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1.
Artigo em Russo | MEDLINE | ID: mdl-35485059

RESUMO

A review on the pathogenesis, clinical picture and diagnosis of dislocations of the cerebellar tonsils in the large occipital foramen and the spectrum of Chiari malformations Type 1 is provided. The issues of surgical treatment of such patients are discussed.


Assuntos
Malformação de Arnold-Chiari , Tonsila Palatina , Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Humanos , Tonsila Palatina/patologia
2.
J Otolaryngol Head Neck Surg ; 51(1): 14, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35387688

RESUMO

BACKGROUND: Tonsillectomy is a commonly performed procedure in Canada. The rate of occult malignancy is rare in adult and pediatric populations. At present, no guidelines exist surrounding the need for routine histopathological evaluation of tonsil specimens when no malignancy is suspected. METHODS: We sent a confidential online survey to active members of the Canadian Society of Otolaryngology - Head and Neck Surgery (CSO-HNS) about their current tonsillectomy practice and beliefs surrounding the need for routine histopathological evaluation of tonsillectomy specimens when no malignancy is suspected. We used Opinio survey software for data collection and descriptive statistics. RESULTS: 95 participants completed our survey (response rate 19.3%). Most participants reported performing both adult and pediatric tonsillectomies. When no malignancy is suspected, participant responses were split between whether they send tonsil specimens in pediatrics only (4.2%), in adults only (31.6%), or not sending specimens (29.5%). Half of the participants reported that routinely sending specimens to rule out occult malignancy is an institutional policy. Approximately 75% of participants were in favour of removing this practice in both the pediatric and adult populations. CONCLUSION: Eliminating the practice of automatically sending tonsil specimens for histopathological evaluation when no malignancy is suspected was supported by the majority of study participants. This is in keeping with Choosing Wisely, a campaign designed to facilitate conversations about unnecessary medical tests and procedures. Institutional change is likely required in order to alter this practice.


Assuntos
Neoplasias Primárias Desconhecidas , Otolaringologia , Cirurgiões , Tonsilectomia , Adulto , Canadá , Criança , Estudos Transversais , Humanos , Neoplasias Primárias Desconhecidas/patologia , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Tonsilectomia/métodos
3.
Vestn Otorinolaringol ; 87(1): 4-8, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35274885

RESUMO

OBJECTIVE: To summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders. The effectiveness of adenotomy, adenotonsillotomy and/or adenotonsillectomy in children is demonstrated, depending on the severity of obstructive sleep apnea syndrome. Evaluation of breathing in sleeping children by polygraphic methods is necessary for early detection of obstructive sleep apnea syndrome and monitoring the effectiveness of surgical treatment.


Assuntos
Apneia Obstrutiva do Sono , Tonsilectomia , Adenoidectomia , Criança , Humanos , Tonsila Palatina/patologia , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/cirurgia
4.
JCI Insight ; 7(5)2022 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-35133979

RESUMO

IgA nephropathy (IgAN) is a leading cause of kidney failure, yet little is known about the immunopathogenesis of this disease. IgAN is characterized by deposition of IgA in the kidney glomeruli, but the source and stimulus for IgA production are not known. Clinical and experimental data suggest a role for aberrant immune responses to mucosal microbiota in IgAN, and in some countries with high disease prevalence, tonsillectomy is regarded as standard-of-care therapy. To evaluate the relationship between microbiota and mucosal immune responses, we characterized the tonsil microbiota in patients with IgAN versus nonrelated household-matched control group participants and identified increased carriage of the genus Neisseria and elevated Neisseria-targeted serum IgA in IgAN patients. We reverse-translated these findings in experimental IgAN driven by BAFF overexpression in BAFF-transgenic mice rendered susceptible to Neisseria infection by introduction of a humanized CEACAM-1 transgene (B × hC-Tg). Colonization of B × hC-Tg mice with Neisseria yielded augmented levels of systemic Neisseria-specific IgA. Using a custom ELISPOT assay, we discovered anti-Neisseria-specific IgA-secreting cells within the kidneys of these mice. These findings suggest a role for cytokine-driven aberrant mucosal immune responses to oropharyngeal pathobionts, such as Neisseria, in the immunopathogenesis of IgAN. Furthermore, in the presence of excess BAFF, pathobiont-specific IgA can be produced in situ within the kidney.


