The Tonsillar Immunity Project
Research type
Research Study
Full title
Tonsillar Immunity Project: functional characterisation of tonsillar immune cells across different age groups
IRAS ID
311973
Contact name
Muzlifah Haniffa
Contact email
Sponsor organisation
Newcastle Upon Tyne Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research Summary
The tonsils are a key site of immune surveillance, detecting microorganisms as they enter the aerodigestive tract and initiating an immune response. In early life, infection (tonsillitis) is very common, resulting in over 26,000 hospital admission in England alone last year. Although most cases of tonsillitis are short-lived, a subset of patients developed recurrent tonsillitis, which is commonly managed surgically with removal of the tonsils (tonsillectomy).
At present, tonsillectomy is routinely offered to patients after having ≥ 7 episodes in 1 year, 5 episodes per year over 2 years, or 3 episodes per year over 3 years. This practice is based upon a relatively small, single-centre American study published in 1984. We don’t know why some people get recurrent tonsillitis and others just single episodes, or why it is a condition predominantly of the young. A biomarker to identify susceptible individuals would potentially avoid years of recurrent episodes of tonsillitis with their associated antibiotic use, time off work, and quality of life impairment.
We propose retaining samples of tonsil tissue that would normally be discarded or destroyed from children and adults undergoing routine tonsillectomies. Additionally, microbiology swabs would be taken from the tonsillar surface and crypts at the time of collection to investigate the tonsillar microbiome.
We will then use cutting-edge laboratory techniques to characterise the immune cells present in the tonsils across the lifespan, in both illness (recurrent tonsillitis) and health, by examining their genetic instructions at a single-cellular level. This will allow us to identify differences in immune activity between individuals suffering from recurrent tonsillitis and those not, and in turn identify possible biomarkers for susceptibility to recurrent infections. It will also allow us to recognise potentially modifiable pathways responsible for persistent inflammation in those with recurrent tonsillitis, which could lead to alternative therapies for recurrent tonsillitis.Summary of Results
The tonsils are immune structures that help you fight off infections. We used cutting edge laboratory techniques to identify and characterise 121 types of cells in the tonsils in a "tonsil cell atlas". This will provide a valuable resource for researchers to better understand different diseases affecting the tonsils including recurrent tonsillitis and tonsil cancer.
REC name
West of Scotland REC 4
REC reference
22/WS/0126
Date of REC Opinion
3 Oct 2022
REC opinion
Further Information Favourable Opinion