Subsets of tonsillar lymphocytes and activated cells in each subset analysed by two-color flow cytometry

We analysed subsets of tonsillar lymphocytes and activated cells in each subset by two-color flow cytometry. There were many helper T cells (CD 4+ leu 8-) and few inducer T cells (CD 4+ leu 8+) in the tonsil. The situation was the reverse in the peripheral blood. The tonsil had few suppressor T cells (CD 8+ CD 11+). The proportion of activated cells (HLA-DR+) was low in the peripheral blood and high in the tonsil. In the tonsil, the ratio of cells with transferrin receptors to total lymphocytes was higher in the B than in the T subset, and higher in the subset of CD 4+ than in that of CD 8+ cells. Activated and proliferating lymphocytes were more abundant in the tonsils of children than in those of adults and more abundant in patients with hyperplastic tonsillitis than in those with recurrent tonsillitis.     

慢性扁桃体炎患者外周血T淋巴细胞亚群的分析与临床意义

目的：探讨慢性扁桃体炎患者外周血T淋巴细胞各亚群的变化特点及其与肾损害的关系。方法：采用流式细胞仪检测54例慢性扁桃体炎患者和52例健康体检者的外周血初始T细胞、功能T细胞、激活T细胞及凋亡T细胞亚群百分比,并结合血清半胱氨酸蛋白酶抑制剂（CystatinC）、ASO和ESR水平进行统计学分析。结果：慢性扁桃体炎患者外周血CD3^＋T细胞、CD3^＋CD8^＋T细胞、CD4^＋CD28^＋T细胞、CD8^＋CD28^＋T细胞、CD4^＋HLA—DR^＋T细胞、CD8^＋HLA—DR^＋T细胞、CD8^＋CD95^＋T细胞与健康对照组相应细胞亚群之间的差异无统计学意义（P〉0．05）。但CD4^＋T细胞、CD4^＋CD45RA^＋T细胞和CD4^＋CD25^＋T细胞减少,CD4^＋CD45RO^＋T细胞、CD8^＋CD38^＋T细胞和CD4^＋CD95^＋T细胞增加,CD4^＋／CD8^＋和CD4^＋CD45RA^＋／CD4^＋CD45RO^＋比值下降,与健康对照组相应细胞亚群之间的差异有统计学意义（P〈0．05）。慢性扁桃体炎患者的外周血CD4^＋CD45RA^＋T细胞百分比与其血清Cystatin C浓度负相关。结论：本研究通过对外周血各T细胞亚群变化特点的系统研究,证实了慢性扁桃体炎患者机体存在T细胞免疫平衡紊乱。CD4^＋CD45RA^＋T细胞的变化可以作为慢性扁桃体炎患者肾损害的相关参考指标。     

Lymphocyte subsets of maxillary mucosa in chronic inflammation

Subsets of infiltrating lymphocytes within maxillary sinus mucosae of patients with chronic sinusitis were investigated by immunoperoxidase staining of frozen sections with the use of monoclonal antibodies. The most commonly observed infiltrating cell type was suppressor/cytotoxic T cells (CD8+) and smaller subpopulations of lymphocytes were helper/inducer T cells (CD4+) and B cells (CD20+). Variable numbers of HLA-DR+ cells were commonly observed in the lamina propria. The fibrous type of chronic sinusitis was found to have more suppressor/cytotoxic T cells (CD8+) and lower CD4/CD8 ratio than the other histopathological types.     

Functional and phenotypic analysis of lymphocytes in head and neck cancer.

We compared the phenotype and antitumor effector function of lymphocytes obtained from tumor tissues, lymph nodes, and the peripheral blood of patients with head and neck cancer. Freshly isolated tumor-infiltrating lymphocytes were deficient in CD4+ T cells in comparison with lymph node lymphocytes (LNL) and peripheral blood lymphocytes. A significantly higher CD4/CD8 ratio observed in LNL vs tumor-infiltrating lymphocytes and peripheral blood lymphocytes was attributable to both a significant enrichment in CD4+ T cells as well as a decrease in CD8+ T cells. The percentage of natural killer cells (CD3-CD56+) was uniformly low in both tumor-infiltrating lymphocytes and LNL. In patients with cervical metastases, LNL contained an increased proportion of CD16+ cells. Tumor-involved lymph nodes were not enriched in the CD8+C11b+ subset of T "suppressor" lymphocytes compared with uninvolved lymph nodes. Also, tumor-involved lymph nodes had significantly fewer CD4+ T cells than did uninvolved lymph nodes. In comparison with peripheral blood lymphocytes, freshly isolated tumor-infiltrating lymphocytes and LNL were depleted of cytotoxic effector cells, as indicated by low or absent cytotoxic activity against tumor cell targets. The ability to generate lymphokine-activated killer cells was significantly reduced in LNL in comparison with peripheral blood lymphocytes. In patients with head and neck cancer, depressed local and regional antitumor responses are associated with a deficiency of functional cytotoxic effector cells rather than an increase in suppressor T lymphocytes.     

