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PubMed2006

Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls.

BACKGROUND: Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. OBJECTIVE: To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. MATERIALS AND METHODS: Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. RESULTS: There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). CONCLUSIONS: Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome.

Adenoidectomy↗
PubMed2000

Differential cytokeratin and glycoconjugate expression by the surface and crypt epithelia of human palatine tonsils.

Human palatine tonsils are clinically important due to their susceptibility to tonsillitis and association with other local and systemic diseases. Paradoxically, the tonsils function as antigen sampling sites of the mucosal immune system and, consequently, the tonsil epithelia perform both protective and antigen sampling roles. These epithelia are divided into stratified squamous epithelium overlying the tonsil surface and crypt epithelium lining the tonsil crypts, the latter of which includes reticular areas which are infiltrated by lymphocytes and are responsible for antigen sampling. In this study we characterised cytokeratin and glycoconjugate expression by healthy epithelia of human palatine tonsils. We identified pan-epithelial tonsil markers and also demonstrated that the surface and reticular crypt epithelia are differentiated by the expression of multiple cytokeratins. The latter finding supports the hypothesis that these epithelia undergo alternate differentiation pathways and possess different functional roles. In addition, we identified cell subpopulations in the tonsil epithelia which may represent distinct cell subtypes including specialised antigen sampling cells. These findings establish a basis for future studies to investigate histochemical changes in tonsil epithelia that are associated with or predispose to local and/or systemic disease.

Adolescent↗
PubMed2004

Significance of asymptomatic tonsil asymmetry.

OBJECTIVE: Asymmetry of tonsils that arouses suspicion for malignancy is one of the indications for tonsillectomy. The purpose of this study was to evaluate the incidence of occult malignancy in patients with asymptomatic unilateral tonsillar enlargement. Study design and setting A prospective controlled trial was carried out in two institutions, Beyoglu Research and Training Hospital and Karaelmas University Hospital, during a 6-year period. Of patients selected for tonsillectomy, patients with unilateral tonsillar enlargement were identified and were included in this study. Patients who had risk factors that were significant for malignancy were excluded. After excision, two tonsil specimens were measured before sending for histology. Matched controls with symmetric tonsils underwent the same procedures. Preoperative diagnosis of tonsil asymmetry with the postoperative histologic diagnosis were correlated for the incidence of malignancy. RESULTS: Of the 792 patients undergoing tonsillectomy, 53 patients (6.69%) with asymmetry of tonsils and who had no other risk factors for malignancy underwent tonsillectomy. The size difference of the tonsils ranged from 0 to 19 mm. In the control group of 51 patients with symmetric tonsils, the size difference ranged from 0 to 8 mm. The analysis showed statistically significant difference in the degree of asymmetry between the two groups (P <.001). Most of the specimens contained reactive lymphoid hyperplasia in both groups (58.49% and 54.9%, respectively). No malignancies or unusual pathological findings were encountered on histologic examination in either group. Conclusion and significance Tonsil asymmetry may only be apparent in patients with an otherwise normal physical examination, secondary to benign hyperplasia or anatomical factors. Therefore, the presence of tonsil asymmetry without factors such as suspicious appearance, significant systemic signs and symptoms, progressive enlargement of the tonsil, concomitant neck adenopathies, and history of malignancy or immunocompromise, may not indicate malignancy, as a sole clinical feature.

Adolescent↗
PubMed2006

Functions of tonsils in the mucosal immune system of the upper respiratory tract using a novel animal model, Suncus murinus.

CONCLUSION: The human palatine tonsils and the nasopharyngeal tonsil were considered the defense mechanism against ingested or inhaled foreign pathogens. The current findings suggest that the tubal tonsils possess abilities of active transportation of foreign antigens, and will act as inductive and effector sites in the mucosal immune system. Our results also indicated a significant difference in roles of immune responses among individual tonsillar organs, suggesting functional sub-compartmentalization. OBJECTIVES: To address the function of tonsils in inducing local immune responses, we evaluated the antigen uptake of tubal tonsils and the induction of specific immune responses in a small laboratory animal with both tubal and palatine tonsils, i.e. Suncus murinus. MATERIALS AND METHODS: S. murinus were injected with 2 x 10(6) CFU of FITC-labeled Staphylococcus aureus via the right tympanic cavity. The distribution of the FITC-labeled S. aureus was examined under a fluorescent microscope. S. murinus were also immunized with 100 microg of ovalbumin (OVA) mixed with 2 microg of cholera toxin (CT) via the right external ear meatus every 2 days for 2 weeks. One week after the final immunization, sera, pairs of tubal and palatine tonsils, and the neck lymph nodes were obtained to evaluate the induction of specific immune responses. RESULTS: The FITC-labeled S. aureus particles were detected in tubal tonsils and also in cervical lymph nodes. Total IgA-producing cells and OVA-specific antibody-producing cells were identified in the immunized tubal tonsils. Trans-external ear meatus immunization of tubal tonsils also evoked systemic antibody responses.

