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Characterization of clinical tonsil stages by their T-cell count. Immunopathological description of tonsils after a peritonsillar abscess.

The T-cell counts in five different clinical tonsil stages are compared. No particularities were observed, with the exception of the condition after a peritonsillar abscess. The differences existing between the individual groups are discussed as age-dependent. A considerable increase in T-cells is found in the abscess tonsil compared with other tonsils and the T-cell count in blood. Its pathomechanism is discussed.

Adolescent↗

Analysis of lymphocytes in tonsils and blood from patients with chronic tonsillitis.

A series of B, T and natural killer cell (NK) monoclonal antibodies was used to determine the distribution of lymphocyte subpopulations in cell suspensions obtained from tonsils of seventeen patients with chronic tonsillitis. The percentage of lymphocytes reacting with the monoclonal antibodies was determined by means of cytofluorometry. The majority of the tonsillar lymphocytes stained with the B-cell specific monoclonal antibody OKB-7. The T lymphocytes were composed of a majority of OKT4+ lymphocytes. Only a minority of the lymphocytes stained with the NK cell specific antibody Leu-7, whereas Leu-11b+ lymphocytes were virtually absent. In ten out of the seventeen patients T lymphocytes were purified from the tonsils and the blood and studied for the presence of the following activation antigens: OKT9, OKT10 and anti-HLA-Dr. These antigens were not detected on the membrane of these lymphocytes. This indicates that T lymphocytes activated in vivo express these antigens in a low amount.

Adolescent↗

[Morphofunctional characteristics of palatine tonsil tissue and lacuna contents in chronic tonsillitis].

Relationships between microbiological features and cell composition of lacunar content and morphofunctional status of the immunocompetent tissue of palatine tonsils were studied by histological, histochemical, morphometrical, microbiological, and cytological methods. Cytological and microbiological data on the lacuna content were found to reflect the reactive condition of the tonsils and should be regarded as a component of the morphofunctional characteristics of the palatine tonsils as a whole.

Adolescent↗

Carbon-dioxide laser-assisted tonsil ablation for adults with chronic tonsillitis: a 6-month follow-up study.

Sixty-six adult patients with a mean age of 44 years (range: 16-78) with chronic tonsillitis underwent laser-assisted tonsil ablation between January 1998 and January 2002. Instead of vaporization of the tonsil surface, extended serial tonsillectomy was performed, namely, vaporizing 80-90% of the palatine lymphoid tissue. Of the 66 patients, 49 (74%) underwent local anesthesia (LA group) and 17 (26%) general anesthesia (GA group). In the LA group, one surgical session sufficed for 40 patients (82%); two sessions were required for seven patients (14%) and three sessions for two patients (4%). Monopolar electrocautery was necessary to ensure hemostasis in two patients (3%). Median value results revealed a pain-intensity score of 4.5 (range: 0-10) for the GA group and 5 (range: 0-10) for the LA group. Pain lasted for 3 days (range: 0-15) in both groups (nonsignificant difference). A satisfaction score of 10 (range: 1-10) was recorded for the GA group and 8 (range: 1-10) for the LA group (P=0.029). The minimum follow-up was 6 months. Forty of the 49 LA group patients (82%) and 16 of the 17 GA group patients (94%) would recommend the surgical procedure and would accept undergoing the same operation again (nonsignificant difference).

Adolescent↗

Immunological function of human tonsil. Surface topology of human tonsil lymphocytes using the scanning electron microscope (SEM).

The surface topology of the lymphocytes in human tonsils was performed by means of the scanning electron microscope (SEM). It was revealed that human tonsils consist of both 40.7% villous and 26.6% smooth surface lymphocytes. In general, the percentage results agree with those of E and EAC binding lymphocytes of human tonsils, as previously reported. Our serial experiments using immunological techniques proved the existence of two lymphocytes (T and B cell) having immunological roles.

Adolescent↗

[Palatine tonsils and immunity. VIII. Soluble factors produced by lymphocytes of the palatine tonsils and other lymphoid formations in rabbits].