Assuntos
Glomerulonefrite por IGA , Microbiota , Animais , Humanos , Imunidade Humoral , Imunoglobulina A , Camundongos , Tonsila Palatina/patologia
5.
Acta Otolaryngol ; 142(2): 182-186, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35073502

RESUMO

BACKGROUND: Peritonsillitis (PT) is defined as cellulitis in peritonsillar tissue without pus. The pathogenesis of peritonsillar infections is controversial. OBJECTIVE: To explore whether minor salivary glands are involved in the development of PT and to identify clinical findings that predict the evolution of PT to peritonsillar abscess (PTA). MATERIAL AND METHODS: We included 146 adult patients treated for acute tonsillitis (AT; n = 54), PT (n = 34), or PTA (n = 58) at the Helsinki University Hospital. The treating physician recorded tonsillar, oropharyngeal, and dental findings. We analysed serum C-reactive protein (S-CRP) and amylase (S-Amyl). For PTA, pus samples were analysed; for AT and PT, throat cultures were collected. Patients with PT or PTA (PT/PTA; n = 92) were classified into groups with or without tonsillar exudate or hyperaemia (tonsillar findings). RESULTS: The PT group without tonsillar findings had lower S-CRP than the PT group with tonsillar findings (p=.0275). The PT/PTA group without tonsillar findings had higher S-Amyl than the PT/PTA group with tonsillar findings (p=.0278). Three out of 34 (8.8%) patients with PT returned to the emergency department; 1 (2.9%) developed PTA. CONCLUSIONS: Elevated S-Amyl in the PT/PTA group without tonsillar findings suggests that minor salivary glands are sometimes involved in the development of peritonsillar infections.


Assuntos
Abscesso Peritonsilar , Sialadenite , Adulto , Proteína C-Reativa , Humanos , Tonsila Palatina/patologia , Abscesso Peritonsilar/terapia , Glândulas Salivares Menores/patologia
7.
Oral Radiol ; 38(1): 171-174, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33990904

RESUMO

Actinomycosis is a chronic suppurative infection that can develop almost anywhere in the body. Cervicofacial actinomycosis is the most common form of the disease. We report a case of tonsillar actinomycosis that causes massive, asymmetric enlargement of tonsil and mimics the neoplasia. The most common cause of asymmetric tonsil hypertrophy is tonsillar squamous cell carcinoma and lymphomas. Tonsillar actinomycosis is a rare entity that should be kept in mind, if cases cannot be clarified with clinical and laboratory findings, when radiological findings are suspicious about malignancy.


Assuntos
Actinomicose , Neoplasias Tonsilares , Actinomicose/diagnóstico por imagem , Actinomicose/patologia , Humanos , Hipertrofia/patologia , Tonsila Palatina/diagnóstico por imagem , Tonsila Palatina/patologia , Neoplasias Tonsilares/diagnóstico por imagem , Neoplasias Tonsilares/patologia
8.
Pediatr Res ; 91(5): 1099-1105, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34952935

RESUMO

BACKGROUND: The typical characteristic of pediatric obstructive sleep apnea syndrome (OSAS) is systemic inflammation and adenotonsillar hypertrophy (ATH), but the inflammatory markers and mechanism of adenotonsillar proliferation are unclear. METHODS: IHC, qPCR, and western blotting were used to identify the expression of CHI3L1 in the tonsils of children with OSAS. The primary tonsil lymphocytes (PTLCs) from children with OSAS were cultured and recombinant human CHI3L1 protein was added to culture media. After the stimulation with CHI3L1 protein of different concentrations and time points, lymphocyte proliferation was assessed by CCK-8 kits and flow cytometry. The activation of ERK1/2 and the effects on the proliferation of PTLCs were observed by western blotting. RESULTS: The expression of CHI3L1 was higher in the OSAS group than in the PS group. CHI3L1 (100 ng/mmol for 24 h) resulted in a significant increase in the proliferation rate. The ERK1/2 activator (PMA) promoted the proliferation of PTLCs and inhibitor AG126 significantly inhibited proliferation. CONCLUSIONS: CHI3L1 can promote the proliferation of tonsil lymphocytes via ERK1/2 pathways. This result indicates that CHI3L1 may play an important role in the pathogenesis of OSAS in children. Inhibition of CHI3L1 or ERK1/2 may be potential therapeutic targets for CHI3L1-induced proliferation in childhood OSAS. IMPACT: CHI3L1 may be an inflammatory marker in childhood OSAS. CHI3L1 can promote the proliferation of PTLCs in a concentration and time-dependent condition. CHI3L1 can promote the proliferation of tonsil lymphocytes via ERK1/2 pathways.


