CD4 and Recurrent tonsillitis: This preventive effect can be explained by the mechanisms of tonsillectomy as reducing the chance of developing chronic tonsillitis, decreasing the production of pathogenic IgA,[7] and increasing CD4+ CD25+ Treg cells.[30] Furthermore, corticosteroid pulse therapy can reduce IgA1 production via inducing apoptosis of memory T lymphocytes.[31] Based on these therapeutic mechanisms, the combination of tonsillectomy and even only a single-course corticosteroid pulse is efficient to reset the vicious cycle of the mucosa-bone marrow axis, resulting in the prevention of relapse.