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PubMedDate not supplied

Human interferon production in tonsil and adenoid tissue cultures.

Using Sendai virus as an inducer, tonsil lymphocytes produce alpha interferon (IFN-alpha) 1,000 times more potent than that reportedly induced using Newcastle disease virus in such lymphoid tissue. Alpha and gamma interferons can be produced from tonsil and adenoid lymphocyte cultures in amounts comparable with those produced from cultures of pooled peripheral blood lymphocytes. Lymphocytes from both tonsils and adenoids are equal in the amount of IFN each produces. The IFN-producing potential of lymphocytes appears constant in humans between the ages of 3 and 38 years and is not adversely affected during the first trimester of pregnancy. Since approximately one billion lymphocytes are obtained from each of these tissues, they represent a potential source of significant quantities of IFN for investigational use.

Adenoids↗
PubMed1994

Tissue transmigration of CZON (Cosmosin) to middle ear mucosa, maxillary sinus mucosa, and palatine tonsils.

The concentration of CZON was determined by HPLC in surgical patients with chronic otitis media, sinusitis, and tonsillitis. One gram of CZON was injected intravenously prior to surgery. The time course of the mean tissue CZON level was as follows: In the middle ear mucosa, 3.7 micrograms/g at 15 min, 7.2 micrograms/g at 30 min, and 2.9 micrograms/g at 1 hr (the half life: 21.3 min). In the maxillary sinus mucosa, 10.5 micrograms/g at 15 min, 11.8 micrograms/g at 30 min, and 2.8 micrograms/g at 1 hr (the half life: 17.5 min). In the tonsils, 14.9 micrograms/g at 15 min, 9.3 micrograms/g at 30 min, and 2.0 micrograms/g at 1 hr (the half life: 13.2 min). The concentration was high in the maxillary sinus mucosa and the tonsils, but was low in the middle ear mucosa. In the formers the transfer ratio reached its peak 15 to 30 min after administration, but in the latter the peak was reached 30 to 60 min after administration. The order of the transfer ratio at each region was above 25%. The tissue concentration exceeded the MIC80s of frequent isolates from these infections. CZON is considered to be a highly useful drug in the treatment of these infections.

Adolescent↗
PubMed2003

Telithromycin (HMR 3647) achieves high and sustained concentrations in tonsils of patients undergoing tonsillectomy.

Telithromycin, the first ketolide antimicrobial to be developed for clinical use, has potent activity against group A beta-haemolytic streptococci (GABHS), including macrolide-resistant strains. The penetration of telithromycin into tonsils was assessed in 22 adults undergoing tonsillectomy at 3, 12 or 24 h after the fourth dose of oral telithromycin 800 mg once daily. Telithromycin rapidly penetrated tonsillar tissues, achieving a mean concentration of 3.95 mg/kg at 3 h post dose, 3.4 times greater than the corresponding plasma concentration (1.22 mg/l. The mean tonsil:plasma concentration ratio increased to 13.1 at 24 h post dose, indicating slower elimination from tonsils than plasma. Tonsillar and plasma concentrations exceeded the MIC(50) for GABHS throughout the 24-h dosing period. These findings suggest that telithromycin may be an effective new alternative treatment for GABHS tonsillopharyngitis.

Administration, Oral↗
PubMed1998

[Plea for an evaluation of beta hemolytic streptococcal tonsillitis: from diagnosis to treatment].

There is no justification to maintain a systematic antibiotic treatment of all tonsillitis as currently practiced in France. Indeed, it is today possible to exclude the streptococcal origin of tonsillitis with a fair probability using a rapid diagnosis test. It is therefore mandatory that these tests are made available to the French practitioner. Additionally, alternatives to the classical 10-day penicillin V treatment of streptococcal tonsillitis must be seriously considered: shorter duration treatment with oral cephalosporins, macrolides or amoxicillin have proved to be as efficient and of lower cost; they are also probably safer due to a better compliance related to the shorter duration.

Child↗
PubMed1998

[Acute tonsillitis: towards a new therapeutic strategy].

There is a need for revising the current practice for treatment of acute tonsillitis in France, i.e., systematic antibiotic treatment. There are three main reasons for this revision: 1) group A betahemolytic streptococcus is involved in only 20% of acute tonsillitis (80% being viral); 2) rheumatic fever has become very rare; 3) efficient rapid diagnostic tests are now available, allowing a selection of patients with streptococcal tonsillitis who must be treated.

Acute Disease↗
PubMed1987

Chronic tonsillitis, tonsillectomy and sickle cell crises.

