Immunoglobulin-secreting cells in the surface secretion on the pharyngeal tonsils

As B-lymphocytes on the pharyngeal tonsils constitute a considerable part of the leukocytes in the surface secretion, and their biological role is obscure, we explored their possible function with respect to immunoglobulin production. Twenty children scheduled for routine adenoidectomy participated. Surface secretion from 10 children was analysed for presence of plasma cells and cells from the secretions of the other 10 children were tested in enzyme-linked immunosorbent spot assays (ELISPOT-assays) for their capacity to secrete and produce IgA, IgM and IgG. Plasma cells and cells that secreted IgA, IgM and IgG respectively were present in the secretions of all tested children. In eight of ten children the IgG immunocytes, Ig-producing blasts and plasma cells. outnumbered the IgA immunocytes. The number of immunoglobulin secreting cells (ISCs) was reduced by half or more in cell suspensions exposed to the reversible protein synthesis inhibitor cycloheximide. It is concluded that immunocytes that produce and secrete immunoglobulin are present in the surface secretion on the pharyngeal tonsils. The production represents an addition to the immunoglobulins transported to the secretion by the poly-Ig receptor and by passive diffusion. The results shed new light on the pathogenesis of mucosal infections in the upper airways.

Increased occurrence of IgE+ and FcepsilonRI+ cells in adenoids from atopic children

BACKGROUND

To examine the influence of atopy on the different cell populations in adenoids, we investigated the presence of IgE+ cells, cells expressing the high-affinity receptor for IgE (Fc(epsilon)RI), and various other cell populations in adenoid tissue, in atopic and nonatopic children with otitis media with effusion (OME) or adenoid hyperplasia (AH).

METHODS

Cryostat sections of adenoids from 14 atopic and 16 nonatopic children suffering from long-lasting OME (n=15) or obstructive AH (n=15) were investigated with immunohistochemical markers for T-cell subsets, mast cells, eosinophils, plasma cells, CD25, CD1a, IgE, and Fc(epsilon)RI.

RESULTS

Sensitization to allergens was correlated to an increase of IgE+ cells in the epithelium (P<0.01), the extrafollicular area (P<0.0001), and the follicles (P<0.001) of the adenoids and an increase of Fc(epsilon)RI+ cells in the extrafollicular area (P<0.01). A minority of the IgE+ cells were plasma cells. No significant differences in cells stained for IgE, Fc(epsilon)RI, or the other markers were observed between patients with OME and AH.

CONCLUSIONS

Atopy is associated with increased numbers of IgE+ and Fc(epsilon)RI+ cells in adenoids irrespective of whether the child has OME or AH.

The macrophage origin of the HIV-expressing multinucleated giant cells in hyperplastic tonsils and adenoids

Replication and storage of virus are characteristic features of hyperplastic lymphoid tissues in HIV infection. In opportunistic infections, HIV is synthesized by phagocytic mononuclear and Langhans'-type multinucleated macrophages that coexpress the dendritic cell-associated S-100 and p55 antigens. However, similar cells in hyperplastic tonsils and adenoids from HIV+ individuals were alternatively identified as macrophages or, on the basis of the same S-100 and p55 staining, as dendritic cells. To consider establishing the role of these HIV-rich cells in HIV disease, it is important to reconcile this apparent discrepancy in identity. Hyperplastic tonsils and adenoid specimens were analyzed by HIV RNA in situ hybridization (ISH), light and transmission electron microscopy (TEM), and immunohistochemistry (IHC) (HIV Gag p24 protein, S-100, p55, CD68, HAM56, lysozyme, alpha-1-anti-trypsin, and alpha-1-anti-chymotrypsin). In HIV+ pediatric and adult surgical specimens (n = 11), the giant cells and their mononuclear counterpart were positive for both macrophage and p55 and S-100 IHC markers. In addition, TEM, p24 IHC, and ISH showed HIV expression by cells with typical features of macrophages. Furthermore, these cells were not unique to HIV+ specimens, being seen in 20% of hyperplastic T&A surgical specimens (n = 57) lacking HIV as well as in several types of granulomatous processes, such as sarcoidosis. These cells appear to represent an activated phenotype that can develop independent of HIV, but that may represent a viral host in HIV-infected individuals. Thus, the giant and mononuclear cells that produce striking amounts of HIV in tonsils and adenoids are of macrophage origin, yet, as in opportunistic infections, share dendritic cell-associated antigens, reflecting a common CD34+ bone marrow progenitor.

