BACKGROUND: The decline of infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. With this regard, we examined the relationship of frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. METHODS: Sixty-seven asthmatic children (ages 3-14) who had no signs or symptoms of acute tonsillitis were included. The control group consisted of 92 randomly selected children who had no signs or symptoms of asthma or acute tonsillitis. Parents were interviewed about the incidence of tonsillitis diagnosed by physicians and history of tonsillectomy; tonsil sizes were evaluated by oropharyngeal inspection by the same observer using the Brodsky L. Scala. RESULTS: A statistically significant association is found between frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. CONCLUSIONS: Our data suggests that recurrent tonsillitis is associated with a decline in the prevalence of asthma by inducing a Th 1 predominant immune response. Our findings are compatible with the hygiene hypothesis.
BACKGROUND: The decline of infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. With this regard, we examined the relationship of frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. METHODS: Sixty-seven asthmatic children (ages 3-14) who had no signs or symptoms of acute tonsillitis were included. The control group consisted of 92 randomly selected children who had no signs or symptoms of asthma or acute tonsillitis. Parents were interviewed about the incidence of tonsillitis diagnosed by physicians and history of tonsillectomy; tonsil sizes were evaluated by oropharyngeal inspection by the same observer using the Brodsky L. Scala. RESULTS: A statistically significant association is found between frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. CONCLUSIONS: Our data suggests that recurrent tonsillitis is associated with a decline in the prevalence of asthma by inducing a Th 1 predominant immune response. Our findings are compatible with the hygiene hypothesis.