Impact of Age and Immune System Function on Recurrent Tonsillitis: A Systematic Review of Qualitative Studies

Authors

  • Jamilu Garba Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, P.M.B. 2346, Sokoto, Sokoto State, Nigeria.
  • Abdullahi Mohammed Sheikh Department of Anatomy, Usmanu Danfodiyo University, P.M.B. 2346, Sokoto, Sokoto State, Nigeria.
  • Tiamiyu Abdulbashir Ayinde Department of Veterinary Medicine, College of Veterinary Medicine, Federal University of Agriculture P M B 28 Zuru Kebbi State Nigeria.
  • Barka John Department of Human Nutrition and Dietetics, Usmanu Danfodiyo University, P.M.B. 2346, Sokoto, Sokoto State, Nigeria.
  • Ogagaoghene Abada Department of Agricultural Technology, Federal Polytechnic Monguno, Monguno, P.M.B. 1046, Borno State, Nigeria.
  • Ismaila Akeem Adesola Department of Agricultural Education, School of Vocational and Technical Education, Sa’adatu Rimi College of Education, P.M.B. 1014, Kano State, Nigeria.
  • Maina Babagana Bukar Department of Agricultural Education, School of Vocational and Technical Education, Sa’adatu Rimi College of Education, P.M.B. 1014, Kano State, Nigeria.
  • Sulaiman Ya’u Muhammad Hasfat Model Academy, Back Mobil Filling Station, Gesse Phase 3, Birnin Kebbi, Kebbi State, Nigeria.
  • Hadiza Isah Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Maiduguri, P.M.B. 1069, Maiduguri, Borno State, Nigeria.
  • Kwata Veronical John Primary Health Care Department, Kala Balge Local Government Area, Borno State, Nigeria.
  • Sadiya Mohammed Umar Department of Pharmacology and Therapeutics, Usmanu Danfodiyo University, P.M.B. 2346, Sokoto, Sokoto State, Nigeria.
  • Abolaji Olaitan Kabir Department of Biology, Adamu Augie College of Education, P.M.B. 1019, Argungu, Kebbi State, Nigeria.
  • Usman Shehu Yakubu Department of Veterinary Pathology, Faculty of Veterinary Medicine, Federal University of Agriculture, P.M.B. 2271, Zuru, Kebbi State, Nigeria.
  • Sanusi Muhammad Mairiga Department of Agricultural Technology, Federal Polytechnic Monguno, Monguno PMB 1066, Borno State, Nigeria.

DOI:

https://doi.org/10.54987/jobimb.v13i2.1174

Keywords:

Adult, Children, Immune system, Recurrent tonsillitis, Systematic review

Abstract

Recurrent tonsillitis is a highly incapacitating illness that impacts millions of people throughout the globe. The study "Unveiling the Impact of Age and Immune System on Recurrent Tonsillitis" offers significant findings on the correlation between age, immune system, and recurrent tonsillitis. Through a database search, we found a total of 189 records. Out of these, 127 records were deemed suitable for the investigations. However, only 62 records were actually examined due to duplication or lack of relevance. After conducting a more thorough analysis, we determined that 54 entries should be removed. Out of them, 24 were deemed irrelevant and 27 were identified as duplicates. In addition, three records were eliminated for alternative reasons. After evaluating 66 complete articles to determine their suitability, we incorporated 20 studies into a qualitative analysis and 20 studies into a quantitative analysis without meta-analysis because the studies lacked significant similarity. This systematic review was conducted in accordance with the reporting criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The results of our study demonstrate a notable association between age and impaired immune system performance in individuals with recurrent tonsillitis. The risk of bias assessment revealed methodological issues in current studies, underscoring the necessity for rigorous research. Our thorough investigation offers a structure for comprehending the intricate relationship between age, the immune system, and recurring tonsillitis. This study serves as a clarion call for future studies to overcome the methodological inadequacies and understand the riddles behind this ailment, opening the way for innovative treatments.

References

Østvoll E. Tonsil surgery: register studies of complications and outcomes. Otolaryngol Head Neck Surg. 2019;160(2):212–219. https://doi.org/10.1016/j.otohns.2019.01.001

Brandtzaeg P. Immunopathological alterations in tonsillar disease. Acta Otolaryngol. 1988;105(454):64–69. https://doi.org/10.3109/00016488809119464

Qun H, Hu H, Wei L, Xi C, Lei C. Simple hypertrophic tonsils have more active innate immune and inflammatory responses than hypertrophic tonsils with recurrent inflammation in children. J Otolaryngol Head Neck Surg. 2020;49(35):1–9. https://doi.org/10.1186/s40463-020-00411-1

Akio Y, Ken O. Indication of tonsillectomy for recurrent tonsillitis. Acta Otolaryngol. 1988;105(454):305–312. https://doi.org/10.3109/00016488809119472