鼻息肉中肥大细胞雌激素受体的表达及其意义

目的 检测雌激素受体在鼻息肉肥大细胞和ＣＤ４＾＋、ＣＤ８＾＋及ＣＤ６８＾＋细胞上的表达。方法 采用抗肥大细胞,抗ＣＤ４＾＋、ＣＤ８＾＋、ＣＤ６８＾＋细胞以及抗雌激素受体的单顾隆抗体对９例鼻息肉标本进行免疫组化及双标免疫染色。结果 所有上述细胞亚群中相应抗体清晰地检测到。形态学观察,雌激素受体阳性细胞明显与ＣＤ４＾＋、ＣＤ８＾＋、ＣＤ６８＾＋细胞不同,但也肥大细胞相似,双标免疫洒以,只有肥大细胞而非     

The kinetics of CD80 and CD86 expression on antigen-presenting cells in cedar pollinosis subjects

CD80 and CD86, which are costimulatory molecules in T-cell activation, play important roles in the differentiation of Th1- or Th2-phenotypes. The results of blocking studies using neutralizing antibodies have suggested that CD80 and CD86 also play important roles in sensitization to cedar pollen antigen, but very few studies have examined the kinetics of CD80 and CD86 expression on antigen-presenting cells (APC). We studied the kinetics of CD80 and CD86 expression on APC after allergen-stimulation in cedar pollinosis subjects. A skin-prick test was performed in nine subjects with pollinosis and seven control subjects. Peripheral blood mononuclear cells (PBMC) were isolated and stimulated with Japanese cedar pollen extract. Zero to 8 days following in vitro stimulation, the expression of CD80 and CD86 in either CD14+ or CD19+ cells was analyzed by two-color flow cytometry. The expression of CD28, CTLA-4 and CD40L on CD4+ cells was analyzed by two-color flow cytometry after eliminating either CD14+ or CD19+ cells. After in vitro stimulation, the expression of both CD80 and CD86 was significantly upregulated in pollinosis subjects compared to control subjects. However, the difference was observed in the kinetics of CD80 and CD86 expression following allergen stimulation. The expression of CD86 was upregulated earlier than that of CD80 after in vitro stimulation. In the absence of CD19+ cells, the expression of CD28, CTLA-4, and CD40L in CD4+ cells was significantly lower than that in the absence of CD14+ cells. These results indicate that CD19+ cells of pollinosis subjects expressed higher CD80 and CD86 than that of control subjects, and that the kinetics of CD80 and CD86 expression following stimulation differed. In pollinosis subjects, CD19+ cells may thus function as APC in allergen-induced activation of PBMC.     

淋巴细胞在慢性鼻-鼻窦炎组织中的表达及意义

目的：探讨B淋巴细胞（CD20）和T淋巴细胞亚群（CD4、CD8）在慢性鼻-鼻窦炎（CRs）中的表达及在炎症反应中的作用。方法：采用免疫组织化学技术检测B淋巴细胞（CD20）和辅助性T细胞（CD4）、细胞毒性T细胞（CD8）在实验组[分为15例CRS不伴鼻息肉（CRSsNP）组、12例CRS伴鼻息肉（CRSwNP）组、7例复发性CRSwNP组]和对照组（13例下鼻甲黏膜对照）中的表达。采用Mann-WhitneyU检验分析实验组和对照组B淋巴细胞、T淋巴细胞亚群的表达情况,实验组组间淋巴细胞浸润比较用单因素方差分析One—WayANOVA。结果：与对照组相比,实验组有明届的13淋巴细胞（CD20）和T淋巴细胞亚群（CD4、CD8）浸润（P〈0．05）：T淋巴细胞、亚群（CD4、CD8）在CRSwNP组和复发性CRSwNP组病变中的表达明显高于CRSsNP组（P〈0．05）;CD4在复发性CRSwNP组中的表达明显高于CRSwNP和CRSsNP组（P〈0．01）。结论：实验组鼻腔黏膜中B淋巴细胞、辅助性T细胞和细胞毒性T细胞高表达,均参与炎症的形成,其炎症匣应与T淋巴细胞浸润密切相关。     