A comparison was made of the activity of solbule factors produced by thelymphocytes of the palatine tonsils, the appendix, the spleen and thelymph nodes of rabbits in stimulation with a specific antigen (complete antigen of streptococcus, group A) and PHA. The blastogenic factor produced by the lymphoid cells of the spleen and the lymph nodes was highly active. Lymphocytes of the palatine tonsils and of the appendix produced a factor withlow activity after PHA stimulation. A factor intensifying the transformation in the presence of a complete streptococcus antigen was produced by lymphocytes of the spleen and the lymph nodes of the immunized animals. The lymphocytes of the palatine tonsils and the appendix failed to produce this factor.

Animals↗

Immunological aspects of tonsils and of tonsillitis.

The human tonsils are responsible for the final antigen-induced differentiation of B-cells to plasma cells. Their main function could be the expansion of memory IgA-B-cells, allowing J-chain expression and final differentiation under secondary signals. IgA/J+-cells have been shown to migrate into mucosal membranes, allowing a protection against microorganisms. Recurrent tonsillitis obviously interferes with this complex immunological network, possibly resulting in a reduced mucosal protection by IgA. Furthermore, bacterial antigens can initiate the liberation of biochemical inflammatory mediators. Among these, arachidonic acid products can play a key role. They can induce epithelial damage and decreased ciliary function. Furthermore, they influence tonsillar immunological reactions.

Arachidonic Acid↗

[Melatonin in palate tonsils with recurrent acute tonsillitis and tonsillar hypertrophy].

Tonsils are a point of contact between the environment and the immune system. The pineal hormone melatonin is influenced by environmental dark-light variations and modulates the immune system. We measured the amount of melatonin present in pediatric tonsillar infectious and obstructive processes. The highest levels of tonsillar melatonin were found in tonsillar hypertrophy and the lowest levels in recurrent acute tonsillitis, with or without hypertrophy. Melatonin has an immunostimulative function and an antiapoptotic effect. The relationship between low tonsillar melatonin concentrations and infection, as well as high melatonin levels and increased tonsillar size is discussed.

Acute Disease↗

[The palatine tonsils and immunity. Report VII. Soluble factors produced by the lymphocytes of the palatine tonsils in vitro].

A study was made of the production of a blastogenic factor and lymphotoxin in the cultures of lymphocytes of the palatine tonsils removed from patients with chronic tonsillitis; the activity of this blastogenic factor and lymphotoxin was studied in the test-cultures of autologous and allogenic lymphocytes and the transplantable HeLa cells. The antigens of the pathogenic streptococcus and staphylococcus induced production of the blastogenic factor and lymphotoxin; as to the antigens of saprophytic bacteria-they produced no such action. The antigen-specific blastogenic factor intensified the immune response to the homologous antigen, whereas the factor obtained in stimulation of lymphocytes with PHA-to all the microbial antigens under study.

Antigens↗

[Palatine tonsils and immunity. VI. Effect of thymosin and palatine tonsil extract on the immunologic reactivity of neonatally thymectomized and intact mice].

Experiments were conducted on Wistar rats, intact and neonatally thymectomized CBA mice; a study was made of the immunological activity of the extracts of the thymus and the palatine tonsils of calves obtained by the method of Goldstein et al (1966). The extract of the palatine tonsils obtained proved to contain a small amount of thymosin at whose expense an insignificant restoration of immunological reactivity occurs in its administration neonatally to thymectomized mice.

Animals↗

[Clinical-morphological assessment of the functional status of tonsils in clinical manifestations of chronic tonsillitis].

Correlations between lacunar content and morphofunctional condition of palatine tonsil immunocompetent tissue were studied histologically, histochemically, morphometrically, microbiologically and cytologically. The microbiological and cytological lacunar findings provide a life-time assessment of tonsillar functional activity. Clinical efficiency of the method makes it valuable for choice of treatment and evaluation of the response to conservative treatment of chronic tonsillitis.

B-Lymphocytes↗

The lymphoepithelial organization of the tonsil: an immunohistochemical study in chronic recurrent tonsillitis.