Adenoids↗
PubMed2002

Correlation on cine MR imaging of size of adenoid and palatine tonsils with degree of upper airway motion in asymptomatic sedated children.

OBJECTIVE: The objective of this study was to use MR fluoroscopy to evaluate variations in size of the adenoid and palatine tonsils and the relationship between tonsil enlargement and airway motion dynamics in asymptomatic children during sleep. SUBJECTS AND METHODS: We performed sagittal midline cine MR imaging (fast gradient-echo series: TR/TE, 8.2/3.6 sec; flip angle, 80 degrees; slice thickness, 8 mm; 128 consecutive images; imaging time, 2 min; displayed in cine mode) in children referred for MR imaging of the brain who required sedation. The largest transverse diameter of the adenoids was recorded. A subjective impression was made as to whether the adenoids were enlarged or normal in size. Palatine tonsils were considered enlarged when a soft-tissue mass was identified on the midline cine images, and maximum diameter was recorded. Enlarged and nonenlarged adenoid and palatine tonsil groups were compared using motion parameters (chi-square or Fisher's exact test): mouth position (opened or closed); vertical motion (present, absent); nasopharyngeal, oropharyngeal, and hypopharyngeal motion (static patent, dynamic patent, intermittent collapsed, or static collapsed, and greatest change in size). RESULTS: We studied 148 subjects who had a mean age of 3.4 years. The adenoid tonsils were considered enlarged in 64 patients (43%), and the palatine tonsils were considered enlarged in 29 patients (20%). The mean size of the enlarged adenoid tonsils was 11.6 mm and of the nonenlarged adenoid tonsils was 6.2 mm. Enlarged adenoids correlated with the open mouth position (p = 0.0242) and increased dynamic motion of the oropharynx (p = 0.0413). A trend was also seen for increased dynamic motion of the nasopharynx (p = 0.0723). Enlarged palatine tonsils correlated with an increased frequency of dynamic motion of the oropharynx (p = 0.0006) and the nasopharynx (p = 0.0033) and a trend for increased frequency of the open mouth position (p = 0.0692). CONCLUSION: Large adenoid and palatine tonsil size affects breathing dynamics of the upper airway even in asymptomatic children.

Adenoids↗
PubMed1996

Role of gamma delta-T cells in the palatine tonsil.

Gamma delta-T cells in the tonsil were evaluated by flow cytometric analysis and immunohistological study using monoclonal antibodies to the gamma delta-T cell receptor. Flow cytometric analysis using TCR-gamma/delta-1 showed that 2.2%, of T cells in the tonsil obtained from patients with recurrent or chronic tonsillitis expressed the gamma delta-T cell receptor. Immunohistologically, gamma delta-T cells were found mainly in the extrafollicular area, i.e., the T-cell zone, and showed strong migration to the crypt epithelium in tonsils with infections. The comparison on number of gamma delta-T cells in cases with simple hypertrophic tonsil and in cases with recurrent or chronic tonsillitis showed that tonsils with repeated or chronic infections had a significantly greater number of gamma delta-T cells than tonsils without infection. To address the functional aspects of gamma delta-T cells in the tonsil, the production of IL-2 of separated gamma delta-T cells was measured by solid phase ELISA. Increased IL-2 production was observed with staphylococcal enterotoxin A and B stimulation, and this increase was blocked by antibody to the gamma delta-T cell receptor, indicating that the production of IL-2 may be triggered by the interaction between the gamma delta-T cell receptor and staphylococcal enterotoxin. Our results show that gamma delta-T cells in the tonsil, especially in the crypt epithelium, may be activated by various bacterial antigens or heat shock protein released from damaged epithelial cells. The activated gamma delta-T cells will produce cytokines including IL-2 and function as so-called 'first-layer' immunity.

