Amígdalas y adenoides: defensa ante agentes patógenos y su implicancia estomatológica / Tonsils and adenoids: defend to pathogenic agents and their stomatological involvement

La función de las amígdalas siempre ha sido discutida, desde afirmar que no tenían funcionalidad, hasta la actualidad que se plantea un papel inmunológico, con actividad linfocitaria de defensa, debido a la localización de linfocitos en el tejido de las amígdalas. Este artículo de actualización pretende describir desde la embriología, histología, fisiología, patología y estomatología, el rol que desempeñan las mismas en su papel inmunológico ante la acción de agentes patógenos. Se destaca la acción conjunta de las amígdalas palatinas, amígdalas faríngeas o adenoides, amígdalas peritubarias, amígdalas linguales y todo el resto de tejido linfático que conforman el anillo linfático faríngeo o anillo de Waldeyer, ya que cumplen un rol determinante en la defensa del organismo (AU)

The function of the tonsils has always been debated, from stating that they had no functionality, to the present day that an immunological role is proposed, with lymphocyte defense activity, due to the location of lymphocytes in the tissue of the tonsils. This update article aims to describe from embryology, histology, physiology, pathology and stomatology, the role they play in their immunological role against the action of pathogens. The joint action of the palatine tonsils, pharyngeal or adenoid tonsils, peritubal tonsils, lingual tonsils and all the rest of the lymphatic tissue that make up the pharyngeal lymphatic ring or Waldeyer's ring is highlighted, since they play a decisive role in the defense of the organism (AU)

Repercussão da adenotonsilectomia sobre o sistema imune a curto e longo prazo / Short and long term impact of adenotonsillectomy on the immune system

As tonsilas palatinas e faríngea são órgãos linfoides imunologicamente reativos, que manifestam anticorpos específicos e atividade de células B e T em resposta a uma variedade de antígenos, desempenhando funções de imunidade humoral e celular. Os possíveis efeitos imunológicos da adenotonsilectomia ainda permanecem controversos. OBJETIVO: O propósito desse estudo foi investigar o impacto da tonsilectomia na imunidade celular e humoral em crianças a curto e longo prazo. MÉTODO: Desenho do estudo: longitudinal prospectivo. Foram incluídas 29 crianças com indicação de adenotonsilectomia por hipertrofia adenoamigdaliana. IgA, IgM e IgG séricas e contagem de linfócitos foram analisados em 3 períodos: antes, 1 a 2 meses (curto prazo) e 12 a 14 meses (longo prazo) após o procedimento cirúrgico. RESULTADOS: Houve aumento estatisticamente significante de linfócitos TCD4+ a curto prazo após adenotonsilectomia. Os valores de IgA e IgG apresentaram diminuição significante a longo prazo, mas permaneceram dentro dos parâmetros de normalidade para a faixa etária. CONCLUSÃO: Os resultados do presente estudo indicam que a adenotonsilectomia, tanto a curto como a longo prazo, não apresenta repercussão negativa sobre a imunidade celular e humoral das crianças submetidas a este procedimento.

Palatine and pharyngeal tonsils are immune reactive lymphoid organs that manifest specific antibodies and B/T-cell activity to respond to a variety of antigens. They perform humoral and cellular immune functions. The possible effects of adenotonsillectomy upon the immune system remain controversial. OBJECTIVE: To study the short and long-term impacts of tonsillectomy upon the cellular and humoral immunity of children. METHOD: This longitudinal prospective study included 29 children referred to adenotonsillectomy for adenotonsillar hypertrophy. Serum IgA, IgM, and IgG and lymphocyte counts were analyzed at three points in time: before surgery, 1-2 months after surgery (short term), and 12-14 months after surgery (long term). RESULTS: TCD4+ cell counts were significantly increased shortly after surgery. IgA and IgG values were significantly reduced in the long run, but were within normal ranges for this age group. CONCLUSION: This study indicated that adenotonsillectomy does not pose negative short or long term impacts upon the cellular and humoral immunity of children submitted to the procedure.

IgM, IgG, IgA serum levels and lymphocytes count before and after adenotonsillectomy

Tonsils and adenoids are involved in both local immunity and immune surveillance for the development of immune defense mechanisms. A number of investigators have found decreased immunoglobulin levels after adenotonsillectomy while others have failed to find significant changes. The effects of adenotonsillectomy on the cellular immunity of children have not been investigated extensively. To observe the change in humeral and cellular immune systems before and after operation in patients undergoing adenotonsillectomy. The study comprised 102 patients; all of the patients underwent adenotonsillectomy. The levels of IgG, IgA, and IgM were measured for humoral immunity and the percent of CD7 and CD19 positive cells were determined in blood samples taken from these patients 24 hours before operation and also 2 and 8 weeks after the operation. The results were subjected to statistical analysis. The present study shows that the serum level of IgA would rise few weeks after the operation. Changes in the IgM and IgG level were not statistically significant postoperatively. In addition, no significant change was detected in B lymphocyte count before and after adenotonsillectomy. In our study, there was a slight decrease in the T lymphocyte count in the early stage of post operation, which returned to normal preoperative value after 8 weeks. Several immune system parameters maintain its normal status several weeks after adenotonsillectomy

Mecanismos imunológicos da mucosa das vias aéreas superiores e fisiopatologia do anel linfático de Waldeyer: conceitos atuais / Immune mechanisms of the upper airways mucosa and pathophsiology of linphatic Waldeyer´s ring: current concepts

As vias aéreas superiores (VAS) são a principal porta de entrada do organismo. Apresentam uma ampla cobertura mucosa como barreira física aos agentes infecciosos, irritantes ambientais, etc. Há importantes mecanismos imunes específicos e inespecíficos nesta área.

Amigdalites: aspectos imunológicos, microbiológicos e terapêuticos / Tonsillitis: imunologics, microbiologics and therapeutic aspects

As amígdalas têm peculiaridades anatômicas, e o fato de que existe uma relação entre as amígdalas e o sistema imunológico tem sido claramente demonstrado. Vírus e bactérias são capazes de estimular as células mononucleares das amígdalas, e podem ter um papel importante na etiologia das migdalites recorrentes e hipertróficas. Os autores revisam os aspectos mais importantes da imunologia e bacteriologia das amigdalites, bem como seu tratamento.

Tonsil do have anatomical peculiarities, and the fact that there is a relationship between tonsils and te immune system has been clearly demonstrated. Virus and bacteria are known to stimulate the tonsillar mononuclear cells and may play an important role in the etiology of recurrent and hypertrophic tonsillitis. The authors revise te most important aspectos of the immunology and bacteriology of tonsils, as wells as ist treatmento.

Imunofisiologia do anel linfatico de Waldeyer / Imunnophisiology of Waldeyer's linfatic ring

O anel linfatico de Waldeyer (ALW), descrito pelo anatomista alemao Wilhelm Von Waldeyer, consiste em um aglomerado de tecido linfoide localizado de forma a circundar o istmo da orofaringe e a transicao entre a naso e orofaringe. Seus componentes sao tonsila faringea (adenoides), localizada na regiao mediana mais superior da parede superior da rinofaringe, estendendo-se lateralmente ate o ostio tubareo, encontrando o tecido que ai forma a tonsila tubarea. Abaixo e laterlamente a estes componentes, na abertura da orofaringe, encontra-se a tonsila palatina. O anel e completado pelas tonsilas linguais, que ocupam quase toda a extensao mais posterior do 1/3 posterior da lingua