Interactions between leukocytes and crypt epithelium were extensively investigated in 12 cases of chronic recurrent tonsillitis, using immunohistochemistry and cytofluorimetric analysis of cell suspensions. Intraepithelial leukocytes are a mixed cell population composed of 50 per cent CD20-positive B lymphocytes, 40 per cent T lymphocytes with a 2.7 CD4/CD8 ratio, and 10 per cent CD68-positive macrophages. About 4 per cent of intraepithelial leukocytes are proliferating cells, as indicated by Ki-67 staining. Leukocyte infiltration is associated with expression on epithelial cells of the adhesion molecules ICAM-1 and VCAM-1. Crypt epithelium is supported by a basement membrane showing frequent interruptions and connected with the reticular stroma of the lymphoid tissue, which was stained for fibronectin, tenascin, collagen, and laminin. Extracellular matrix (ECM) distribution was correlated with integrin expression on B and T lymphocytes. It was found that the ECM was arranged differently in the follicles and in the extrafollicular area and that B and T lymphocytes exhibited different patterns of integrin expression.

Adolescent↗

[Oxidative profile of tonsil infection. Study of antioxidant enzymes in tonsil and blood].

In order to investigate the effect of oxidative damage due to free radicals on ENT infectious diseases, levels of superoxide dismutase (SOD), glutathione-peroxidase (GPx) and reductase (GRt) and the total antioxidant status (TAS) were measured by spectrophotometry on tonsillar tissue obtained from tonsillectomy in 538 patients, who were divided in three groups according to their surgical indication: tonsillar hypertrophy (n = 235), recurrent tonsillitis (n = 280) or peritonsillar abscess (n = 23). SOD concentration were also measured on adenoid tissue and middle ear exudate in 75 patients from the first two groups. Erythrocyte and tonsillar SOD levels were significantly greater in the abscess group, and lower in the hypertrophic one. These differences were similar for GPx and TAS. For GRt, its level in abscess were lower than in the other two groups in a statistically significant way. There were strong correlations between erythrocyte and tonsillar SOD, tonsillar SOD and GPx, tonsillar SOD and TAS, and tonsillar GPx and TAS. SOD concentrations from adenoid tissue and middle ear exudate did not affect its blood level. So, we can conclude that tonsillar oxidative damage is determined by the frequency or the severity of local infections, and it can be evaluated by measuring the SOD concentration in the tonsillar tissue or in the peripheral blood. So, it can be considered a good marker of tonsillar damage.

Adenoids↗

[Light microscopic findings of cryosurgically treated tonsils following chronic tonsillitis (author's transl)].

The light microscopic findings of tonsillar tissues from nineteen patients (aged 13-51) with the clinical diagnosis of chronic tonsillitis are described at sequential intervals following cryosurgical treatment. The Cooper instrument was used, containing liquid nitrogen and capacity limited cryoprobes as well as probes of a flow system. Two consecutive freeze-thaw cycles were used during a single session in each patient, with freezing time varied from 30 seconds to three minutes. In addition to primary cryosurgical tissue changes such as hyperemia, edema, inflammation, necrosis, fibroplasia with capillary increase, collagenous fibrosis and reepithelialisation, the following could be found: 1. A different cryosensibility of the cells and fibers within the cryolesion: The tonsillar septae are much more resistant to cold than the lymphoid tissue. Of this latter tissue, the reticulin cells and the lymphoblasts are more sensitive to the cold changes than are the matured lymphocytes. In the epithelium the stratum basale is as sensitive to cold as the lymphoreticulum. The outer epithelial cells are more resistant to cold than the basal cells. 2. A quick proliferation in the periphery of the cryolesion is seen in the form of an acanthosis and papillomatosis which begins before slough of necrotic debris occurs. 3. Sharp demarcation and protracted sloughing of necrotic epithelium from the free tonsillar surface or crypts and lymphoid tissue can be seen. 4. Reepithelialization can first be seen following slough of the cryonecrosis twenty days following cryosurgery, after which total reepithelialization occurs.

Adolescent↗

Proliferation of cells and intracellular c-AMP content: comparative investigations of autologous lymphatic cells from palatine tonsils, nasopharyngeal tonsils, and blood.

The c-AMP content and thymidine incorporation were determined in tonsillogenic, adenoid, and peripheral lymphatic cells. A significant c-AMP decrease with simultaneous increase of the thymidine incorporation compared to the blood lymphocytes was noted in the tonsillogenic and adenoid cells. The negative regulative effect of c-AMP on cell proliferation and the function of tonsils at this processes are discussed.

Adenoids↗