Muscarinic ciliostimulation requires endogenous prostaglandin production

Prostaglandin E2 (PGE2) is a known modulator in upper airway ciliary activity and may be involved in the transduction of the muscarinic acetylcholine receptor signal. We studied the in vitro effects of muscarinic ciliostimulation on ciliary beat frequency (CBF) and PGE2 in human adenoid explants to determine whether PGE2 production is an essential step in the signal transduction mechanism. Methacholine applied to adenoid explants significantly increased ciliary beat frequency. This effect was blocked by the application of diclofenac, a cyclooxygenase inhibitor. Using radioimmunoassay, PGE2 production was measured during ciliostimulation with methacholine. Methacholine produced a significant increase in production in PGE2 during ciliostimulation. The roles of phospholipase C and phospholipase A2 in prostaglandin production were investigated by inhibiting these enzymes. D609, a phospholipase C inhibitor, significantly inhibited ciliary beat frequency increase and PGE2 production during methacholine stimulation. However, PACOCF3, a phospholipase A2 inhibitor, did not block ciliary beat frequency increase or PGE2 production in response to methacholine. These data show that phospholipase C is required for PGE2 production and ciliostimulation.

Do the leukocytes in the surface secretion on the adenoid have an immunological function?

To elucidate whether leukocytes in the surface secretion on the adenoid have a potential immunological function, imprint samples of surface secretion were obtained from the adenoid of 11 children and the corresponding mucosal area of 10 adults. May-Grünewald-Giemsa staining was used for evaluation of cell morphology and spatial relations, and immunohistochemical staining for identification of granulocytes, B cells, T cells and macrophages. The children's imprints showed large numbers of leukocytes, with mononuclear cells in the majority. The adults' imprints were characterized by moderate numbers of epithelial cells and few leukocytes. In six out of seven adenoid secretions successfully analysed with all four CD antigens, there was the simultaneous presence of granulocytes, B cells, 1 cells and macrophages. This was the case in one of nine analysable adult secretions. The CD-positive cells were often seen in juxtaposition, in clusters of two to 10 cells, as well as in contact with leukocytes of unknown CD antigenicity and epithelial cells. The simultaneous presence in the secretion of morphologically intact and CD antigen-presenting leukocytes in juxtaposition could indicate a potential immunological function of these cells.

Role of adenoids in the pathogenesis of otitis media: a bacteriologic and immunohistochemical analysis

Adenoidectomy is frequently performed in children suffering from recurrent or chronic otitis media with effusion and is thought to produce a long-term effect in preventing further episodes of otitis media. Bacteriologic analysis of adenoids from 60 patients revealed a significantly elevated colonization rate of middle ear pathogens in children with a present or previous history of ear disease compared to children with adenoidal hypertrophy only. The predominant pathogen was nontypeable Haemophilus influenzae, followed by Streptococcus pneumoniae and Moraxella catarrhalis. Quantitative analysis did not demonstrate a bacterial overload in the otitis group. Lectin histochemical analysis of the adenoids revealed no significant differences between the three groups; nevertheless, colonization with S pneumoniae demonstrated an increased labeling pattern with succinylated wheat germ agglutinin, indicating the exposure of N-acetyl-glucosamine as part of its own receptor structure. On the basis of these results, we support the concept of adenoidectomy in order to remove a bacterial focus; however, we could not verify the hypothesis of bacterial overgrowth in the nasopharynx.