Assuntos
Tonsila Faríngea , Apneia Obstrutiva do Sono , Tonsila Faríngea/patologia , Biomarcadores , Proliferação de Células , Criança , Proteína 1 Semelhante à Quitinase-3 , Humanos , Tonsila Palatina/patologia , Apneia Obstrutiva do Sono/etiologia
9.
J Anat ; 240(1): 166-171, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34342906

RESUMO

The palatine tonsils form an important part of the human immune system. Together with the other lymphoid tonsils of Waldeyer's tonsillar ring, they act as the first line of defense against ingested or inhaled pathogens. Although histologically stained sections of the palatine tonsil are widely available, they represent the tissue only in two dimensions and do not provide reference to three-dimensional space. Such a representation of a tonsillar specimen based on imaging data as a 3D anatomical reconstruction is lacking both in scientific publications and especially in textbooks. As a first step in this direction, the objective of the present work was to image a resected tonsil specimen with high spatial resolution in a 9.4 T small-bore pre-clinical MRI and to combine these data with data from the completely sectioned and H&E stained same palatine tonsil. Based on the information from both image modalities, a 3D anatomical sketch was drawn by a scientific graphic artist. In perspective, such studies could help to overcome the difficulty of capturing the spatial extent and arrangement of anatomical structures from 2D images and to establish a link between three-dimensional anatomical preparations and two-dimensional sections or illustrations, as they have been found so far in common textbooks and anatomical atlases.


Assuntos
Imageamento Tridimensional , Tonsila Palatina , Humanos , Imageamento por Ressonância Magnética , Tonsila Palatina/diagnóstico por imagem , Tonsila Palatina/patologia
10.
Arkh Patol ; 83(6): 27-34, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34859983

RESUMO

Along with central immune organs, the peripheral lymphoepithelial organs of the pharynx are actively involved in protecting the body from infections. Adaptive, or induced, immunity occurs during the postnatal ontogenesis of immunocompetent lymphocytes, which includes the secondary somatic recombination of the V genes with the participation of recombination-activating gene (RAG) and terminal deoxynucleotidyl transferase (Tdt) proteins. This publication discusses the results of detection of Tdt-positive cells in the pharyngeal and palatine tonsils of children of different ages, who had been operated on for adenoid vegetations and chronic tonsillitis. Attention is drawn to the localization of Tdt+ cells, the level of Tdt expression, an attempt to clarify the phenotype, destination, and place in the diagnostic arrays of functional markers when an adaptive immunity is generated in children.


Assuntos
Tonsila Faríngea , DNA Nucleotidilexotransferase , Tonsila Faríngea/patologia , DNA Nucleotidilexotransferase/genética , Humanos , Hiperplasia/patologia , Linfócitos , Tonsila Palatina/patologia , Faringe
11.
Medicine (Baltimore) ; 100(44): e27616, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34871225

RESUMO

RATIONALE: Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician. PATIENT CONCERNS: We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Clinical examination revealed mild pharyngeal erythema, marked enlargement of the left tonsil infiltrating the lateral pharyngeal wall and the uvula and painful, mobile, nonadherent to deep bilateral latero-cervical adenopathy. DIAGNOSIS: Positive interferon-gamma release assay (QuantiFERON-TB gold). Mantoux test reading was 16 mm. INTERVENTIONS: During hospitalization, the patient received Clindamycin and Gentamicin for 3 days i.v., with discrete relief of symptoms and inflammatory markers. On the 4th day of hospitalization, treatment with Imipenem/Cilastin is started for 7 days in micro-perfusion, with tonsil hypertrophy decrease in size and favorable clinical evolution. OUTCOME: Tonsil hypertrophy decreased in size and patient had a favorable clinical evolution. At discharge, the patient was given a 6-month course of anti-tuberculous drug. LESSONS: The particularity of this case is represented by the rarity of primary tuberculosis of tonsils in children, with unilateral involvement, displaying at the same time a common issue encountered in the current practice: the limitations and the difficult course of setting the diagnosis due to the involvement of relatives in the medical act.


