Treatment options for nontuberculous mycobacterial adenitis in children.
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PURPOSE: Non-obese diabetic (NOD) mice develop an autoimmune exocrinopathy characterized by hyposecretion of saliva and acinar cell atrophy. As the protein kinase C (PKC) system is involved in the signal transduction pathways associated with primary secretion and acinar cell differentiation and growth, the PKC profile was analysed in NOD mice. METHODS: Lacrimal glands from BALB/c, NOD, NOD scid and transgenic NOD x interferon-gamma (IFN-gamma) mice were analysed for their PKC profiles using antibodies against several conventional (alpha, beta, gamma), novel (delta, epsilon, theta) and atypical (iota, lambda) PKC isoforms using the Streptavidin/HRP (horseradish peroxidase) method. RESULTS: Acinar cells in BALB/c control mice expressed two conventional (alpha, beta) and two atypical (iota, lambda) PKC isoforms. In NOD and transgenic NOD x IFN-gamma mice the same isoforms were more strongly expressed. NOD scid mice lacked all other PKC isoforms except PKC lambda. CONCLUSIONS: Co-expression of several PKC isoforms in single cell type may be necessary for transcriptional activation and agonist-induced secretory responses. Hyposecretion in NOD mice was paradoxically associated with up-regulation of the PKC system. This may be associated with a deranged signal transduction per se rather than with the immune-inflammation, as the transgenic NOD x IFN-gamma mice showed similar PKC profiles. The NOD model does not reproduce lack/consumption of PKC II and PKC as in Sjögren's syndrome. This may be because the receptor autoantibodies in mice are directed against the adrenergic, not muscarinic, receptors. Lack and/or low level PKC expression in NOD scid mouse may explain the excessive acinar cell apoptosis in this model.
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Needle aspirates from 53 inflamed cervical lymph glands were studies for aerobic and anaerobic bacteria and mycobacteria. Bacterial growth was achieved in 45 patients (85%). Sixty-six bacterial isolates were recovered, averaging 1.5 isolates per specimen (0.8 aerobes and 0.7 anaerobes), with as many as 4 isolates in some specimens. Aerobic organisms alone were recovered in 27 aspirates (60%) of the 45 culture-positive aspirates, anaerobic bacteria alone in 8 (18%), and mixed aerobic and anaerobic bacteria in 9 specimens (20%). Mycobacterium scrofulaceum was recovered in one (2%). The predominant aerobic organisms were Staphylococcus aureus (14 isolates) and group A beta hemolytic streptococci (8). A total of 31 anaerobes were recovered, including gram-positive cocci (9, including 6 Peptococcus sp. and 3 Peptostreptococcus sp.), 8 Bacteroides sp. (including 3 B. melaninogenicus), 5 Propionibacterium acnes, and 4 Fusobacterium nucleatum. These data demonstrate the role of anaerobic organisms in cervical lymphadenitis and the need to culture aspirated material for both aerobic and anaerobic microorganisms.
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