University of Oulu

Tejesvi MV, Tapiainen T, Vänni P, Uhari M, Suokas M, Lantto U, Koivunen P and Renko M (2021) Tonsil Mycobiome in PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis) Syndrome: A Case-Control Study. Front. Cell. Infect. Microbiol. 10:616814. doi: 10.3389/fcimb.2020.616814

Tonsil mycobiome in PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome : a case-control study

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Author: Tejesvi, Mysore V.1,2,3; Tapiainen, Terhi2,4,5; Vänni, Petri3,4;
Organizations: 1Ecology and Genetics, Faculty of Science, University of Oulu, Oulu, Finland
2Biocenter Oulu, University of Oulu, Oulu, Finland
3Genobiomics LLC, Oulu, Finland
4PEDEGO Research Unit, University of Oulu, Oulu, Finland
5Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
6Department of Otorhinolaryngology, Oulu University Hospital, Oulu, Finland
7Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.5 MB)
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Language: English
Published: Frontiers Media, 2021
Publish Date: 2021-04-15


Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA) is the most common periodic fever syndrome in children with unknown etiology, effectively treated with tonsillectomy. Earlier we have shown that tonsil microbiome is different in patients with PFAPA as compared to that in controls. Recently, fungal microbiome, mycobiome, has been linked to the pathogenesis of inflammatory diseases. We now investigated the role of mycobiome of tonsils in PFAPA. Random forest classification, a machine learning approach, was used for the analysis of mycobiome data. We examined tonsils from 30 children with PFAPA and 22 control children undergoing tonsillectomy for non-infectious reasons. We identified 103 amplicon sequence variants, mainly from two fungal phyla, Ascomycota and Basidiomycota. The mean relative abundance of Candida albicans in the tonsil mycobiome was 11% (95% CI: 19 to 27%) in cases and 3.4 % (95% CI: -0.8% to 8%) in controls, p =0.104. Mycobiome data showed no statistical difference in differentiating between PFAPA cases and controls compared to a random chance classifier (area under the curve (AUC) = 0.47, SD = 0.05, p = 0.809). In conclusion, in this controlled study, tonsillar mycobiome in children with PFAPA syndrome did not differ from that of the controls.

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Series: Frontiers in cellular and infection microbiology
ISSN: 2235-2988
ISSN-E: 2235-2988
Volume: 10
Article number: 616814
DOI: 10.3389/fcimb.2020.616814
Type of Publication: A1 Journal article – refereed
Field of Science: 1183 Plant biology, microbiology, virology
3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the Society for Pediatric Research and the Finnish Medical Foundation.
Dataset Reference: We have deposited the Ion Torrent fungal raw data in the Sequence Read Archive (SRA) with accession number SRP132771.
Copyright information: © 2021 Tejesvi, Tapiainen, Vänni, Uhari, Suokas, Lantto, Koivunen and Renko. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.