The influence of tonsillectomy on cell-mediated immune response

Summary In order to ascertain the influence of a possible immunoregulatory effect of tonsils on the organism, phytohaemagglutinin (PHA) and concanavalin A (Con A) stimulation and the suppressor index in peripheral blood lymphocytes were determined in the pre-operative and postoperative course. Consistent statements on a possible effect of the tonsil can not be made from the results obtained.     

童年后扁桃体切除对人体免疫功能远期影响的研究

目的探讨童年后扁桃体切除对人体免疫功能的远期影响。方法采用配对对照法,对30例扁桃体切除术后5年以上(平均20.5年)、切除时年龄10岁以上(平均21.5岁)的病例和30例未行扁桃体切除的配对对照者进行术后病史问卷调查和相关免疫学指标检测。结果与对照组比较,观察组病例术后上感发生频率、免疫相关性疾病罹患率的组间差异无统计学意义,但上呼吸道慢性炎症罹患率为40%,显著高于对照组(6.7%,P<0.05);血清IgA水平和中性粒细胞比例虽然显著低于对照组(P<0.05),但观察组病例的绝对数值仍在正常范围内;其余各项相关指标组间差异均无统计学意义。结论童年后扁桃体切除可能会增加上呼吸道慢性炎性疾病(特别是慢性咽炎)的罹患率,甚至可能引起个别免疫学指标改变,但对人体一般健康状况和整体免疫功能无明显远期影响。     

Early stage impacts of tonsillectomy on immune functions of children

OBJECTIVE: The purpose of this study was to investigate the changes in the humoral and cellular immunity of patients with chronic tonsillitis before and 1 month after tonsillectomy. PATIENTS AND METHODS: 37 patients scheduled for tonsillectomy were enrolled in this study. The levels of CD3+, CD4+, CD8+, CD19+, CD25+ and CD16+ + 56+ were measured for cellular immunity, and levels of IgG, IgA, IgM, C3 and C4 were measured for humoral immunity in blood samples taken from these patients before and 1 month after the operation. RESULTS: The levels of CD3+, CD8+ and CD19+ were reduced in post-operative period as compared to pre-operative period but this was not statistically significant (P > 0.05). However it was found that the level of CD4+ was significantly increased while the level of CD25+ was reduced (P < 0.05) in the post-operative period. There were statistically significant differences between pre- and post-operative levels of immunoglobulins, C3 and C4, which were decreased after tonsillectomy (P < 0.05), but these levels were comparable with those of the control group. CONCLUSION: The results from the present study indicate that humoral and cellular immunity of patients undergoing tonsillectomy were decreased in the early period and came to normal later. The cellular and humoral immune responses are stimulated in patients with tonsillitis, and tonsillectomy removes this stimulus without negatively affecting the patient's immune functions.     

The cell-mediated response of the guinea pig's middle ear

In this project, we studied the cell-mediated response of guinea pig's middle ear. The specific objective was to characterize rejection of skin grafts on the back (allo- and iso-grafts) after primary stimulation (iso- or allo-) in the ear or on the back. The method used was the mixed lymphocyte response with and without phytohemagglutinin (PHA). Preliminary results showed that the middle ear is able to mount a normal immune response, both locally and systemically. Such basic studies will help us to understand the otologic immune response as a whole and may shed some light on the immune phenomena observed in middle ear transplantations.     

Studies on the cell-mediated immune response of tonsillar lymphocytes with regard to the clinical course and patient's age

There was no statistically significant difference in the intensity of the cell-mediated immune response of tonsillar T cells among different pathological conditions of the tonsils nor among different age groups. The tonsillar cell population of the adult was smaller than that of the child. Tonsillar cells were separated into 3 fractions with different specific gravities. In tonsillar cells from adults, fraction III consisting mainly of small lymphocytes with a high specific gravity occupied a larger portion than in those from children. Fraction I consisting of cells with a low specific gravity had a greater number of cells in the swollen tonsils of children than in the tonsils of adults. However, the absolute numbers of the cells in fraction III in adults and in children were nearly the same. The proportion of T cells in fraction III was higher than in fraction I. Hence, the proportion of T cells in adults' tonsils is higher than in children's tonsils. The cells composing fraction I include some cells that have undergone blastoid transformation in response to various stimuli and some lymphoid cells that are ontogenetically immature T cells, besides mature T cells. The cells composing fraction III include fully mature T cells and the total cell population of fraction III does not differ significantly with age. It seems likely that the child's tonsil contains a larger number of cells under antigenic stimulation or in preparation for immune response than does the adult's tonsil.     