Adolescent↗
PubMed2002

Asymmetric tonsil size in children.

OBJECTIVE: To assess the clinical implications of asymmetrically enlarged tonsils in children. DESIGN: A prospective controlled study of asymmetric tonsil size in children scheduled for tonsillectomy with or without adenoidectomy. Data were recorded on tonsil size and position, tonsillar fossa depth, degree of asymmetry, and pathological findings. Control patients were matched for age, sex, race, diagnosis, and surgical procedure. PATIENTS: A total of 258 children, aged 2 to 18 years, scheduled for tonsillectomy with or without adenoidectomy during a 27-month period. SETTING: A tertiary care academic medical center. RESULTS: Forty-seven children (18.2%) were determined to have asymmetric tonsils. There were 43 matched controls with symmetric tonsils. Three-dimensional quantitative measurements of the resected tonsils revealed little or no actual asymmetry in tonsil size even though preoperative intraoral observations gave the impression that one tonsil was larger than the other. Statistically, tonsillar asymmetry was more apparent than real. When measured by volume, there was asymmetry in both groups. However, there was no statistical difference in the degree of asymmetry between the groups (P =.50). A difference in the depth of the tonsil fossa contributed to the putative asymmetry (P<.001). No malignant neoplasms were identified on microscopic examination in either group. CONCLUSIONS: Tonsillar asymmetry in children may often be an illusion secondary to a difference in the depth of the tonsillar fossa. Tonsillar asymmetry in children in the absence of other findings such as ipsilateral cervical adenopathy or other constitutional symptoms may not indicate a malignancy.

Adenoidectomy↗
PubMed1991

The relationship of tonsil bacterial concentration to surface and core cultures in chronic tonsillar disease in children.

Fifty-five tonsils removed for chronic tonsillar disease (chronic tonsillitis and obstructive tonsillar hyperplasia) underwent surface swab and quantitative core cultures in order to identify the relationship between core bacterial concentration and the presence of aerobic bacteria on the tonsil surface. The accuracy of a single core culture was further established by quantitative cultures of 9 sections per tonsil in an additional 19 tonsils. The results indicate that many (61.5%) but not all aerobic bacteria which were found in the tonsil core were cultured from the surface of the tonsil. Conversely, the tonsil core bacteria with the highest bacterial concentrations are more likely to be present on the tonsillar surface and the greater the bacterial concentration, the more likely the bacteria are to be found in most if not all areas of the tonsil core. Therefore, the core bacterial concentration appears to be related to the presence of aerobic bacteria on the tonsillar surface. Surface bacteria may not, however, be truly representative of the core bacterial environment. Implications for the management of chronic tonsillar disease will be discussed.

Bacteria↗
PubMed2005

The role of anaerobic bacteria in tonsillitis.

This review summarizes the information that supports the potential importance of anaerobic bacteria in tonsillitis. Some anaerobic bacteria possess interfering capability with Group A beta-hemolytic streptococci (GABHS) and other pathogens. The possible role of anaerobes in the acute inflammatory process in the tonsils is supported by several observations: anaerobes have been isolated from the cores of tonsils of patients with recurrent GABHS and non-GABHS tonsillitis (NST); the recovery of anaerobes as predominant pathogens in abscesses of tonsils, in many cases without any aerobic bacteria; their recovery as pathogens in well-established anaerobic infections of the tonsils (Vincent's angina); the increased recovery rate of encapsulated pigmented Prevotella and Porphyromonas spp. in acutely inflamed tonsils; their isolation from the cores of recurrently inflamed NST; and the response to antibiotics in patients with NST. Furthermore, immune response against Prevotella intermedia is present in patients with recurrent NST, and an immune response can also be detected against P. intermedia and Fusobacterium nucleatum in patients who recovered from peritonsillar cellulitis or abscesses, infectious mononucleosis and acute non-streptococcal and GABHS tonsillitis. Although more studies are needed, these findings support the possible pathogenicity of Gram-negative anaerobic bacilli in tonsillitis.