Assuntos
Antituberculosos/uso terapêutico , Doenças Faríngeas/diagnóstico , Tonsilite/microbiologia , Tuberculose Laríngea/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose/tratamento farmacológico , Tonsila Faríngea , Adolescente , Feminino , Humanos , Hipertrofia , Tonsila Palatina/patologia , Tuberculose/diagnóstico , Tuberculose Laríngea/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico
12.
Front Immunol ; 12: 674080, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34745084

RESUMO

Tonsil hyperplasia is the most common cause of pediatric obstructive sleep apnea (OSA). Despite the growing knowledge in tissue immunology of tonsils, the immunopathology driving tonsil hyperplasia and OSA remains unknown. Here we used multi-parametric flow cytometry to analyze the composition and phenotype of tonsillar innate lymphoid cells (ILCs), T cells, and B cells from pediatric patients with OSA, who had previous polysomnography. Unbiased clustering analysis was used to delineate and compare lymphocyte heterogeneity between two patient groups: children with small tonsils and moderate OSA (n = 6) or large tonsils and very severe OSA (n = 13). We detected disturbed ILC and B cell proportions in patients with large tonsils, characterized by an increase in the frequency of naïve CD27-CD21hi B cells and a relative reduction of ILCs. The enrichment of naïve B cells was not commensurate with elevated Ki67 expression, suggesting defective differentiation and/or migration rather than cellular proliferation to be the causative mechanism. Finally, yet importantly, we provide the flow cytometry data to be used as a resource for additional translational studies aimed at investigating the immunological mechanisms of pediatric tonsil hyperplasia and OSA.


Assuntos
Linfócitos/imunologia , Tonsila Palatina/imunologia , Tonsila Palatina/patologia , Apneia Obstrutiva do Sono/imunologia , Pré-Escolar , Feminino , Citometria de Fluxo , Humanos , Hiperplasia , Imunidade Inata , Masculino , Receptores CXCR5/análise , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/análise
13.
Pan Afr Med J ; 39: 276, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34754353

RESUMO

Fibroepithelial polyps represent a frequent cutaneous lesion of mesodermal origin, with a prevalence of 1.2% and are rarely located at palatine tonsils. We present a rare clinical report of a 70-year-old female patient with fibroepithelial polyp of palatine tonsil. This entity represents the eighth case of palatine tonsil fibroepithelial polyp in the English literature. She presented with a polypoid mass at the right tonsil and unspecified throat symptoms. Physicians should pay attention to such lesions because of the residual risk of malignant transformation, along with non-specific symptoms. Differential diagnosis was among neurofibroma, lipoma, squamous papilloma and fibroepithelial polyp. Histopathological examination following tonsillectomy showed a structure rich in vesicles inside lamina propria and surrounding inflammation, establishing the diagnosis of a fibroepithelial polyp. It requires vigilance during complete clinical examination, in order to detect masses at patients with throat symptoms that could have remained undiagnosed until they become even life threatening.


Assuntos
Neoplasias Fibroepiteliais/diagnóstico , Pólipos/diagnóstico , Neoplasias Tonsilares/diagnóstico , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Fibroepiteliais/patologia , Neoplasias Fibroepiteliais/cirurgia , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Pólipos/patologia , Pólipos/cirurgia , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/cirurgia , Tonsilectomia
14.
Oral Oncol ; 122: 105552, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34610523

RESUMO

Blastoid variant of mantle cell lymphoma (MCL) is an aggressive and extremely rare malignancy. MCL may be diagnosed in lymph nodes and/or extranodal sites exhibiting a poor prognosis. MCL with primary presentation in palatine tonsils has been rarely reported. Herein, we report the case of a 73-year-old man with a painless nodular mass on the right palatine tonsil. A biopsy was performed, and microscopic analysis revealed a neoplasm composed of small to medium sized lymphocytes with finely dispersed chromatin, roundish nucleus and many mitoses. The tumor cells were positive for CD20 (L26), CD5 (4C7), Cyclin D1 (EP12), Bcl2 (124) and Ki-67 (MIB-1; 90%), and negative for Bcl6 (PG-B6p), MUM1 (MUM1p) and CD3 (Polyclonal). These findings led to the diagnosis of blastoid variant of MCL. Diagnostic workup with computed tomography scan excluded other sites of disease. The patient was treated successfully with cyclophosphamide, doxorubicin, vincristine and prednisolone (mini-CHOP regimen). Although the blastoid variant of MCL is rare, it should be included in the differential diagnosis of rapid-growing masses in the palatine tonsil.