A study of the effect of tonsillectomy on the frequency of sickle cell pain crises was carried out on 15 patients with sickle cell disease (Hb SS) who presented with complaints of frequent pain crises and were found to have chronic tonsillitis. They comprised 9 females and 6 males and ranged in age from 6 to 35 years, with a mean of 15 years. Tonsillectomy was performed under general anaesthesia. The mean number of pain crises in the one-year period after tonsillectomy was 1.5 and was significantly less than the mean number 4.7 in the one year preceding the operation (p less than 0.001). Four patients failed to show a reduced number of crises and these were those whose tonsils at operation showed no pus in their tonsillar crypts. It is thus observed that chronic tonsillitis, symptoms of which may not be volunteered at examination, is a potent inductor of sickle cell pain crisis and that tonsillectomy is an effective mode of treatment, especially when the tonsillar crypts contain pus.

Adolescent↗
PubMed1991

Peritonsillar abscess: risk of disease in the remaining tonsil after unilateral tonsillectomy à chaud.

The occurrence of disease in the remaining tonsil after unilateral tonsillectomy à chaud in the treatment of peritonsillar abscess, was studied in 536 patients. No patient had a history of previous severe tonsillitis at the time of the unilateral tonsillectomy, 6.1 per cent of the patients were readmitted for surgery of the remaining tonsil during the follow-up period. Ninety-seven per cent of these patients were younger than 30 years of age. Previous investigations have shown increasing frequency by age of pharyngitis after bilateral tonsillectomy. We suggest bilateral tonsillectomy in all cases of patients younger than 30 years old who suffer from peritonsillar abscess irrespective of previous tonsillar disease. Patients older than 30 should be treated with unilateral ablation, unless there is a clear indication for bilateral tonsillectomy.

Adolescent↗
PubMed1994

Spontaneous tonsillar haemorrhage in acute tonsillitis.

The presentation and management of four cases of spontaneous haemorrhage from the tonsil in association with acute tonsillitis are reported and discussed. Interestingly, younger patients presented with haematemesis. This is a newly recognised, rare, but potentially dangerous complication of acute tonsillitis. Its possible aetiology, pathophysiology and treatment options are discussed.

Acute Disease↗
PubMed1984

Tympanometric findings in patients with adenoid hyperplasia, chronic sinusitis and tonsillitis.

Tympanograms were done on 120 patients with adenoid hyperplasia, chronic sinusitis and chronic tonsillitis to measure the middle-ear pressure as a parameter to eustachian tube function. The results were compared with those obtained in 50 normal subjects. The statistical significance of the mean values of middle-ear pressure is very highly significant in patients with adenoid hyperplasia, significant in chronic sinusitis group and insignificant in patients with chronic tonsillitis, as compared to the normal control group. Hence, eustachian tube dysfunction is maximum in patients with obstructing adenoids, less in chronic sinusitis and least in chronic tonsillitis.

Acoustic Impedance Tests↗
PubMed2000

Platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) is associated with a naïve B-cell phenotype in human tonsils.

In B cells, signaling through the B-cell antigen receptor (BCR) is negatively modulated by the co-ligation of immunoglobulin (Ig)-immunoreceptor tyrosine-based inhibitory motif (ITIM)-bearing molecules such as FcgammaRIIB1, B-cell transmembrane protein CD72, paired immunoglobulin-like receptor PIR-B, leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1), Ig-like transcript ILT2, biliary glycoprotein BGP-1 and B-cell co-receptor CD22. The co-expression of multiple Ig-ITIM receptors may provide B cells with different mechanisms of regulating inhibitory pathways at different stages of differentiation. In this study, we have examined the expression of a newly defined Ig-ITIM receptor, PECAM-1 (CD31) on human B-cells. Human tonsillar B cells were purified using negative selection by depleting T cells with a combination of monoclonal antibodies and magnetic bead separation. Following purification, the pattern of PECAM-1 expression was analyzed in B-cell subpopulations using two- and three-colour fluorescence. To complement this work, PECAM-1 localization in the context of distinct areas of human tonsil was defined by immunohistochemical analysis of tonsil sections. Finally to investigate somatic mutation, Ig variable (V) region genes belonging to the nonpolymorphic VH6 family were amplified by polymerase chain reaction (PCR), subcloned and sequenced from sort-purified CD19+ PECAM-1+ and CD19+ PECAM-1- B cells. Our results demonstrate that PECAM-1 is associated with an unstimulated resting B-cell phenotype, localization to the follicular mantle and marginal zones of human tonsil and expression of unmutated Ig V region genes. These studies suggest that PECAM-1 appears on the cell surface at the naive B-cell stage and is lost as B cells differentiate into memory cells, indicating that PECAM-1 is primarily involved in naive or immature B-cell function.

Antigens, CD↗
PubMed2003

HIV-gp160 modulates differentially the production in vitro of IgG, IgA and cytokines by blood and tonsil B lymphocytes from HIV-negative individuals.