Respiratory syncytial virus induces selective production of the chemokine RANTES by upper airway epithelial cells

The presence of histamine and eosinophil cationic protein in nasopharyngeal secretions of infants with respiratory syncytial virus (RSV)-induced bronchiolitis implies the activation of basophil and eosinophil leukocytes, but the specific mechanism of their recruitment has not been elucidated. Chemokines are potent and selective leukocyte chemotactic molecules that are also expressed by airway epithelial cells. Therefore, the pattern of chemokines produced in response to RSV infection was investigated in primary cultures of human nose- and adenoid-derived epithelial cells. Interleukin-8, growth-related peptide-alpha, and monocyte chemotactic protein-1 were constitutively released by uninfected epithelial cells and were not further enhanced by infection with RSV. RANTES (regulated upon activation, normal T cell-expressed and -secreted), which was present in negligible concentrations in uninfected cultures, was strongly induced by RSV infection, in a dose- and time-dependent manner. Through the release of RANTES, epithelial cells may control the selective concentration and activation of basophils and eosinophils in RSV-infected airway mucosa.

Concentrations of azithromycin in tonsilar and/or adenoid tissue from paediatric patients

Azithromycin levels in tonsillar and/or adenoid tissue were determined in children (1.6-7.5 years old) who were scheduled for surgical removal of their tonsils and/or adenoids. The children received azithromycin oral suspension 10 mg/kg once daily for 3 days. Tissue samples were obtained during surgery 1 (n = 4), 2 (n = 5), 4 (n = 6), or 8 (n = 5) days after the last dose of azithromycin. Serum samples were also obtained from four children in each of these groups at the time of surgery. Mean tissue concentrations of azithromycin were 10.33 +/- 3.01, 7.21 +/- 4.04, 9.30 +/- 3.74 and 1.49 +/- 0.48 mg/kg, respectively, 1, 2, 4 and 8 days after the last dose. At the corresponding times, serum concentrations were markedly lower: 47.25 +/- 19. 19, 14.00 +/- 8.45, 8.00 +/- 2.16 and < 4 micrograms/L, respectively. The mean tissue:serum concentration ratios were, 227 +/- 54, 547 +/- 184 and 956 +/- 355, respectively, 1, 2 and 4 days after treatment. No adverse events attributable to azithromycin were observed in any of the 23 children who had received at least one dose of azithromycin. The study shows that levels of azithromycin in tonsillar and adenoid tissue were consistently higher than in serum and remained elevated up to 8 days after the end of dosing, supporting the use of a short-course (3-day), once-daily regimen of azithromycin in the treatment of upper respiratory tract infections.

Concentrations of cefpodoxime in plasma, adenoid, and tonsillar tissue after repeated administrations of cefpodoxime proxetil in children

Cefpodoxime proxetil was administered to 36 children undergoing tonsillectomy, adenoidectomy or both. It was very well tolerated. The detectable tissue concentrations of cefpodoxime were moderate but remained constant (approximately 0.05 mg/kg) 3, 6, and 12 h after the last dose of the drug, while the respective plasma concentrations were declining. This suggests the possibility of twice-daily administration. However, 30% of children did not have quantifiable concentrations in the tonsil and more than half the adenoids did not have quantifiable levels. Whether a higher dosage would lead to higher and more satisfactory tissue concentrations is a matter for further investigation.

Growth of influenza A virus in primary, differentiated epithelial cells derived from adenoids

Epithelial cells of adenoid origin were grown in tissue culture to examine viral replication in cells that are the primary target of many human pathogens. These cells remained highly differentiated, with subpopulations of cells which retained active ciliary motility and others which demonstrated specialized secretory functions. The epithelial cells were permissive for growth of influenza A virus. Primary respiratory epithelial cells provide a model system for examining virulence, cell tropism, and receptors which replicate in the nasopharynx.

Intraepithelial lymphocyte subpopulations and dendritic accessory cells in normal and hypertrophic adenoids

The adenoids have been studied by immunocytochemistry and electron microscopy in children with and without adenoidal enlargement. Compared with normal adenoids, the enlarged ones showed a marked increase in the number of intraepithelial gamma-delta TCR+ lymphocytes and a slight increase in the number of intraepithelial CD8+ lymphocytes. This was accompanied by large amounts of dendritic human lymphocyte antigen (D related) (HLA-DR+) S-100+ accessory cells in the lymphoid tissue underlying the epithelium. By electron microscopy, dead epithelial cells apposed to intraepithelial lymphocytes, and clefts of the epithelial lamina, could be seen frequently in the enlarged adenoids, whereas, in the normal ones, they could not. Based on these findings, the hypothesis is drawn that imbalance of the system of the intraepithelial cytotoxic lymphocytes may lead to increased killing of epithelial cells and uncontrolled penetration of exogenous agents, and hence be involved in the pathogenesis of adenoidal hypertrophy.

