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HOW COME? Tonsils play a key part in stopping illnesses

Why do we have tonsils? asks Kevin Spellman of ManorvilleGot tonsils? The answer may depend on when you were born.

Researchers say the number of tonsillectomies in the United States has plunged over the last 50 years. By the 1970s there were more than a million done each year. Today, the number is just over 500,000.

Once upon a time, getting your tonsils taken out was almost expected. A history of sore throats and infections usually prompted the operation, with all the (soothing) ice cream you could eat held out as the reward.

These days, doctors are much less likely to recommend a tonsillectomy as a way to stop frequent throat infections. In fact, research shows that tonsils may play a key part in stopping many illnesses, including lung infections like the flu. Tonsils sit in a strategic position in the throat, an open doorway for pathogens. By sampling bacteria, viruses and other intruders, tonsils help the body mount a coordinated defense.

There are actually four different kinds of tonsils arrayed around the back of the throat, including tonsils at the root of the tongue and behind the nose (aka the adenoids). It's the palatine tonsils, on either side of the dangly uvula, that we think of as tonsils: pink, olive-shaped and spongy.

The tonsils are part of the body's immune system. Like lymph nodes, tonsils are made of lymphoid tissue. Tonsils are small, but their surface area is large, since each has up to 30 cavelike crypts. So as germs pass through the throat, they often make contact with the tonsil surface.

Tonsils are also teeming with lymphocytes, white blood cells that identify incoming pathogens. In 2012, researchers at Ohio State University discovered that tonsils actually manufacture T lymphocytes, a critical part of the immune system's defense against invading bacteria and viruses, as well as cancer cells.

The "T" is for thymus, an organ behind the breastbone in front of the heart. The thymus, which is large in children but shrinks in puberty, was long thought to be the body's only T-cell factory. But now, the "T" could also refer to tonsils. Researchers studied tonsil tissue from children who'd had tonsillectomies. In the tonsils they discovered T lymphocytes at five stages of development, from earliest-stage cells to almost-mature cells.

If recurring infections cause abscesses in the tonsils, or if tonsil size interferes with breathing, a doctor will often still recommend removal. In fact, 80 percent of tonsillectomies are now done to open airways and ease breathing problems during sleep.

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