Local infiltration of T-lymphocyte subsets as a prognostic indicator in patients with nasopharyngeal carcinoma

We studied tumor-host interactions in 47 patients with NPC. The local infiltration of T-lymphocyte subsets was investigated by an immunoperoxidase technique using monoclonal antibodies. Biopsy specimens of patients without cervical metastasis showed more T-lymphocyte (T11) infiltration. The amount of Leu-3a (helper/inducer) and T8 (cytotoxic/suppressor) cell infiltration did not correlate with the age, sex, clinical stage, and peripheral blood T4 and T8 cells of the patients. A higher incidence of Leu-3a cell infiltration was found in patients with high serum IgA antibody titers to EBV VCA. A trend of better prognosis was revealed in those cases with no or slight stromal T8 cell infiltration. A local immune response was found to exist which may prevent the spread of NPC to the cervical nodes, but this needs further study to evaluate the local infiltration of T-lymphocyte subsets as a prognostic indicator.     

Immunohistology of tumor tissue in local administration of recombinant interleukin-2 in head and neck cancer

Biopsied specimens from patients treated by local administration of rIL-2 were examined immunohistologically. Lymphocytes infiltrating into the cancer tissue before and after administration of rIL-2 were observed on paraffin embedded sections by Hematoxilin Eosin (HE) stain in relation to the clinical effect. And their subsets were identified on frozen sections by Avidin Biotin peroxidase Complex (ABC) method using monoclonal antibodies to examine what kinds of effector cells were induced and increased in the tumor site by rIL-2 in vivo. The intensity of increasing of tumor infiltrating lymphocytes (TIL) was correlated with the clinical effect of local administration of rIL-2. Tumor Infiltrating Lymphocytes were mainly T lymphocytes, of which Leu-2a+ cells (suppressor/cytotoxic T cells) and Leu-3a + 3b+ cells (helper/inducer T cells) were almost equally observed. Leu-2a+ cells were considered to be mainly cytotoxic T lymphocytes because few Leu-2a+ cells were stained with anti-Leu-15 antibody. After administration of rIL-2, marked infiltration of T lymphocytes was observed and there was no obvious different response in degree of infiltration between Leu-2a+ cells and Leu 3a + 3b+ cells. Furthermore, IL-2 receptor+ T lymphocytes (activated T lymphocytes) were increased after administration of rIL-2. And natural killer (NK) cells were slightly observed and also increased after administration of rIL-2. These findings suggest local administration of rIL-2 has possibility to induce cytotoxic T lymphocytes, to increase NK cells and to activate these lymphocytes in vivo.     

Alterations in T-lymphocyte subpopulations in patients with head and neck cancer. Correlations with prognosis

Impaired cell-mediated immunity has been consistently demonstrated in patients with advanced head and neck squamous cancer (HNSC); however, the results of prior studies of correlations of cellular immune parameters with treatment outcome have been inconsistent, and routine assessment of immune parameters has been of limited clinical use. To determine the prognostic importance of alterations in the proportions of various T-lymphocyte subpopulations in the peripheral blood of patients with HNSC, levels of T3, T4, T6, T8, T9, T10, T11, and Leu 7 cells were quantitated by flow cytometry in 80 previously untreated patients and prospectively correlated with tumor characteristics and clinical course (median length of follow-up, 27 months). The mean helper/suppressor cell ratio (T4/T8) increased progressively with increasing tumor stage and was significantly elevated among patients with cancer as a group and in patients with advanced (stage III or IV) disease compared with 40 normal subjects. Decreased disease-free survival was significantly associated with elevated T4/T8 ratios and low percent T8 and T11 cell levels. The prognostic significance of percent T8 (cytotoxic/suppressor) cell levels persisted even after adjusting for known prognostic factors of tumor stage, T class, N class, and tumor site. These correlations provide new insight into immune alterations in HNSC that may prove useful in identifying patients with early clinical disease who have a poor prognosis.     

