Talayero PJA, Catorena MA, Soda MA, Chávez GL, Sada OI

Language: Spanish
References: 49
Page: 119-132
PDF size: 213.16 Kb.

ABSTRACT

Background: The palatine tonsils are an anatomical and functional barrier that depend on the intervention of the adaptive immune system. In cases of chronic tonsillitis, antigen presentation and cell activation processes can be modified, so removing therapeutically tonsils which are chronically sick should be considered a potential advantage.
Objectives: To identify the phenotypic and functional characteristics of lymphocytes T and B and tonsillar tissue dendritic cells. To assess the therapeutic impact of this measure on decision-making for the management of these patients.
Patients and methods: Ten pediatric patients referred to tonsillectomy were studied to obtain palatal mononuclear cells and to identify lymphoid and myeloid subpopulations by flow cytometry. Later, we assessed the functionality of T lymphocytes CD4 and CD8.
Results: T lymphocytes CD4 and CD8 are considered functional due to their ability to produce multiple cytokines, to exert cytotoxic activity and to differentiate in populations of memory. The study of populations of myeloid, plasmacytoid and dendritic cells revealed that there is 1.39% myeloid cells and 0.19% plasmocytoid cells in the tonsillar tissue.
Conclusions: T lymphocytes CD4 and CD8 of tonsillar tissue are functional despite being subjected to chronic stimulation for repeat infections. Contrary to the literature, we reject that this tissue is dysfunctional.

REFERENCES

1. Cummings CFP, Harker L, Haughey B, et al. Cummings otolaryngology head and neck surgery. Saint Louis: Elsevier Mosby, 2005.

2. Bailey BJJ. Head and neck surgery otolaryngology. Philadelphia: Lippincott Williams & Wilkins, 2006.

3. Oykhman P, Mody CH. Direct microbicidal activity of cytotoxic T-lymphocytes. J Biomed Biotechnol 2010;2010:249482.

4. Dorner T, Radbruch A. Antibodies and B cell memory in viral immunity. Immunity 2007;27:384-392.

5. Figdor CG. Molecular characterization of dendritic cells operating at the interface of innate or acquired immunity. Pathol Biol 2003;51:61-63.

6. El-Serag HB, Hepworth EJ, Lee P, Sonnenberg A. Gastroesophageal reflux disease is a risk factor for laryngeal and pharyngeal cancer. Am J Gastroenterol 2001;96:2013-2018.

7. Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 2004;83:1-1438.

8. Brandtzaeg P, Surjan L, Berdal P. Immunoglobulin systems of human tonsils. I. Control subjects of various ages: Quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations. Clin Exp Immunol 1978;31:367-381.

9. Brandtzaeg P. Immune functions and immunopathology of palatine and nasopharyngeal tonsils. In: Bernstein JM, Ogra PL, editors. Immunology of the ear. New York: Raven Press, 1987;63-106.

10. Lieberman J. The abcs of granule-mediated cytotoxicity: New weapons in the arsenal. Nat Rev Immunol 2003;3:361-370.

11. Ejzenberg. Diagnosis and management of chronic tonsillitis. V IAPO Manual of Pediatric Otorhinolaryngology 2005:100-105.

12. Baugh RF, Archer SM, Mitchell RB, Rosenfeld RM, et al. Clinical practice guideline: Tonsillectomy in children. Otolaryngol Head Neck Surg 2011;144:S1-30.

13. Cantani A, Bellioni P, Salvinelli F, Businco L. Serum immunoglobulins and secretory IgA deficiency in tonsillectomized children. Ann Allergy 1986;57:413-416.

14. Boyaka PN, Wright PF, Marinaro M, Kiyono H, et al. Human nasopharyngeal-associated lymphoreticular tissues. Functional analysis of subepithelial and intraepithelial B and T cells from adenoids and tonsils. Am J Pathol 2000;157:2023-2035.

15. Ikinciogullari A, Dogu F, Egin Y, Babacan E. Is immune system influenced by adenotonsillectomy in children? Int J Pediatr Otorhinolaryngol 2002;66:251-257.

16. Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report 2009:1-25.

17. Younis RT, Lazar RH. History and current practice of tonsillectomy. Laryngoscope 2002;112:3-5.

18. Paradise JL, Bluestone CD, Bachman RZ, Karantonis RZ, et al. History of recurrent sore throat as an indication for tonsillectomy. Predictive limitations of histories that are undocumented. N Engl J Med 1978;298:409-413.

19. Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am 1989;36:1551-1569.

20. Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D. Pediatric obstructive sleep apnea: Complications, management, and long-term outcomes. Proc Am Thorac Soc 2008;5:274-282.

21. Ali NJ, Pitson DJ, Stradling JR. Snoring, sleep disturbance, and behaviour in 4-5 year olds. Arch Dis Child 1993;68:360-366.