Penetration of cefprozil into tonsillar and adenoidal tissues

Penetration of cefprozil into tonsillar and/or adenoidal tissues was investigated for patients undergoing tonsillectomy and/or adenoidectomy. A total of 29 patients ranging in age from 2 to 14 years participated in the study. The tonsils and/or the adenoids were removed at times ranging from 0.33 to 3.17 h after oral administration of a dose of either 7.5 or 20 mg/kg of body weight. A blood sample was also collected as soon as the tissue sample was removed. Plasma, tonsil, and adenoid samples were analyzed for cis and trans isomers of cefprozil by high-performance liquid chromatographic assays. The concentrations of the cis isomer of cefprozil in plasma ranged from 0.60 to 9.87 micrograms/ml at the 7.5-mg/kg dose level and from 1.04 to 20.40 micrograms/ml at the 20-mg/kg dose level. The corresponding concentrations of the cis isomer in tonsil tissue ranged from 0.48 to 2.42 micrograms/g and from 1.00 to 4.29 micrograms/g, respectively. The corresponding concentrations of the cis isomer in adenoid tissue ranged from 0.40 to 4.20 micrograms/g and from 1.74 to 4.94 micrograms/g, respectively. The concentrations of the trans isomer were about 1/10 of those observed for the cis isomer. The median ratios of the cefprozil concentration in tonsillar tissue to that in plasma were 0.37 and 0.47 for patients receiving a 7.5- or a 20-mg/kg oral dose of cefprozil, respectively. The corresponding median ratios for the adenoidal tissue were 0.46 and 0.82, respectively. The cefprozil concentrations in either the tonsillar or the adenoidal tissue at both dose levels over 3.17 h after dosing are much higher than the MICs for common pathogens which cause pharyngitis or tonsillitis.

Distribution characteristics of immunoglobulin-secreting cells in adenoids. Relationship to age and disease

Forty-four adenoids and 52 palatine tonsils from 71 children and adolescents (age 3-21 years) undergoing surgery because of adenoidal hypertrophy or recurrent tonsillitis were examined for the presence of immunoglobulin-secreting cells (ISC) employing an enzyme-linked immunospot assay (ELISPOT). ISC constituted less than 2% of the mononuclear cell population. Adenoids contained IgG, IgA, and IgM ISC in significantly lower numbers than palatine tonsils. The predominant isotype of the ISC was IgG, in adenoids accounting for 62% of the ISC and in palatine tonsils for 73%. The relative numbers for IgA and IgM ISC were similar. A significant correlation existed between autologous adenoids and palatine tonsils for the numbers of IgA and IgM ISC, but not for the numbers of IgG cells. These observations suggest that, adenoid and palatine tonsils display similar immunoglobulin distribution patterns within a single individual. However, individuals with hypertrophied adenoids exhibited a numeric decrease in IgG ISC with increasing age (P less than 0.01). Both lymphoid tissues may be involved in mucosal immune defense.

Cytokines produced in lymph follicles

The events occurring inside lymph follicles during a germinal center reaction are poorly understood. Using B and T lymphoid cell populations prepared from human tonsillar lymph follicles, and enriched or not in macrophages or in follicular dendritic cells, we examined the production of cytokines by these cells in vitro. Interleukin 6 (IL-6) and tumor necrosis factor (TNF) were found in the supernatants of cultures stimulated with phytohemagglutinin or pokeweed mitogen. IL-1 beta was occasionally detected; its secretion apparently depends on the origin of the tonsils, the stimulation, and the cell populations. IFN-gamma and IL-2 were not produced in significant amounts by these lymph follicle cells. IL-4 was only found in very low concentrations in the supernatant of the different cell cultures. The cell populations containing follicular dendritic cells produced more IL-6 and TNF than the others, especially than those composed of only B and T cells.