Antibodies, Bacterial↗
PubMed1998

Tonsillar lymphocyte subsets in recurrent acute tonsillitis and tonsillar hypertrophy.

Recurrent acute tonsillitis is usually produced directly by micro-organisms, mainly beta-hemolytic streptococcus. Idiopathic tonsillar hypertrophy is presented without infection history and usually leads to obstructive sleep apnea. We have measured lymphocyte subsets in tonsillar cellular suspensions of infectious and obstructive tonsillar pathology by flow cytometry. Comparing with peripheral blood, the CD4+/CD8+ ratio for tonsillar pathology varies from 4.0 to 5.0 while in peripheral blood the ratio was 1.3. In tonsils the ratio of B lymphocytes/T lymphocytes is 1.6, being 0.3 in peripheral blood, cytotoxic T lymphocytes represent 8% in tonsils and 29% in peripheral blood, virgin or nonstimulated T lymphocytes (CD4+ CD62L+) consist of 3% in tonsils and 16% in peripheral blood. The immature B lymphocytes (CD20+ CD5+) represent 23% in tonsils and 12% in peripheral blood. In regards to NK cells (CD3- CD16+), 1% was found in tonsils and 11% in peripheral blood. In tonsils B lymphocytes and a low proportion of cytotoxic T lymphocytes predominate, in comparison to peripheral blood, with a CD4+/CD8+ ratio four times greater than tonsils. We have found in tonsils a significant increase of T cells (CD3+ and TCR alpha+ beta+) in infectious processes in comparison to obstructive pathology.

Acute Disease↗
PubMed1995

Changes in the core tonsillar bacteriology of recurrent tonsillitis: 1977-1993.

Microbiological studies of the core of tonsils removed from children with recurrent tonsillitis due to group A beta-hemolytic streptococci were conducted during three periods, with 50 patients in each period: 1977-1978 (period 1), 1984-1985 (period 2), and 1992-1993 (period 3). Mixed flora were present in all tonsils, with 8.1 organisms per tonsil (3.8 aerobes and 4.3 anaerobes). The predominant isolates in each period were Staphylococcus aureus, Moraxella catarrhalis, Peptostreptococcus species, pigmented Prevotella species, Porphyromonas species, and Fusobacterium species. The rate of recovery of Haemophilus influenzae type b increased from 24% in period 1 to 76% in period 2 (P < .001); a decline to 12% in period 3 correlated with a concomitant increase in the frequency of recovery of non-type b strains of H. influenzae from 4% and 10% in periods 1 and 2, respectively, to 64% in period 3 (P < .001). Both the rate of recovery of beta-lactamase-producing bacteria and the number of these organisms per tonsil increased over time. Specifically, beta-lactamase-producing strains were detected in 37 tonsils (74%) during period 1, in 46 tonsils (92%) during period 2, and in 47 tonsils (94%) during period 3, and the number of such strains per tonsil increased from 1.1 in period 1 to 2.9 and 3.3 in periods 2 and 3, respectively.

Adolescent↗
PubMedDate not supplied

Comparison of the microbiology of group A and non-group A streptococcal tonsillitis.

We studied the microbial flora of tonsils removed from 20 children who suffered from recurrent group A beta-hemolytic streptococcal (GABHS) tonsillitis and 20 who had tonsillar hypertrophy following recurrent non-GABHS tonsillitis. Similar polymicrobial aerobic and anaerobic flora were recovered from the cores of the tonsils in each group. beta-Lactamase-producing bacteria (BLPB) were recovered more often in the group with GABHS. This difference was due mostly to the lower incidence of beta-lactamase-producing strains of Branhamella catarrhalis and Bacteroides sp in hypertrophic tonsils following non-GABHS tonsillitis. beta-Lactamase-producing Staphylococcus aureus was found with equal frequency in both groups. These findings demonstrate that although BLPB are recovered more often in recurrently inflamed tonsils following GABHS infection, BLPB also can be found in hypertrophic tonsils following non-GABHS tonsillitis.

Bacterial Infections↗
PubMed2003

Fine needle aspiration in chronic tonsillitis: reliable and valid diagnostic test.

