Endotoxicosis and methods of its correction in chronic tonsillitis

Introduction. The pathogenesis of chronic tonsillitis (CT) is still poorly understood, and the assessment of endotoxicosis in CT needs further investigation. Purpose. To study the role of endogenous intoxication and methods of its correction in CT in patients aged 16–20 years, considering the current geopolitical situation in the world, i.e., studying the age group subject to initial military registration and conscription into military service.
Material and methods. Forty-two people with CT were examined. According to the CT classification, they were divided into 2 groups: the first group of 20 people (the comparison group) included patients with compensated CT, the second group of 22 people (the main group) included patients with decompensated CT. There was also a control group of 15 practically healthy people. The research methods included the assessment of endogenous intoxication by studying the activity of lipid peroxidation, immune activity, and the state of hemostasis.
Results. We found that the exacerbation of CT is accompanied by pronounced endotoxicosis, which contributes to exacerbating the severity of the disease. The main factors contributing to endogenous intoxication were activation of lipid peroxidation, imbalance of immune activity, and liver dysfunction. The degree of endotoxicosis had a direct relationship with the form of the disease: in the compensated form, disorders of the homeostasis, including endogenous intoxication, resolved by the end of the study on the 8th day of the disease, while in the decompensated form, the disorders persisted. Despite the fact that the currently widely used standard CT therapy reduces the severity of endotoxicosis and partially reverses homeostatic alterations, its effect manifests only after 4 days of conservative therapy. Early tonsillectomy quickly helps to suppress endotoxicosis, limits oxidative effects, corrects the immune balance, restores the liver, and reduces complications.
Conclusion. Endogenous intoxication is a key component of the pathogenetic process of CT, contributing to the aggravation of the disease and the development of complications.
Key words: chronic tonsillitis, endotoxicosis, oxidative stress, immunity, liver
Conflict of interest. The authors declare no conflict of interest.
Funding. The study was performed without external funding. For citation: Mironov V.G., Kim A.S., Mironov I.V. Endotox