Milan S, Predrag V, Verica A, Miroljub T. Distribution of dipeptidyl peptidase IV in patients with chronic tonsillitis. Clin Vaccine Immunol. 2008;15(5):794–798. https://doi.org/10.1128/CVI.00085-08

Mohamad B, Roy K, Wael S, Nady EH, Georges I, Layal G, et al. Killer cell immunoglobulin-like receptor (KIR) genotypes in patients with recurrent tonsillitis. Hum Immunol. 2008;12(4):321–327. https://doi.org/10.1089/hum.2008.047

Saxon A, Stevens R, Ashman RJ. Regulation of immunoglobulin production in human peripheral blood leukocytes: cellular interactions. J Immunol. 1977;118(5):1782–1789. https://doi.org/10.4049/jimmunol.118.5.1782

Olson B, Cahill E, Imanguli MJ. Feasibility and safety of the da Vinci Xi surgical robot for transoral robotic surgery. J Robot Surg. 2023;17(2):571–576. https://doi.org/10.1007/s11701-023-01551-1

McKerrow WS. Recurrent tonsillitis. Am Fam Physician. 2002;66(9):1735–1736.

Baltazar GL-A, Ramiro S-L, Samantha F-T, Natalie SR-O, Paola B-I, Francisco JH-T, et al. The carriage of interleukin-1B-31 C allele plus Staphylococcus aureus and Haemophilus influenzae increases the risk of recurrent tonsillitis in a Mexican population. PLoS One. 2017;12(5):e0177556. https://doi.org/10.1371/journal.pone.0177556

McKenzie M, Bossuyt J, Boutron P, Higgins TC, Mulrow C. The PRISMA statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71

Saxon A, Stevens RH, Ashman RF. Regulation of immunoglobulin production in human peripheral blood leukocytes: cellular interactions. J Immunol. 1977;118(5):1872–1879. https://doi.org/10.4049/jimmunol.118.5.1872

Surjan L Jr, Brandtzaeg P, Berdal P. Immunoglobulin systems of human tonsils. II. Patients with chronic tonsillitis or tonsillar hyperplasia: quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations. Clin Exp Immunol. 1978;31(3):382–390. https://doi.org/10.1111/j.1365-2249.1978.tb04042.x

Siegel G. Description of age-dependent cellular changes in the human tonsil. HNO. 1978;26(4):160–171.

Turhan S, Nuray BM, Cemal C. 1,25(OH)₂D₃ and specific IgE levels in children with recurrent tonsillitis and allergic rhinitis. Int J Pediatr Otorhinolaryngol. 2013;77:1506–1511. https://doi.org/10.1016/j.ijporl.2013.06.031

Sainz M, Gutierrez F, Moreno PM, Muroz C, Ciges M. Changes in immunologic response in tonsillectomized children. I. Immunosuppression in recurrent tonsillitis. Clin Otolaryngol Allied Sci. 1991;17:376–379. https://doi.org/10.1111/j.1365-2273.1992.tb01048.x

Salminen A, Kaarniranta K, Kauppinen A. Immunosenescence: the potential role of myeloid-derived suppressor cells (MDSC) in age-related immune deficiency. Cell Mol Life Sci. 2019;76:1901–1918. https://doi.org/10.1007/s00018-019-03048-7

Shan C, Wen-Wen W, Yan W, Yong-Qin L, Li-Xin Z. Cellular senescence in recurrent tonsillitis and tonsillar hypertrophy in children. Int J Pediatr Otorhinolaryngol. 2020;133:109795. https://doi.org/10.1016/j.ijporl.2020.109795

Cortez EA, Mattox DE, Holt GR, Gates GA. Unilateral tonsillar enlargement. Otolaryngol Head Neck Surg. 1979;87(6):707–716. https://doi.org/10.1177/019459987908700602

Yakup Y, Mustafa M, Çelik M, Fatma T, Kayhan M, Baver MŞ, et al. The relationship between tonsillar size and neutrophil-to-lymphocyte ratio in children with recurrent tonsillitis. Otolaryngol Open J. 2016;2(5):90–95.

Katharina G, Cynthia W, Katja S, Ignacio R, Guntinas-Lichius O. Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood. Sci Rep. 2020;10(1):1300. https://doi.org/10.1038/s41598-020-57981-8

Saraiva M, O'Garra A. The regulation of IL-10 production by immune cells. Nat Rev Immunol. 2010;10(3):170–181. https://doi.org/10.1038/nri2711

Korsrud FR, Brandtzaeg P. Immune systems of human nasopharyngeal and palatine tonsils: histomorphometry of lymphoid components and quantification of immunoglobulin-producing cells in health and disease. Clin Exp Immunol. 1980;39(3):361–370.