Fine needle aspiration (FNA) of the tonsil as a diagnostic tool in evaluating the microflora in chronic tonsillitis has not been popularized. A prospective study of 30 patients with chronic tonsillitis undergoing tonsillectomy was undertaken. FNA of the tonsil core was done under local/general anaesthesia. The reliability of the culture by FNA of the tonsil core was then validated with the reference (gold) standard which is the dissected tonsil core. The sensitivity of FNA culture as compared to core culture was 100 per cent and 93 per cent under general and local anaesthesia respectively. The positive predictive value of FNA culture as compared to core culture was 92 per cent and 82 per cent for general and local anaesthesia respectively. These factors indicate that FNA of the tonsil core is reliable and valid. It can safely be performed as an out-patient procedure under local anaesthesia. This is reported for the first time. Identifying the bacterial organism within the infected tonsil for appropriate antibiotic therapy could revolutionize the management of chronic tonsillitis.

Adolescent↗
PubMed1995

Upregulated local cytokine production in recurrent tonsillitis compared with tonsillar hypertrophy.

In children with recurrent tonsillitis there may be persistent antigen deposition in tonsil tissue. even between exacerbations. If so, upregulation of immunocompetent cells should occur continuously, in contrast to tonsil tissue from children with tonsillar hypertrophy. The cytokine pattern was studied in cell suspensions prepared from tonsils obtained from 12 children undergoing tonsillectomy. The study group comprised 6 children with recurrent tonsillitis and 6 who had a history of tonsillar hypertrophy causing sleep apnea. Cytokine-producing cells (IL-1alpha, IL-1beta, TNFalpha, IL-6, IL-8, IL-2, IFNgamma, TNFbeta, IL-10 and IL-4) were characterized at the single-cell level by use of cytokine-specific monoclonal antibodies and indirect immunofluorescence technique. A constitutive production of IL-1alpha, IL-1beta, TNFalpha, and IL-8 was found in both groups (10-300/10(5) cells). However, the frequency of spontaneous IL-2, IFNgamma, TNFalpha, IL-6 and IL-10 was consistently low (10 +/- 10 cells) in both groups. Following restimulation by T-cell receptor ligation, using immobilized anti-CD3 mAb, with concentrations chosen so that it did not activate resting cells, increased frequencies of TNFalpha, IL-6, IL-8, IL-2, IFNgamma, IL-4 and 1L-10 synthesizing cells were induced in the recurrent tonsillitis group. Significantly higher incidences of IL-1beta, IL-6 and IL-2 producing cells were found in the recurrent tonsillitis group (60-200/10(5) cells, p <0.05). Microbiological evaluation in the tonsil tissue could not reveal tiny differences between the studied groups regarding bacterial or viral pathogens. However, this does not exclude persistent increased intracellular deposition of microbial antigens as a possible explanation for the elevated incidence of IL-1beta, TNF-alpha, IL-6, IL-8, IL-2, IFNgamma, IL-10 and IL-4 expressing cells noticed in patients with recurrent tonsillitis.

Cells, Cultured↗
PubMed2003

[Comparison of adenoid and tonsil core cultures in chronic adenotonsillitis].

OBJECTIVES: Tonsil and adenoid core cultures were compared and beta-lactamase producing bacteria were determined in patients with chronic adenotonsillitis. PATIENTS AND METHODS: Thirty-two patients (21 boys, 11 girls; mean age 5 years) with chronic adenotonsillitis underwent elective adenotonsillectomy. The core swaps of tonsil and adenoid tissues were obtained under sterile conditions and were inoculated in 5% sheep blood agar, eosin methylene blue agar, and chocolate agar plates. The frequency of beta-lactamase producing isolates were assessed. RESULTS: Staphylococcus aureus was the most common pathogen both in tonsil and adenoid core cultures. Among pathogenic bacteria isolated from tonsil (n=27) and adeonid (n=22) cultures, the same strains were isolated in 20 cultures (75%). The frequencies of beta-lactamase producing bacteria were 44% and 41% in tonsil and adenoid core cultures, respectively. S. aureus was associated with beta-lactamase production in 88% and 100% in tonsil and adenoid tissues, respectively. CONCLUSION: Differences between tonsil surface and core bacterial flora may have implications in the etiopathogenesis and treatment of chronic tonsillitis. The range of species isolated seems to be similar for both chronic tonsillitis and adenoiditis.

Adenoids↗
PubMed1983

Control of Arthus tonsillitis by the administration of an antiplasminic agent.

