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Tonsillar microbiota in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) syndrome

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Abstract

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a childhood febrile syndrome of unknown origin that is often cured with tonsillectomy. We aimed to compare the bacterial microbiota of the tonsils removed from PFAPA patients with those of controls. We used next-generation sequencing technology to investigate the bacterial microbiota of the tonsils of 30 PFAPA patients and 24 controls. We found significant differences in the presence and relative abundance of many bacteria between PFAPA cases and controls. For example, cyanobacteria, potential producers of microcystins and other toxins, were more common in the case samples (14/30, 47 %) than in the controls (4/24, 17 %, p = 0.02), and the mean relative abundance of cyanobacteria was higher in the case samples (0.2 %) than in the controls (0.01 %, p = 0.01). Streptococci were present in all samples in both groups, but their mean relative abundance was lower in the case samples (3.7 %) than in the controls (9.6 %, p = 0.01). Typical nasopharyngeal microbes such as fusobacteria, Prevotella, Tannerella, Porphyromonas, and Parvimonas dominated the microbiota of the tonsils in both groups. The microbiota of the tonsils removed from PFAPA patients differed significantly from those of the controls. Tonsillar microbiota may play a role in triggering the inflammatory processes that lead to symptoms of PFAPA.

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Authors and Affiliations

  1. Genetics and Physiology, Faculty of Science, University of Oulu, P.O. Box 3000, 90014, Oulu, Finland

    M. V. Tejesvi, A. M. Pirttilä & M. Suokas

  2. PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland

    M. Uhari, T. Tapiainen, U. Lantto, P. Koivunen & M. Renko

  3. Department of Children and Adolescents, Oulu University Hospital, P.O. Box 23, 90029, Oulu, Finland

    M. Uhari, T. Tapiainen & M. Renko

  4. Department of Otorhinolaryngology, Oulu University Hospital, P.O. Box 23, 90029, Oulu, Finland

    U. Lantto & P. Koivunen

Authors
  1. M. V. Tejesvi
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  2. M. Uhari
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  3. T. Tapiainen
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  4. A. M. Pirttilä
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  5. M. Suokas
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  6. U. Lantto
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  7. P. Koivunen
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  8. M. Renko
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Corresponding author

Correspondence to M. Renko.

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The Ethics Committee of the Northern Ostrobothnia Hospital District, Oulu, Finland, approved the study plan.

Funding

This work was supported by the Society for Pediatric Research and The Finnish Medical Foundation.

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The authors declare that they have no conflict of interest.

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The parents provided their written informed consent.

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Tejesvi, M.V., Uhari, M., Tapiainen, T. et al. Tonsillar microbiota in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) syndrome. Eur J Clin Microbiol Infect Dis 35, 963–970 (2016). https://doi.org/10.1007/s10096-016-2623-y

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  • DOI: https://doi.org/10.1007/s10096-016-2623-y

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