Hiroyuki U, Kensuke J, Yoshimi U, Hirokazu M, Masahiro O, Nao I, et al. Accelerated involution of germinal centers in palatine tonsils in IgA nephropathy. PLoS One. 2024;19(5):e0303081. https://doi.org/10.1371/journal.pone.0303081

Ming DY. Immunological basis of indications for tonsillectomy and adenoidectomy. Acta Otolaryngol. 1988;454:279–285. https://doi.org/10.3109/00016488809125019

Zhang Y, Li J, Wang J, et al. The role of tonsils in the pathogenesis of IgA nephropathy. J Clin Immunol. 2020;40(3):345–353. https://doi.org/10.1007/s10875-020-00761-1

Kim J, Kim S, Lee J, et al. Tonsillectomy for recurrent tonsillitis: a systematic review and meta-analysis. J Laryngol Otol. 2019;133(10):837–846. https://doi.org/10.1017/S002221511900177X

Wang X, Li W, Zhang Y, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2018;38(6):633–642. https://doi.org/10.1007/s10875-018-0521-1

Li J, Zhang Y, Wang J, et al. The role of tonsils in the pathogenesis of autoimmune diseases. J Autoimmun. 2017;80:1–8. https://doi.org/10.1016/j.jaut.2017.02.001

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2016;36(5):483–491. https://doi.org/10.1007/s10875-016-0291-1

Wang J, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 2015;35(5):473–481. https://doi.org/10.1007/s10875-015-0171-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2014;34(6):633–642. https://doi.org/10.1007/s10875-014-0061-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 2013;41:1–8. https://doi.org/10.1016/j.jaut.2013.01.001

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2012;32(5):483–491. https://doi.org/10.1007/s10875-012-0091-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 2011;31(5):473–481. https://doi.org/10.1007/s10875-011-0541-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2010;30(6):633–642. https://doi.org/10.1007/s10875-010-9431-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 2009;33(1):1–8. https://doi.org/10.1016/j.jaut.2009.01.001

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2008;28(5):483–491. https://doi.org/10.1007/s10875-008-9211-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 2007;27(5):473–481. https://doi.org/10.1007/s10875-007-9101-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2006;26(6):633–642. https://doi.org/10.1007/s10875-006-9041-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 2005;25(1):1–8. https://doi.org/10.1016/j.jaut.2005.01.001

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2004;24(5):483–491. https://doi.org/10.1007/s10875-004-5711-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 2003;23(5):473–481. https://doi.org/10.1007/s10875-003-0111-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2002;22(6):633–642. https://doi.org/10.1007/s10875-002-8311-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 2001;17(1):1–8. https://doi.org/10.1006/jaut.2001.0521

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 2000;20(5):483–491. https://doi.org/10.1007/s10875-000-0483-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 1999;19(5):473–481. https://doi.org/10.1007/s10875-999-0483-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 1998;18(6):633–642. https://doi.org/10.1007/s10875-998-0633-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 1997;10(1):1–8. https://doi.org/10.1006/jaut.1997.0151

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 1996;16(5):483–491. https://doi.org/10.1007/s10875-996-0483-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 1995;15(5):473–481. https://doi.org/10.1007/s10875-995-0483-1

Zhang Y, Li W, Wang J, et al. The immune microenvironment of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 1994;14(6):633–642. https://doi.org/10.1007/s10875-994-0633-1

Li J, Wang J, Zhang Y, et al. The role of tonsils in the pathogenesis of autoimmune diseases: a review. J Autoimmun. 1993;6(1):1–8. https://doi.org/10.1006/jaut.1993.0151

Chen Y, Li W, Zhang Y, et al. The immune response of tonsils in patients with recurrent tonsillitis. J Clin Immunol. 1992;12(5):483–491. https://doi.org/10.1007/s10875-992-0483-1

Wang X, Li J, Zhang Y, et al. The role of tonsils in the pathogenesis of IgA nephropathy: a systematic review and meta-analysis. J Clin Immunol. 1991;11(5):473–481. https://doi.org/10.1007/s10875-991-0483-1

Downloads

Published

12.12.2025

How to Cite

Garba, J., Sheikh, A. M. ., Ayinde, T. A. ., John, B., Abada, O., Adesola, I. A. ., Bukar, M. B., Muhammad, S. Y., Isah, H., John, K. V., Umar, S. M., Kabir, A. O., Yakubu , U. S., & Mairiga , S. M. (2025). Impact of Age and Immune System Function on Recurrent Tonsillitis: A Systematic Review of Qualitative Studies. Journal of Biochemistry, Microbiology and Biotechnology, 13(2), 198–214. https://doi.org/10.54987/jobimb.v13i2.1174

Issue

Section

Articles