HIV1-gp160 holds promises in anti-HIV vaccinal strategies. However, this molecule has been described to exhibit superantigenic activities. The present study aimed at examining the effect(s) of HIV1-gp160 on human B cells and in particular on B cells originating from HIV- donors. We purified human B cells of various origins, i.e. from blood and from tonsils (representing a mucosal-type origin), and we tested these cells (stimulated with a polyclonal B cell activator, interleukin (IL)-2 and IL-10 as cytokines, and recombinant HIV1-gp160) for the production of IgG and IgA in an in vitro model. Gp160 induced significantly less total IgG by blood - but not tonsil-originating - B cells and did not affect total IgA production. Further, HIV1-gp160 up-regulated IL-2-, IL-4- and IL-10-mRNA levels in stimulated blood B cells (these cytokines are known to be active on B cell activation and differentiation). Interestingly, HIV1-gp160 also up-regulated IL-1beta-, transforming growth factor (TGF)-beta-, interferon (IFN)-gamma- and IL-12-mRNA levels in stimulated mucosal-type, tonsil-originating, B cells. As these latter cytokines are involved in proinflammatory activities, HIV-gp160 delivery at the mucosal sites would be compatible with an adjuvant activity.

B-Lymphocytes↗
PubMed2001

Is there agreement among general practitioners, paediatricians and otolaryngologists about the management of children with recurrent tonsillitis?

Tonsillectomy is the second most common operation undertaken in children in the United Kingdom, but the rate at which tonsillectomy is performed varies greatly across the Health Authorities. The reasons for the variation appear to be related to differences in local medical practice rather than differences in regional morbidity. This study was undertaken to compare the factors used to diagnose tonsillitis in children, the indications for tonsillectomy and the expected benefits of tonsillectomy in children by general practitioners, paediatricians and otolaryngologists. There was poor correlation between general practitioners, paediatricians and otolaryngologists in all study objectives. There appears to be no consistent clinical pathway by which children with recurrent tonsillitis are managed. The wide variation in tonsillectomy rates across the United Kingdom will probably continue until the decision-making process of doctors involved in the treatment of children with recurrent tonsillitis is better understood.

Child↗
PubMed2000

Intercellular communication in the immune system: differential expression of connexin40 and 43, and perturbation of gap junction channel functions in peripheral blood and tonsil human lymphocyte subpopulations.

The distribution and function of connexins (integral membrane proteins assembled into gap junction intercellular communication channels) were studied in human lymphocyte subpopulations. The expression of mRNA encoding connexins in peripheral blood and tonsil-derived T, B and natural killer (NK) lymphocytes was examined. Connexin43 (Cx43) mRNA was expressed in peripheral blood and tonsil lymphocytes, but Cx40 mRNA expression was confined to tonsil-derived T and B lymphocytes; Cx26, Cx32, Cx37 and Cx45 were not detected by reverse transcription-polymerase chain reaction (RT-PCR). Western blot analysis also demonstrated the presence of Cx40 and Cx43 proteins in T and B lymphocytes in a manner coincidental to the mRNA detection. Stimulation in vitro of T and B lymphocytes with phytohaemagglutinin (PHA) and lipopolysaccharide (LPS), respectively, increased Cx40 and Cx43 protein expression. Flow cytometric analysis, using antibodies to extracellular loop amino acid sequences of connexins, confirmed the surface expression of connexins in all lymphocyte subpopulations. Assembly of connexins into gap junctions providing direct intercellular channels linking attached lymphocytes was demonstrated by using a dye transfer technique. The exchange of dye between lymphocytes was inhibited by a connexin extracellular loop mimetic peptide and alpha-glycyrrhetinic acid, two reagents that restrict intercellular communication across gap junctions. Dye coupling occurred between homologous and heterologous co-cultures of T and B lymphocytes, and was not influenced by their stimulation with PHA and LPS. The connexin mimetic peptide caused a significant decrease in the in vitro synthesis of immunoglobulin M (IgM) by T- and B-lymphocyte co-cultured populations in the presence or absence of stimulation by PHA. The results identify connexins as important cell surface components that modulate immune processes.

B-Lymphocytes↗
PubMed2000

Differences in lymphocyte subsets in the wall of high endothelial venules and the lymphatics of human palatine tonsils.

Lymphocyte trafficking plays a critical role in disseminating specifically primed lymphocytes all over the body. Most concepts on the interaction of adhesion molecules on lymphocyte subsets and specialized endothelia such as those in high endothelial venules (HEV) are based on animal experiments as kinetic studies cannot be performed in humans. We therefore characterized lymphocyte subsets in the wall of HEV and in the lumen of lymphatics of 18 human palatine tonsils by immunohistology. All subsets studied were found in the wall of HEV (% of lymphocytes): 32% CD20+, 50% CD3+, 14% CD4+, 32% CD8+ and also 21% CD45RA+ and 39% CD45RO+. In the lymphatics, used to indicate lymphocytes emigrating from the tonsils, a different composition was found; e.g. many more T cells and three times more CD45RA+ than RO+ lymphocytes. Thus, HEV are not a selective entry site nor lymphatics an exit for specific lymphocyte subsets only, at least in these tonsils with chronic stimulation.