低温等离子射频扁桃体部分切除术对儿童免疫功能的影响

我科2010-01-2010-12对并发扁桃体肥大的89例OSAHS患儿行低温等离子射频扁桃体部分切除术,并测定术前和术后1周、1个月、3个月、6个月血清中IgG、IgM、IgA、C3、C4水平,以探讨儿童扁桃体部分切除术对免疫功能的影响。1资料与方法1.1临床资料患儿均使用微动敏感睡眠床垫监测系统行睡     

The influence of tonsillar obstruction and tonsillectomy on facial growth and dental arch morphology.

Children, who were tonsillectomized because of sleep apnea were examined with respect to facial growth and dental arch morphology. Dental casts and lateral roentgencephalograms were analysed before surgery and two years after tonsillectomy. The findings were compared to data from children without tonsillary obstruction. A higher proportion of malocclusion than normal, especially open bite and crossbite, was noticed before surgery. Two years after surgery, 77% of the open bites were normalised and 50-65% of the buccal and anterior crossbites. The best results were seen in children operated before the age of 6.     

Experimental autoimmune labyrinthitis induced by cell-mediated immune reaction

This study was designed to establish an experimental cell-mediated autoimmune labyrinthitis model in C57BL/6 mice, which could exhibit high reproducibility and be adopted for precise immunological analysis. Inner ear antigen (IEA) was prepared from bovine membranous labyrinth. Following pretreatment with cyclophosphamide (CP) and primary sensitization with IEA/FCA, many inflammatory cells infiltrated transiently into the perilymphatic and endolymphatic regions of the cochlea, vestibule and the endolymphatic sac, but not into the kidney, lung, brain or liver. This reaction occurred from day 7 and peaked on day 12 in all animals, and then rapidly reduced. This reaction occurred in all experimental mice during day 10 to day 12. The control mice showed no cellular reaction in the inner ear. These results suggest that the inner ear may possess cross-species organ-specific antigen and that a cell-mediated immune reaction may play an important role in the induction of autoimmune labyrinthitis.     

Antibody response to pneumococcal vaccination as related to tonsillectomy

In each of twelve matched pairs of patients undergoing tonsillectomy one patient was vaccinated with Pneumovax, a pneumococcal polysaccharide antigen, prior to tonsillectomy, the other patient being vaccinated after tonsillectomy. Sera were tested for antibody response to three different pneumococcal types of IgG, IgA and IgM classes. The patients with intact tonsils at vaccination did not develop higher antibody response than did those tonsillectomised prior to vaccination. On the contrary, in the case of pneumococcus type 6A, the IgM antibody response in tonsillectomised patients was significantly higher than that in patients with intact tonsils at vaccination (p = 0.021). Thus, the present study did not support the notion that tonsillectomy affects antibody response against pneumococcal vaccination. The palatine tonsils' role as an immunologically reactive organ is also discussed.     

The effect of tonsillectomy on eustachian tube function

A two-part study was designed to investigate the effect of tonsillectomy on eustachian tube function and to identify if any change is related to postoperative pain. Middle ear pressure was measured by tympanometry and results were classified as type A (+50 daPa to ?99 daPa), type B (flat) or type C (?100 daPa to ?350 daPa). Thirty-one patients with type A tympanograms, undergoing tonsillectomy enrolled in study A. Patients had tympanometry the next day and filled in a questionnaire incorporating visual analogue pain scores. In study B, 30 patients underwent a similar protocol and were followed up at 1 week with tympanometry and a questionnaire. A control group of 26 patients undergoing appendicectomy was recruited. Follow-up was available on 23 patients from study B. Combining A and B, on the first postoperative day 39% of patients developed type C tympanograms. No member of the control group developed any change in middle ear pressure. There was no significant relationship between pain scores for throat pain or otalgia and the development of negative middle ear pressure. By day 7 all patients had type A tympanograms. Otalgia was a delayed symptom significantly associated with increased throat pain. Transient negative middle ear pressure commonly occurs following tonsillectomy.     

The influence of phase inversion on the auditory evoked response

The amplitude of the auditory evoked response (N₁P₂) was measured over repeated tests on 24 normal hearing listeners. 200 and 2 000 Hz were presented in-phase (S₀) and out-of-phase (S_π) at moderate intensity levels. Response amplitude for S_π was significantly larger (p < 0.025) than that for S₀ when the tonal stimulus was 200 Hz. The results of psychophysical tests ruled out the possibility that this finding could be attributed to differences in loudness between S_π and S₀. No statistically significant difference in response amplitude was found between S_π and S₀ when 2 000 Hz was employed. These data are discussed with reference to the research on masking level differences.     

The Effect of tonsillectomy and adenoidectomy on neutrophil chemotaxis

Although tonsillectomy and adenoidectomy are common surgical procedures, the effects of these operations on the immune system have not been thoroughly determined. Our data on neutrophil chemotaxic functions in a group of 17 patients with chronic tonsillitis and adenoid hypertrophy show that chronic tonsillitis and adenoid hypertrophy impair neutrophil chemotaxic functions and that there is a subsequent normalization of these values following tonsillectomy and adenoidectomy.