The effects of metoclopramide and cloxacepride on human mast cells from adenoidal tissues

Cloxacepride is an amide of the dopamine antagonist metoclopramide and has been reported to possess oral antiallergic properties in the rat PCA model. Both substances have now been tested in isolated mast cell preparations from human adenoidal tissues to determine whether any therapeutic antiallergic potential in man could be expected. Metoclopramide at concentrations 10(-5)-10(-3) M had no inhibitory effect but instead enhanced Con A-induced histamine release at concentrations greater than 10(-4) M. Cloxacepride at concentrations 10(-5)-10(-4) M significantly inhibited Con A-induced histamine release. This inhibitory effect was not diminished by increasing the preincubation time for up to 30 min. In contrast, cloxacepride concentrations greater than 4 x 10(-5) M caused a substantial histamine release. This effect could not be alleviated by an increase in the number of mast cells per sample. These results then suggest a very narrow range of therapeutic potential for cloxacepride.

[Rational dosing intervals in streptococcal infections of the pharynx]

Optimum therapy of streptococcal pharyngitis is still a matter of great debate. Kill kinetics of streptococci group A were investigated under the influence of fluctuating concentrations of penicillin V, ampicillin, cefalexin and erythromycin. Antibiotic concentrations in our in vitro model were adjusted to concentrations found in vivo in tonsillar tissue, penicillin V showed superior antimicrobial activity to ampicillin, cefalexin and erythromycin. Only the eight hourly administration of concentrations determined after the in vivo administration of either 100,000 IU/kg BW penicillin or 100 mg/kg BW of ampicillin or cefalexin effectively eradicated streptococci in the kinetic model. beta-lactamase forming bacteroides did not interfere with the elimination of streptococci by non beta-lactamase stable antibiotics. These data suggest that penicillin V constitutes the optimum choice of antibiotic. Efficient eradication can be achieved by the administration of a total daily dosage of 100,000 IU/kg BW at 8 hourly intervals.

Human mast cell heterogeneity: histamine release from mast cells dispersed from skin, lung, adenoids, tonsils, and colon in response to IgE-dependent and nonimmunologic stimuli

We have compared the ability of anti-IgE, calcium ionophore A23187, substance P, compound 48/80, poly-L-lysine, and morphine to release histamine from mast cells of human skin, lung, adenoids, tonsils, and colon. Use of a single collagenase/hyaluronidase dispersion technique for all tissues has allowed comparisons of reactivity to be made that are free from methodological variations. Mast cells from all tissues examined secreted histamine in response to anti-IgE and calcium ionophore A23187. However, only skin mast cells were responsive to substance P, compound 48/80, poly-L-lysine, and morphine. Activation of human skin mast cells by these nonimmunologic stimuli clearly distinguishes them from the mast cells of human lung, adenoids, tonsils, and colon and is indicative of functional heterogeneity within the human mast cells population. We propose that the presence of functional receptor sites for neuropeptides and basic compounds on skin mast cells that are not present in mast cell populations from mucosal or lymphoid sources reflects a specialized role for these cells in vascular homeostasis.

Isolation of follicular dendritic cells from human tonsils and adenoids. VI. Analysis of prostaglandin secretion

Follicular dendritic cells (FDC) are able to fix high amounts of immune complexes by C3b or Fc receptors without endocytosis and for long periods of time. In order to determine the function of this retention, we analysed the secretion of prostaglandin E2 (PGE2) by FDC in vitro; indeed, it is well-known that immune complex fixation on cells may induce PGE2 production. FDC were isolated by enzymic digestion of lymph follicles dissected under the biomicroscope from human tonsils or adenoids. Isolated FDC appeared as spherical clusters where they enveloped lymphoid cells with their cytoplasmic extensions. Tests were performed in synthetic culture media or in media supplemented with foetal calf serum. PGE2 production in FDC suspensions was compared to that of lymphocyte or macrophage-enriched populations prepared from the same human tonsils. In all experimental conditions, FDC and macrophage-enriched cell populations produced high levels of PGE2, inversely to lymphoid cell populations. This secretion was inhibited by indomethacin. At the ultrastructural level, we also showed that 3H-arachidonic acid was metabolized in cell membranes of all three cell types. The PGE2 produced in the culture media, according to our experimental conditions, do not influence cell proliferation, as assessed by 3H-thymidine incorporation tests on phytohaemagglutinin-stimulated lymphocytes.