Definite vs adjuvant radiotherapy. Comparative effects on lymphocyte subpopulations in patients with head and neck squamous carcinoma

The recent association of alterations in T-lymphocyte subpopulations and impaired cellular immunity prompted an investigation of the effects of radiotherapy (RT) on serial levels of lymphocyte subsets in 30 patients with head and neck squamous carcinoma. Percentage and absolute levels of T3, T4, T6, T8, T10, T11, and Leu 7 cells were measured before, during, and after RT at monthly intervals for six months and compared with levels in 40 normal subjects. Sixteen patients received curative and 14 postoperative adjuvant RT. Before treatment, mean subset levels were similar among the patient and normal groups except for elevated Leu 7 (natural killer) cells in patients with stage I and II disease. There were profound decreases in absolute levels of each subpopulation during and after RT. The percentage of T4 (helper/inducer) cells decreased, whereas that of T8 (cytotoxic/suppressor) and Leu 7 cells tended to increase. Compared with normal values, the mean T4/T8 ratio decreased significantly by six months after RT, when absolute levels of the subsets had rebounded to pretreatment levels in the definitive RT group but remained profoundly decreased in the adjuvant group. The differing recovery patterns suggest that factors other than RT may contribute to persistent immunosuppression following RT.     

An immunohistochemical study of the endolymphatic sac in patients with acoustic tumors

Intraosseous endolymphatic sacs obtained from patients with acoustic neuromas who had undergone total labyrinthectomy during tumor removal were examined for the presence of T helper/inducer and T suppressor/cytotoxic lymphocytes, B lymphocytes, plasma cells, and macrophages. Immunoperoxidase staining of cryostat sections revealed the presence of T helper/inducer lymphocytes, T suppressor/cytotoxic lymphocytes, and macrophages. The number of B lymphocytes and plasma cells was much smaller than the number of T lymphocytes. The number of T suppressor/cytotoxic lymphocytes was higher than the number of T helper/inducer lymphocytes. This study supports the notion of local immune responsiveness in the human inner ear. This is the first immunohistochemical study to analyze lymphocyte subpopulations; specifically, to provide insight into T-cell function in the endolymphatic sac.     

Inflammatory cells in nasal mucosa and nasal polyps

OBJECTIVE: Since some controversy exists concerning the frequency of inflammatory cells in nasal polyps, we have compared the frequency of tissue inflammatory cells (lymphocytes, neutrophils, eosinophils and plasma cells) including 11 kinds of lymphocyte subsets in the same specimens of nasal mucosa and nasal polyps. METHODS: Histopathological observations and flow cytometric analyses were performed on eight mucosal specimens of the inferior turbinates of patients with nasal polyps and on 13 polyp specimens. RESULTS: Nasal polyps contained significantly more eosinophils, neutrophils and plasma cells than nasal mucosa, and EG2+ cells (activated eosinophils) were significantly more frequent in nasal polyps than in nasal mucosa. Flow cytometric analysis showed that there were no significant differences in the frequencies of lymphocytes and lymphocyte subsets (CD1+, CD2+, CD3+, CD5+, CD7+, CD4+, CD8+, CD10+, CD19+, CD20+ and HLA-DR+ cells) including CD4/8 ratios between nasal mucosa and polyps, though, both nasal mucosa and polyps contained significantly more lymphocytes than eosinophils, neutrophils or plasma cells. The T cell lineage (CD2+, CD3+, CD5+ and CD7+ cells) was found in high frequency and B cell lineage (CD10+, CD19+ and CD20+ cells) in low frequency in both nasal mucosa and polyps. The frequency of HLA-DR+ cells (most of which were activated T cells) was not significantly different between nasal mucosa and nasal polyps. CONCLUSION: Histopathological and flow cytometric analyses were performed on the composition of inflammatory cells in nasal mucosa of the inferior turbinates and in polyps from the same patients. The elevated numbers of activated eosinophils, neutrophils and plasma cells in nasal polyps compared with nasal mucosa suggest that inflammatory processes play important roles in the pathophysiology of nasal polyps. The frequencies of lymphocytes and lymphocyte subsets were not significantly different between these two tissues.     

