authorGudjonsson, Johann Eli
dc.contributor.authorJohnston, Andrew
dc.contributor.authorValdimarsson, Helgi
dc.date.accessioned2012-08-17T11:16:19Z
dc.date.available2012-08-17T11:16:19Z
dc.date.issued2012-05-15
dc.date.submitted2012-08-17
dc.identifier.citationJ. Immunol. 2012, 188(10):5160-5en_GB
dc.identifier.issn1550-6606
dc.identifier.pmid22491250
dc.identifier.doi10.4049/jimmunol.1102834
dc.identifier.urihttp://hdl.handle.net/2336/239051
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractExacerbation 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.
dc.description.sponsorshipIcelandic Research Fund, Icelandic Research Fund for Graduate Students, University of Iceland, National University Hospital in Iceland,en_GB
dc.language.isoenen
dc.publisherAmerican Association of Immunologistsen_GB
dc.relation.urlhttp://dx.doi.org/10.4049/jimmunol.1102834en_GB
dc.rightsArchived with thanks to Journal of immunology (Baltimore, Md. : 1950)en_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAntigens, Bacterialen_GB
dc.subject.meshBacterial Outer Membrane Proteinsen_GB
dc.subject.meshCarrier Proteinsen_GB
dc.subject.meshCell Movementen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshEpitopes, T-Lymphocyteen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshKeratinsen_GB
dc.subject.meshLymphopeniaen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPalatine Tonsilen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPsoriasisen_GB
dc.subject.meshSkinen_GB
dc.subject.meshT-Lymphocyte Subsetsen_GB
dc.subject.meshTonsillectomyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleImprovement of psoriasis after tonsillectomy is associated with a decrease in the frequency of circulating T cells that recognize streptococcal determinants and homologous skin determinants.en
dc.typeArticleen
dc.contributor.departmentDepartment of Immunology, Landspitali University Hospital, 101 Reykjavik, Iceland.en_GB
dc.identifier.journalJournal of immunology (Baltimore, Md. : 1950)en_GB
dc.rights.accessLandspitali Access - LSH-aðganguren
dc.type.categoryÓnæmisfræði, HNE, Húð- og kynen_GB
html.description.abstractExacerbation 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.


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