The effects of prostaglandins of the E and I type on histamine release from human adenoidal mast cells

(PgE1 (10(-8)-10(-6) M) inhibited dose dependently the Con A-induced histamine release from human adenoidal mast cells. Out of two stable PgI analogues tested, EL 784 had a slight inhibitory effect at 10(-10) M, and SE 63 at 10(-4) M. PgI2 itself was ineffective.

Pathological and biochemical study in the adenoid of mucopolysaccharidosis II

In the patients with mucopolysaccharidosis II (MPS II, Hunter's syndrome), conductive and sensorineural hearing deficits are frequently observed. Two patients with MPS II underwent adenoidectomy and an ear douche, and their conductive hearing loss recovered after the surgery. Pathological examination of the adenoids revealed the infiltration of faintly PAS-positive plasmacytes with perinuclear vacuole and strongly Alcian-blue positive fibrotic area. Biochemical study was performed by chromatoscanning of electropholesis. The amount of glycosaminoglicans (GAG) in the specimens was increased 2.8-fold compared with the normal control. The electropholetic pattern showed an increase of dermatan sulfate (DS), heparan sulfate (HS) and hyaluronic acid (HA) in the adenoids of the patients. The ratio of DS to HS was 1.1-1.2. In the patients of MPS II, the accumulation of GAG occurs in the pharyngeal tonsil and causes conductive hearing impairment. We recommend adenoidectomy for such patients.

The effects of adenosine and of some adenosine analogues on the concanavalin A-or acetylcholine-induced histamine release from human adenoidal mast cells

Histamine release induced by concanavalin A (Con A) or acetylcholine is enhanced by adenosine or the adenosine analogues PIA and NECA. The enhancement is not affected by preincubation with adenosine deaminase. The degree of the Con A-induced histamine release decreases with increasing incubation time. Under these conditions, the enhancing effect of adenosine on histamine release is either abolished or even reversed to inhibition.

Penetration of cefaclor to adenoid tissue and middle ear effusion in chronic OME

Cefaclor given per os 20 mg/kg body weight was readily absorbed and distributed to adenoid tissue and to middle ear effusion in children with chronic OME. The levels obtained were above the MIC values of most strains of respiratory pathogens. The penetration characteristics were the same after the first and the 20th dose in a b.i.d. regimen. Elimination was completed within about 12 h. The double dose, 40 mg/kg body weight, did not give higher levels but a longer duration.

Histamine and secretory otitis media

Histamine, both free and cell associated, has been demonstrated in middle ear fluid from patients with secretory otitis media (SOM). Histamine, mainly free in solution, has also been shown to be present in nasopharyngeal secretions taken from close to the Eustachian tube openings into the nasopharynx. The adenoids from patients with middle ear effusion contained significantly (P less than 0.05) more histamine than those with no effusion. However, in preliminary experiments, we could demonstrate no differences in the histamine secretory response of adenoids from SOM and non-SOM patients to anti-immunoglobulin E (anti-IgE), house dust mite antigen and calcium inophore A23187 in vitro. These results support the hypothesis of an inflammatory basis for SOM.

Isolation of follicular dendritic cells from human tonsils and adenoids. II. Immunocytochemical characterization

Follicular dendritic cells (FDC) are specialized cells found only within lymphoid follicles. They bind immune complexes and play a role in the presentation of antigen to follicular B cells and in the generation of B cell memory. In the present report the isolation of FDC from human tonsils and adenoids is described. These isolated cells have an unusual spherical arrangement and enclose lymphocytes within extensions of their membranes. Their ultrastructural features are similar to those observed in situ. The reactivity of isolated FDC with a number of monoclonal antibodies was analyzed by immunofluorescence and by immunostaining (at the electron microscopic level) with colloidal gold. In keeping with the results of previous investigations on tissue sections IgM, IgG and IgA (but not IgD) can be detected on the surface of isolated FDC, as can C3b receptors and the FDC-associated antigen detected by monoclonal antibody R4/23. The immunoglobulins associated with FDC are mostly embedded in an electron-dense material. The majority of the lymphoid cells enclosed within the membrane extensions of FDC are of B cell type. These results suggest that isolated FDC may be suitable for further in vitro investigation of their role in the humoral immune response.