Adult↗
PubMed2002

Fanconi's syndrome, acute renal failure, and tonsil ulcerations after colloidal bismuth subcitrate intoxication.

A 22-year-old woman ingested 5.4 g of colloidal bismuth subcitrate (CBS) in a suicide attempt. After ingestion, she presented with Fanconi's syndrome and acute renal failure to our unit. On the third day after ingestion, she was anuric. Ulcerations of both tonsils were observed 8 days after intoxication. Sodium-2,3-dimercapto-1-propanesulfonate (DMPS) is shown to be an effective chelating agent of heavy metal intoxications, but it has only a small effect on elimination of bismuth salts in patients with renal insufficiency without hemodialysis. In our case, we initiated hemodialysis and intravenous treatment with DMPS 60 hours after intoxication. By repeated measurements of bismuth concentrations in serum and dialyzed fluid, we showed its successful elimination. Serum bismuth level decreased from 640 microg/L to 15 microg/L within 6 days. With elimination of bismuth, renal function improved, and tonsil ulcerations healed. Hemodialysis was discontinued on day 14. Follow-up examination 6 weeks later showed normal renal function. Clinicians should be aware that acute renal failure and tonsil ulcerations can occur after CBS intoxication. Generally, acute renal failure caused by CBS intoxication is reversible. Treatment with the chelating agent DMPS in combination with hemodialysis is highly effective in reducing the serum bismuth level in patients with acute renal failure.

Acute Kidney Injury↗
PubMed1993

[Nicotine concentrations in the palatine tonsil, uvula mucosa and septum cartilage of smokers--a pilot study].

The concentrations of nicotine were determined via radioimmunoassay in the palatine tonsils (n = 22) and in the mucosa of the uvula (n = 5) of eleven male smokers, and in the nasal septal cartilage of four other smokers. The same tissues of five nonsmokers served as controls. The mean values of the nicotine concentrations were 77 ng/g for the tonsils (level of serum: 151 ng/g), 114.5 ng/g for the mucosa of the uvula (level of serum: 215 ng/g) and 36 ng/g for the septal cartilage (level of serum: 97 ng/g). There was no nicotine in the tissues and serum of the control group. The correlations between the nicotine concentrations of the three tissues and the levels of the serum were significant. Another significant correlation was found between the nicotine level of the serum and the daily consumption of cigarettes of the eleven patients on whom tonsillectomy had been performed. These concentrations of nicotine in the three types of tissue and in serum appear to be high after an interval of twelve hours non-smoking. With gas-chromatography/mass-spectrometry also unchanged nicotine was found in the tonsils which is considered to be the damaging substance of tobacco.

Adult↗
PubMed1990

[The tonsils as MALT (mucosa-associated lymphoid tissue) of the nasal mucosa].

One of the most effective defense mechanisms of the nasal mucosa is its immune response leading to the synthesis of antibodies directed against inhaled antigens. In order to understand the immunology of the upper respiratory tract it is essential to know whether this response takes place within the mucosa itself or within regional lymphoid organs. The authors investigated cell populations involved in immune processes within the mucosa and as a model of a lymphoid organ, in the tonsil. Using a range of monoclonal cell surface markers, the authors concentrated on antigen-presenting cells, the B-cell differentiation, and T-cell subpopulations and their corresponding activation markers. The findings demonstrate that the normal mucosa has no organized lymphoid structures and few or no early, maturing, or activated B-lymphocyte stages. The antibody-producing plasma cells found within the mucosa can therefore not be regarded as locally formed. On the contrary, the palatine tonsils demonstrate a typical lymphoid structure and contain all activation and differentiation stages of B-lymphocytes from premature to plasma cells. This would suggest that the human nasal mucosa is not capable of providing a local immune response, but is dependent on lymphoid organs like the tonsil, as the regional "mucosa-associated lymphoid tissue" (MALT).

Antibody-Producing Cells↗
PubMed2002

The influence of environmental pollution on the amount of glycosoaminoglycans in the tissue of palatine tonsils.

In this study, we investigated persons exposed to high and low air pollution caused by metals. This investigation was done against the background of changes in the connective tissue of palatine tonsils. We evaluated the qualitative and quantitative composition of glycosoaminoglycans (GAG) isolated from palatine tonsils. GAGs were separated by column chromatography. We found that as the total amount of GAGs increased, the amount of heparin and chondroitin sulphate also increased, whereas the amount of hyaluronic acid, dermatane sulphate, heparane sulphate and keratane sulphate decreased. The changes observed in the amount of GAGs in the tissue of palatine tonsils can influence the incidence of infections of the upper airways.

Adult↗