Previous reports have shown that fibrinolytic activity was increased in the circulatory blood of rabbits with Arthus tonsillitis. In this study, t-AMCHA was administered intravenously to rabbits, in order to clarify its role as an antiplasminic agent in the control of Arthus tonsillitis. First, to establish the proper method of administration of t-AMCHA and the quantity to be administered, a preliminary estimation was made of the requisite concentration of t-AMCHA in the circulating blood and tonsillar tissue. Then macroscopic observations and histopathological studies were performed on the tonsils of rabbits with Arthus tonsillitis after t-AMCHA administration at various doses. Finally, after injection of the antiplasminic agent, estimations were made of the plasma fibrinolytic activity in the blood of the rabbits under study. It was decided that administration of t-AMCHA at 3-hourly intervals could maintain a constant concentration of the substance in the tonsillar tissue. The marked hyperaemia and bleeding which were observed macroscopically and histopathologically at 1-2 days after the onset of tonsillitis, disappeared from the parenchyma of the tonsils and pharyngeal tissue surrounding the tonsils in the group receiving regular injections of t-AMCHA at 3-hourly intervals. After estimating certain parameters of the fibrinolytic system in the blood, it was found that fibrinolytic activity decreased and whole plasmin was not consumed as a result of the administration of t-AMCHA during the early stage of tonsillitis. The process of Arthus tonsillitis can thus be controlled by the administration of the antiplasminic agent.

Animals↗
PubMed1979

T and B lymphocyte rosettes in tonsils of atopic and non-atopic children.

This investigation was carried out to determine the immunological function of the human tonsils, especially the role of lymphocytes of atopic and non-atopic children. An E- and EAC-rosette forming technique is introduced, with semiquantitative evaluation of T and B lymphocytes in the peripheral blood of 56 normal subjects, 28 atopic and 5 non-atopic children of both sexes and different ages. The percentage of T and B lymphocytes in removed palatine tonsils in 28 atopic and 5 non-atopic children was calculated. The percentage of rosette-forming cells in E and EAC suspensions appeared to be independent of age and sex. The percentage of T lymphocytes in peripheral blood was significantly higher than in the palatine tonsils, whereas the percentage of B lymphocytes was significantly higher in the tonsils of atopic and non-atopic children than in the peripheral blood. The mean percentage of B lymphocytes in the tonsils of atopic children was significantly higher than in non-atopic children. The percentage of B lymphocytes was found to be significantly higher in hypertrophic than in small tonsils. Also, in the tonsils with adhesions there was a statistically significantly higher percentage of EAC rosettes than in the tonsils free of adhesions. The percentage of T lymphocytes was statistically significantly higher in the small tonsils.

Adolescent↗
PubMed2005

Determination of in vivo protein synthesis in human palatine tonsil.

The palatine tonsils are constantly exposed to ingested or inhaled antigens which, in turn, lead to a permanent activation of tonsillar immune cells, even in a basic physiological state. The aim of the present study was to investigate if the immunological activation of the human palatine tonsil is reflected by a high metabolic activity, as determined by in vivo measurement of protein synthesis. The protein synthesis rate of the tonsil was also compared with that of the circulating T-lymphocytes, the total blood mononuclear cells and the whole population of blood leucocytes. Phenotypic characterization of immune-competent cells in tonsil tissue and blood was performed by flow cytometry. Pinch tonsil biopsies were taken after induction of anaesthesia in healthy adult patients (n=12) scheduled for ear surgery, uvulopalatopharyngoplasty or nose surgery. Protein synthesis was quantitatively determined during a 90-min period by a flooding-dose technique. The in vivo protein synthesis rate in the palatine tonsils was 22.8+/-5.7%/24 h (mean+/-S.D.), whereas protein synthesis in the circulating T-lymphocytes was 10.7+/-3.4%/24 h, in mononuclear cells was 10.8+/-2.8%/24 h and in leucocytes was 3.2+/-1.2%/24 h. CD3+ lymphocytes were the most abundant cell population in the tonsil. The in vivo protein synthesis rate in human tonsils was higher compared with the circulating immune cells. This high metabolic rate may reflect the permanent immunological activity present in human tonsils, although cell phenotypes and activity markers do not explain the differences.

Adult↗