Isolation of follicular dendritic cells from human tonsils and adenoids. I. Procedure and morphological characterization

Follicular dendritic cells have been isolated from human tonsils and adenoids and characterized at the ultrastructural level. Follicles were dissected and digested with different hydrolytic enzymes. The cells were separated by sedimentation at unit gravity. By this procedure we obtained follicular dendritic cells enveloping lymphocytes with their cytoplasmic extensions in a way analogous to that described for isolated thymic nurse cells. The ultrastructural features of isolated follicular dendritic cells are similar to those observed in situ. Prolonged enzymatic action caused loss of the enveloped lymphocytes.

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.

The penetration of erythromycin into Waldeyer's ring--tonsil and adenoid tissue

Erythromycin ethylsuccinate was given orally (30-60 mg/kg/day) to 72 otherwise healthy children for different intervals before adenoidectomy. The concentration of erythromycin was assessed in homogenized tissue, in whole blood and in plasma, making it possible to calculate blood-free tissue levels. The tissue levels (1.5-2.0 mg/l) were the same as the plasma levels. Six patients with chronic tonsillitis were given 1000 mg erythromycin ethylsuccinate via a gastric tube, and tonsillectomy à froid was performed three to five hours later. This unusual mode of administration was chosen to avoid tonsil surface contamination, which might cause artificially high values. The concentration of erythromycin was assessed as described above. The levels of erythromycin in the tonsil tissue were the same as the concomitant plasma levels. Erythromycin has been shown to penetrate into adenoid and tonsil tissue and to attain levels similar to the simultaneous plasma levels. It may be inferred from this study that erythromycin penetrates into other lymphatic localities to the same degree.

Proliferation of cells and intracellular c-AMP content: comparative investigations of autologous lymphatic cells from palatine tonsils, nasopharyngeal tonsils, and blood

The c-AMP content and thymidine incorporation were determined in tonsillogenic, adenoid, and peripheral lymphatic cells. A significant c-AMP decrease with simultaneous increase of the thymidine incorporation compared to the blood lymphocytes was noted in the tonsillogenic and adenoid cells. The negative regulative effect of c-AMP on cell proliferation and the function of tonsils at this processes are discussed.

Penetration of azidocillin into the secretion and tissues in chronic maxillary sinusitis and tonsillitis

The penetration of azidocillin into the sinus mucosa and secretion as well as into tonsils and adenoids was studied. Altogehter 73 patients were included and they were arranged in four groups according to age, diagnosis and drug dose. The average azidocillin concentration was satisfactory and predictable in all tissues and well over the MIC for most upper respiratory tract pathogens studied. In the maxillary antrum secretion the values were much lower and in many cases under the MIC for hemophilus. This is thought to depend upon the drug's being bound to proteins in the secretions. The clinical results were good in all cases and the contribution of the surgical operation, particularly in providing drainage for the secretion, is obvious.

Inhibitory effects of mitogens on adenoidal lymphocytes in vitro

Cultures of human adenoidal lymphocytes exposed briefly to either phytohemagglutinin (PHA), Staphylococcus filtrate (Staph-F), concanavalin-A (Con-A), or pokeweed mitogen (PWM) incorporate increased amounts of thymidine earlier than replicate cultures exposed continuously to the mitogens. These effects can begin in the first 24 hr of culture and are seen maximally between 36 and 72 hr. Once a blastogenic response is established, PHA or PWM can diminish that response. Inhibition with PWM requires that the initial stimulation was with this mitogen, while PHA can inhibit blastogenesis to both PHA and PWM-stimulated cells. Because these mitogens can have a paradoxical effect on adenoidal lymphocytes, being capable of both initiating and inhibiting DNA synthesis, this phenomena should be kept in mind when such systems are utilized for the evaluation of antigens and drug effects.