鼻息肉中肥大细胞雌激素受体的表达及其意义

目的检测雌激素受体在鼻息肉肥大细胞和ＣＤ４＋、ＣＤ８＋及ＣＤ６８＋细胞上的表达。方法采用抗肥大细胞,抗ＣＤ４＋、ＣＤ８＋、ＣＤ６８＋细胞以及抗雌激素受体的单克隆抗体对９例鼻息肉标本进行免疫组化及双标免疫染色。结果所有上述细胞亚群均可被相应抗体清晰地检测到。形态学观察,雌激素受体阳性细胞明显与ＣＤ４＋、ＣＤ８＋、ＣＤ６８＋细胞不同,但与肥大细胞相似;双标免疫染色,只有肥大细胞而非ＣＤ４＋、ＣＤ８＋、ＣＤ６８＋细胞与雌激素受体阳性细胞的位置相吻合。结论鼻息肉中肥大细胞表达雌激素受体。这一结果将对揭示呼吸道变态反应和炎性疾病的病理以及雌激素参与炎性反应性疾病的机制将有理论和实用价值。     

鼻咽癌患者外周血CD4+CD25high调节性T细胞分析

目的:探讨鼻咽癌患者外周血CD4 CD25h igh调节性T(Tr)细胞比例变化的特点及其临床意义。方法:采用流式细胞术检测54例初治鼻咽癌患者(鼻咽癌组)和15例健康者(对照组)外周血中CD3 、CD4 、CD8 及CD4 CD25h ighT细胞比例。结果:鼻咽癌患者CD4 T细胞比例、CD4 /CD8 比值均低于对照组(均P<0.05),但CD4 CD25h ighTr细胞比例明显高于对照组(P<0.01)。随疾病进展鼻咽癌患者外周血CD4 CD25h ighTr细胞比例升高[Ⅰ Ⅱ期为(2.28±1.07)%,Ⅲ期为(3.65±1.21)%,Ⅳ期为(4.72±0.87)%],Ⅰ Ⅱ期与Ⅲ、Ⅳ期比较,均P<0.01;Ⅲ期与Ⅳ期比较,P<0.01。结论:CD4 CD25h ighTr细胞可能是鼻咽癌患者免疫抑制的重要原因之一,与鼻咽癌免疫逃逸有关。外周血CD4 CD25h ighTr细胞比例可能成为鼻咽癌一种新的预后判断指标,去除这群细胞可有效诱导肿瘤免疫,为肿瘤治疗提供一种新的方法。     

AIDS-like disproportion of minor T-cell subsets in Japanese patients with Wegener's granulomatosis.

Fifteen Japanese patients with Wegener's granulomatosis (WG) were evaluated according to their lymphocyte subset abnormalities. Two colour immunofluorescent flow cytometry was used to distinguish the lymphocyte subset alterations. WG group showed a decrease in the percentage of CD4+ cells and the increase of CD8+ cells. Within the NK cell family, the functionally unidentified CD8+57+ cells were markedly elevated. The disproportion of the lymphocyte subsets (CD4+ decreases CD8+57+ increases) were similar to those of Acquired Immunodeficiency Syndrome (AIDS) and AIDS relating complexes (ARC). To assess silent infection of Human immunodeficiency virus (HIV), the polymerase chain reaction (PCR) was done for all patients to selectively amplify specific HIV proviral DNA sequences in peripheral blood mononuclear cells, HIV-1 proviral DNA was not found in any patients but these changes of WG might suggest a possible adaptive response to unknown viral infection.     

Localization of T cells and subtypes in the paranasal sinus and turbinate mucosa in patients with chronic sinusitis

