Current views on the functional status of the palatine tonsils in chronic tonsillitis and alternatives in treatment strategies (literature review)

Abstract

Aim: This article presents an analysis of a literature review, which highlights the causal aspects of the development of chronic tonsillitis (CHT).

Material and method: The review contains statistical data on prevalence of this disease and high probability of local (tonsillar) and general (metatonsillar) complications development. Particular attention is paid to the issues of immunological reactivity of the macroorganism in conditions of chronic inflammation of the palatine tonsils (PT). The use of indicators of natural and acquired immunity in the diagnosis of CHT and in determining the direction of its treatment is justified. Data on the importance of biofilm in the genesis of chronic infectious processes, including PT, are systematized. In the etiology of inflammatory PT diseases, the development of their chronic course reflects the paramount importance of a wide range of microorganisms. The concept of biofilm, positioned by the authors as a specialized ecosystem that ensures maintenance of viability of the entire microbial association and preservation of its components, as well as a significant increase in the biomass of this population, has been developed.

Results: The study of biofilms revealed fundamental differences between planktonic and biofilm forms of microbiota existence, including differences in bacterial behavior, biochemical processes, biosynthesis of various substances, and exchange of genetic information. It is clear that biofilms can contribute to the transmission of resistance genes to antibiotics, as well as to other antimicrobial agents.

Conclusions: A study of the literature defines a new strategy for increasing the effectiveness of antimicrobial therapy for biofilm infections, which consists of the use of drugs from different pharmacotherapeutic groups acting to prevent biofilm formation and their morphofunctional destruction. There is experimental evidence that the use of drugs from these pharmaceutical groups can be effective in the complex treatment of diseases associated with biofilm formation.