Prevalence of the Helicobacter pylori in the tonsils and adenoids

IntroductionThere is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue.ObjectiveA clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis.MethodsPhosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients’ serum by using polymerase chain reaction.ResultsHp IgG was detected in 57 (89%) patients’ serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism.ConclusionThis study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas.     

人腭扁桃体隐窝上皮结构的研究

采用扫描电镜、透射电镜及光镜免疫金银法观察了31例慢性扁桃体炎患者和8例胎儿的扁桃体隐窝上皮结构及其中细胞的分布。电镜观察发现隐窝上皮表面存在三种类型微隐窝开口,其腔内有浸润细胞、异物及细菌。有三种特化上皮细胞(M细胞)覆盖于Ⅲ型微隐窝开口处,其结构与肠道M细胞相似,其数量随扁桃体炎的反复发作而减少。形态表明微隐窝是浸润细胞和外来抗原的出入口。M细胞与抗原的摄取及传递有关。光镜免疫金银法观察证明上皮浸润细胞中多数为OKT_s~+细胞,其中OKT_4~+者又占多数而OKT_s~+细胞较少,这些细胞是隐窝上皮参于免疫应答的结构基础。     

Route of lymphocyte migration through the high endothelial venule (HEV) in human palatine tonsil

Eleven palatine tonsils were collected from subjects who underwent tonsillectomy in Christian Medical College Hospital and the route of migration of lymphocytes through the high endothelial vessel was studied under EM. In the interendothelial route, migration of a lymphocyte through HEV wall began with the adhesion of a lymphocyte to the surface of endothelial cells by means of a short cytoplasmic projection in the vicinity of intercellular space. The projection extended into the cleft between adjacent endothelial cells. The lymphocyte migrated through HEV by diapedesis. After the lymphocyte had traversed the interendothelial space, it occupied the subendothelial space. In the transendothelial route, migration of a lymphocyte through HEV was initiated by adherence of the lymphocyte to the endothelial cell. The adherent lymphocyte compressed or invaginated into the cytoplasm of the endothelial cell, entered the endothelial cell, was completely enclosed within the endothelial cell cytoplasm, and emerged from the endothelial cell to occupy the subendothelial space. Evidence is presented from static transmission electron microscopic pictures for the migration of lymphocytes by both interendothelial and transendothelial routes through the high endothelial venule.     

Immunopathological features of palatine tonsil characteristic of IgA nephropathy: IgA1 localization in follicular dendritic cells

IgA nephropathy (IgAN) is generally thought to be mediated by the glomerular deposition of circulating immune complexes containing IgA as the major antibody component. Upper respiratory infections and tonsillitis often precede IgAN. and in some cases tonsillectomy is affective for the (treatment of IgAN. Thus, the tonsil seems to be a unique organ causing initial and/or progressive events to generate nephritogenic immune complexes in IgAN. in this study we focused on the analysis of immunopathological features of the palatine tonsil characteristic of IgAN patients by using an immunohistochemical technique. The IgAl subclass was demonstrated in follicular dendritic cells (FDC) of the tonsil of IgAN patients, but not in FDC of non-IgAN controls. On the other hand, IgA2, IgG, IgM and C3 did not show any differences in distribution between the two groups. Moreover, the expression of decay-accelerating factor (DAF), an inhibitor of homologous complement activation, and transforming growth factor-beta I (TGF-/β1). an inducer of antibody-producing ceils to IgA class switching, in FDC and interdigitating dendritic cells of the tonsil, respectively, which was also clarified in this study for the first time, was found to be identically distributed in the two groups. These findings may support the idea that IgA1. possibly in an immune complex form, is trapped by FDC and plays an important role in the persistent activation of particular B cell repertoires responsible for ihe onset and/or progression of IgAN.     

Blood vascular architecture of the palatine tonsil in the musk shrew (Suncus murinus): scanning electron microscopic study of corrosion casts

The musk shrew, Suncus murinus, is one of the primitive mammals and has a pair of palatine tonsils. In the present study, we investigated the blood microvascular architecture of the tonsil in this animal by scanning electron microscopy of corrosion casts. The paranodular arterioles entered the lymph nodule to form a coarse capillary plexus within the nodule. Some of the arterioles reached the dome region to give rise to a fine meshwork of dome subepithelial capillaries. This dome subepithelial capillary network did not show any hairpin or switch-back patterns, as seen in human and rabbit tonsils. Both of the nodular and dome capillaries were drained into the postcapillary venules in the periphery of the nodular or the paranodular region. On the surface of these cast venules, oval-shaped indentations were seen corresponding to the luminal surface of the high endothelial venules. These venules were collected into the large vein at the bottom of the tonsil. The blood vascular architecture of the musk shrew tonsil is basically the same as those of other mucosa-associated lymphoid tissues in mammals.     

Reticular crypt epithelium and intra-epithelial lymphoid cells in the hyperplastic human palatine tonsil: An immunohistochemical analysis

Extensive immunohistochemical analyses of the hyperplastic human palatine tonsil disclosed variegated B cell phenotypes on the lymphoid cells among the crypt epithelium. The reticular epithelial network was evident by cytokeratin immunostaining. The reticular epithelium near the crypt Iumen was positive for Iysozyme. Secretory component was negative, while HLA-DR was frequently expressed. Intramucosal small Iymphocytes, densely distributed in the Iuminal side, consisted mainly of B cells expressing CD19, CD20, CD21, CD22, CD45R, CD74, DBB42, HLA-DR, HLA-DQ, bcl-2 protein and surface lgM. Some B cells revealed mantle zone phenotypes (surface IgD+, CD5+, CD24+, DBA44+, CD10^--, DNA7^--). Cells of germinocyte phenotype (CD10+, DNA7+) were sparsely seen. A good number of intramucosal lymphoid cells were further labeled for CD11b, a phenotype of so-called B-1 cells. Plasma cells were clustered within the basal half. IgG was their major immunoglobulin class, followed by IgA, IgM and lgD classes. A smaller number of T cells (CD2+, CD3+, CD5+, CD45RO+, TCR αβ+) were identified among the epithelium. CD4+ cells predominated over CD8+ cells. TCR γΔ + cells were rare. Macrophages (CD68+), dendritic histio-cytes (S-100 protein+, CD1+), and natural killer cells (CD16+ or CD57+) were also dispersed. Another unique feature of this lymphoepithelial complex was the existence of HLA-DR intramucosal microvasculature, where lymphocyte recirculation was suggested. Proliferating cell nuclear antigen was detected commonly in the epithelial cells but rarely in the lymphoid cells. Possible lymphoepithelial interactions and morphologic similarities to the thymic medulla are discussed.     

腭扁桃体血管的应用解剖

在30例已固定的成人尸体头部标本上观察了腭扁桃体的动脉、静脉及其毗邻关系。腭降动脉及腭升动脉腭支主要分布于扁桃体的上极和上部;咽升动脉及腭升动脉主干分布于扁桃体的中部;面动脉主干及舌动脉则主要分布于扁桃体的下部和下极。以上各动脉分支均穿过咽上缩肌直接分带于扁桃体。腭扁桃体静脉先于其被膜下形成静脉网,再汇集成1～5支扁桃体静脉,后分别流入扁桃体旁静脉、咽静脉和舌静脉内。