The aim of this study was to quantitate total T lymphocytes (total CD3+ cells) and T-lymphocyte subtypes (CD4+ [T helper] and CD8+ [T suppressor] cells) in patients with chronic sinusitis who were treated with functional endoscopic sinus surgery (FESS) and to investigate the pathophysiology of persistent inflammation in chronic sinusitis. This prospective study was conducted in study and control groups. The study group consisted of 32 patients (20 male, 12 female) with chronic sinusitis who underwent FESS. The control group consisted of 8 nonsinusitis patients (5 male, 3 female) who underwent septoplasty. Specimens from the study group were excised from five regions: the uncinate process, maxillary and ethmoid sinuses, and middle and inferior turbinates. The specimens were examined with x10 magnification by light microscopy, and the slides with a severe inflammatory process were included. Punch biopsy of the control group was taken from the inferior turbinate with patients' written approval. The surgical specimens from the study and control groups were examined with an immunohistochemical staining technique with monoclonal antibodies against CD3, CD4, and CD8 surface antigens of T lymphocytes. In every specimen, the numbers of CD3+, CD4+, and CD8+ cells were calculated in 3 to 4 high magnification field on light microscopy, and the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and deep paraglandular layer of the mucosa was determined. Statistical analysis by Kruskal-Wallis analysis of variance and the Mann-Whitney U test with Bonferroni correction revealed that the CD3 epithelial layer value of the inferior turbinate (p = .030) and the CD4 deep layer value of the middle turbinate (p = .048) were significantly higher than the corresponding values of the control group. In the epithelial (p = .018) and subepithelial (p = .012) layers of the uncinate process group, in the epithelial (p = .050) and subepithelial (p = .012) layers of the ethmoid sinus group, and in the subepithelial (p = .018) and deep paraglandular (p = .012) layers of the middle turbinate group, the difference between the CD4+ and CD8+ cell counts was found to be statistically significant by the Wilcoxon signed rank test. The number of CD4+ cells was higher than the number of CD8+ cells. In conclusion, T cells play a role in the pathophysiology of chronic sinusitis. CD4+ T helper cells, in particular, are predominant at the initiation and regulation of inflammation. The uncinate process, ethmoid sinus, and middle and inferior turbinates have the main roles by T cells and subtypes in the defense system in chronic sinusitis.     

Th1: Mediator Lymphocytes in Experimental Autoimmune Labyrinthitis

A previous study on experimental autoimmune labyrinthitis (EAL) consistently demonstrated transient infiltration of lymphocytes only into the inner ear of mice. To clarify the profile of lymphocytes in the initiation of EAL, the present study investigated cell surface antigens, as well as cytokines, from Day 4 to Day 35, using immunohistochemical techniques. Many CD4+ cells mainly infiltrated the endolymphatic sac as early as Day 4 and gradually spread to the rest of the inner ear. Infiltration peaked on Day 12 and persisted in most animals until Day 35, although the number of cells gradually decreased. In contrast, very few CD8+ cells were found to have appeared in the inner ear of all animals on Day 10, and the number of cells rapidly decreased. Many cells positive for IFN- &#110 and IL-2 were identified in the endolymphatic sac on Day 4. These results suggest that helper T1 lymphocytes, rather than cytotoxic T lymphocytes, may play a central role in the initiation of EAL.     

Th1: mediator lymphocytes in experimental autoimmune labyrinthitis.

A previous study on experimental autoimmune labyrinthitis (EAL) consistently demonstrated transient infiltration of lymphocytes only into the inner ear of mice. To clarify the profile of lymphocytes in the initiation of EAL, the present study investigated cell surface antigens, as well as cytokines, from Day 4 to Day 35, using immunohistochemical techniques. Many CD4+ cells mainly infiltrated the endolymphatic sac as early as Day 4 and gradually spread to the rest of the inner ear. Infiltration peaked on Day 12 and persisted in most animals until Day 35, although the number of cells gradually decreased. In contrast, very few CD8+ cells were found to have appeared in the inner ear of all animals on Day 10, and the number of cells rapidly decreased. Many cells positive for IFN-gamma and IL-2 were identified in the endolymphatic sac on Day 4. These results suggest that helper T1 lymphocytes, rather than cytotoxic T lymphocytes, may play a central role in the initiation of EAL.     

Clinical aspects and distribution of immunologically active cells in the nasal mucosa of patients with nasal polyps after endoscopic sinus surgery and treatment with topical corticosteroids

Summary Clinical parameters of 72 patients who were operated upon for nasal polyps were evaluated as well as biopsy specimens of the mucosa of the middle and inferior turbinates of 41 of these patients. Biopsies were taken at the time of endoscopic sinus surgery (ESS), after 6 months and after 1 year in 23 patients. During the follow-up period the patients were treated with topical corticosteroids (budesonide). At the time of ESS significantly more CD8+ (suppressor/cytotoxic) cells than CD4+ (helper/inducer) cells were found in the middle and inferior turbinates. At 6 months significantly more CD4+ cells were found than at the time of ESS, whereas at 1 year the number of CD4+ cells had decreased and was lower than at 6 months. These data support the theory that the occurrence of nasal polyps is associated with T-cell-dependent disturbances. Clinical evaluation revealed that most of the patients with chronic airway obstruction had better pulmonary functions postoperatively or required less medication for lung disease. These findings show that ESS combined with topical corticosteroids has a positive effect on upper and lower respiratory tract pathology. Correspondence to: A. E. Stoop