Effect of Tonsillectomy and Adenoidectomy on Nasopharyngeal Antibody Response to Poliovirus

TLDR

The study measured nasopharyngeal and serum poliovirus antibody levels before and after tonsillectomy/adenoidectomy in 40 children vaccinated with live poliovirus. After surgery, nasopharyngeal γA antibody fell sharply, γG appeared transiently in half the children, and overall titers dropped 3–8×, with reduced or absent activity lasting up to seven months; children with intact tonsils mounted 2–4× higher nasopharyngeal responses to live poliovirus vaccination.

Abstract

Poliovirus antibody levels in nasopharynx and serum were studied before and after tonsillectomy and adenoidectomy in 40 children previously immunized with live poliovaccine. Before operation, γA poliovirus antibody was present in the nasopharynx of all children, but no γG or γM antibody was detectable. Shortly after operation low levels of γG antibody appeared in the nasopharynx of 50 per cent of subjects. The response was short lived, and disappeared in two months. Pre-existing γA antibody in the nasopharynx declined sharply after operation in all children studied. Mean antibody titers decreased three to four times, and individual titers in several children four to eight times. Four children who had had antibody levels in the nasopharynx failed to demonstrate any such antibody activity after operation. Reduced or absent antibody activity persisted for as long as seven months. In nine children with intact tonsils the antibody response in the nasopharynx after immunization with live poliovaccine was two to four times higher than in eight children whose tonsils had previously been removed.