22. Brunetti L, Rana S, Lospalluti ML, et al. Prevalence of obstructive sleep apnea syndrome in a cohort of 1,207 children of Southern Italy. Chest 2001;120:1930-1935.

23. Muzumdar H, Arens R. Diagnostic issues in pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008;5:263-273.

24. Gozal D, O’Brien LM. Snoring and obstructive sleep apnoea in children: Why should we treat? Paediatr Respir Rev 2004;5 Suppl A:S371-376.

25. Lipton AJ, Gozal D. Treatment of obstructive sleep apnea in children: Do we really know how? Sleep Med Rev 2003;7:61-80.

26. Cyster JG. Chemokines, sphingosine-1-phosphate, and cell migration in secondary lymphoid organs. Annu Rev Immunol 2005;23:127-159.

27. Nutt SL, Tarlinton DM. Germinal center B and follicular helper T cells: Siblings, cousins or just good friends? Nat Immunol 2011;12:472-477.

28. Allen CD, Okada T, Cyster JG. Germinal-center organization and cellular dynamics. Immunity 2007;27:190-202.

29. Sallusto F, Geginat J, Lanzavecchia A. Central memory and effector memory T cell subsets: Function, generation, and maintenance. Annu Rev Immunol 2004;22:745-763.

30. Dorner T, Radbruch A. Selecting B cells and plasma cells to memory. J Exp Med 2005;201:497-499.

31. McHeyzer-Williams LJ, McHeyzer-Williams MG. Antigen-specific memory B cell development. Annu Rev Immunol 2005;23:487-513.

32. Pascual V, Liu YJ, Magalski A, de Bouteiller O, et al. Analysis of somatic mutation in five B cell subsets of human tonsil. J Exp Med 1994;180:329-339.

33. Nagasawa T. Microenvironmental niches in the bone marrow required for B-cell development. Nat Rev Immunol 2006;6:107-116.

34. Radbruch A, Muehlinghaus G, Luger EO, Inamine A, et al. Competence and competition: The challenge of becoming a long-lived plasma cell. Nat Rev Immunol 2006;6:741-750.

35. Grammer AC, McFarland RD, Heaney J, Darnell BF, Lipsky PE. Expression, regulation, and function of B cell-expressed cd154 in germinal centers. J Immunol 1999;163:4150-4159.

36. Tangye SG, Tarlinton DM. Memory B cells: Effectors of long-lived immune responses. Eur J Immunol 2009;39:2065-2075.

37. Davis MM. T cell receptor gene diversity and selection. Annu Rev Biochem 1990;59:475-496.

38. Jenkins MK, Khoruts A, Ingulli E, Mueller DL, et al. In vivo activation of antigen-specific CD4 T cells. Annu Rev Immunol 2001;19:23-45.

39. Seder RA, Ahmed R. Similarities and differences in CD4+ and CD8+ effector and memory T cell generation. Nat Immunol 2003;4:835-842.

40. Geginat J, Lanzavecchia A, Sallusto F. Proliferation and differentiation potential of human CD8+ memory T-cell subsets in response to antigen or homeostatic cytokines. Blood 2003;101:4260-4266.

41. Frentsch M, Arbach O, Kirchhoff D, Moewes B, et al. Direct access to CD4+ T cells specific for defined antigens according to CD154 expression. Nat Med 2005;11:1118-1124.

42. Elzey BD, Grant JF, Sinn HW, Nieswandt B, et al. Cooperation between platelet-derived CD154 and CD4+ T cells for enhanced germinal center formation. J Leukoc Biol 2005;78:80-84.

43. Wolniak KL, Shinall SM, Waldschmidt TJ. The germinal center response. Crit Rev Immunol 2004;24:39-65.

44. Trapani JA, Smyth MJ. Functional significance of the perforin/granzyme cell death pathway. Nat Rev Immunol 2002;2:735-747.

45. Kannan K, Stewart RM, Bounds W, Carlsson SR, et al. Lysosome-associated membrane proteins h-lamp 1 (CD107a) and h-lamp 2 (CD107b) are activationdependent cell surface glycoproteins in human peripheral blood mononuclear cells which mediate cell adhesion to vascular endothelium. Cell Immunol 1996;171:10-19.

46. Lindquist RL, Shakhar G, Dudziak D, et al. Visualizing dendritic cell networks in vivo. Nat Immunol 2004;5:1243-1250.

47. Steinman RM, Banchereau J. Taking dendritic cells into medicine. Nature 2007;449:419-426.

48. Cella M, Engering A, Pinet V, Pieters J, Lanzavecchia A. Inflammatory stimuli induce accumulation of mhc class II complexes on dendritic cells. Nature 1997;388:782-787.

49. Macatonia SE, Hosken NA, Litton M, Vieira P, et al. Dendritic cells produce IL-12 and direct the development of th1 cells from naive cd4+ T cells. J Immunol 1995;154:5071-5079.