Assuntos
Linfoma de Célula do Manto , Tonsila Palatina , Idoso , Humanos , Linfonodos , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/tratamento farmacológico , Masculino , Tonsila Palatina/patologia
15.
PLoS One ; 16(10): e0258495, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648597

RESUMO

Modern histopathology is built on the cornerstone principle of tissue fixation, however there are currently no analytical methods of detecting fixation and as a result, in clinical practice fixation is highly variable and a persistent source of error. We have previously shown that immersion in cold formalin followed by heated formalin is beneficial for preservation of histomorphology and have combined two-temperature fixation with ultra-sensitive acoustic monitoring technology that can actively detect formalin diffusing into a tissue. Here we expand on our previous work by developing a predictive statistical model to determine when a tissue is properly diffused based on the real-time acoustic signal. We trained the model based on the morphology and characteristic diffusion curves of 30 tonsil cores. To test our model, a set of 87 different tonsil samples were fixed with four different protocols: dynamic fixation according to our predictive algorithm (C/H:Dynamic, N = 18), gold-standard 24 hour room temperature (RT:24hr, N = 24), 6 hours in cold formalin followed by 1 hour in heated formalin (C/H:6+1, N = 21), and 2 hours in cold formalin followed by 1 hour in heated formalin (C/H:2+1, N = 24). Digital pathology analysis revealed that the C/H:Dynamic samples had FOXP3 staining that was spatially uniform and statistically equivalent to RT:24hr and C/H:6+1 fixation protocols. For comparison, the intentionally underfixed C/H:2+1 samples had significantly suppressed FOXP3 staining (p<0.002). Furthermore, our dynamic fixation protocol produced bcl-2 staining concordant with standard fixation techniques. The dynamically fixed samples were on average only submerged in cold formalin for 4.2 hours, representing a significant workflow improvement. We have successfully demonstrated a first-of-its-kind analytical method to assess the quality of fixation in real-time and have confirmed its performance with quantitative analysis of downstream staining. This innovative technology could be used to ensure high-quality and standardized staining as part of an expedited and fully documented preanalytical workflow.


Assuntos
Tonsila Palatina/patologia , Fixação de Tecidos/métodos , Fatores de Transcrição Forkhead/metabolismo , Formaldeído/química , Humanos , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Tonsila Palatina/metabolismo , Inclusão em Parafina , Fase Pré-Analítica
16.
Mol Biol Rep ; 48(7): 5579-5586, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34292473

RESUMO

OBJECTIVES: Tonsil tissue is a very important component of the human immunity system, contributing to the functioning of the cellular and humoral defence system, especially in childhood. The endoplasmic reticulum (ER) is an organelle that has a very important function in the balanced functioning of cells, in which the accumulation of a cellular protein called ER stress occurs in case of dysfunction. ER stress influences the pathogenesis of many diseases and immune system functions. We aimed to investigate the relation between the diseases of tonsil tissue and ER stress response to elucidate the mechanisms of diseases related with the immune system. METHODS: A prospective study was conducted in 46 children aged between 2 and 16 years who underwent tonsillectomy for chronic tonsillitis or tonsillar hypertrophy. Tonsil tissue was separated into two groups according to their size and evaluated in terms of ER stress markers and apoptosis markers by Real-time PCR and Western blot analysis. RESULTS: The ΔCT levels of ER stress markers (ATF4, ATF6, CHOP, GRP78, EIF2AK3, ERN1, GRP94) were greater in children with chronic tonsillitis (p < 0.005). In contrast, the tonsillar hypertrophy group had greater ΔCT levels of apoptosis markers (BAX, BCL-2) according to the Real-time PCR method (p < 0.005). According to the Western blot analysis, the normalized levels of ATF4, ATF6, CHOP, GRP78, and ERN1 genes were found greater in the chronic tonsillitis group than the tonsillar hypertrophy group. There was no difference between the two groups in terms of normalized BCL-2 and BAX levels by Western blot analysis. CONCLUSION: This is the first study in the literature investigating the effect of the ER stress pathway on the etiopathogenesis of tonsil diseases. It was concluded that the ER stress pathway plays a role in the etiopathogenesis of chronic tonsillitis. Investigating the relationship between ER stress and structures such as the tonsil tissue that make up the immune system can help create new treatment strategies. CLINICAL TRIAL REGISTRATION: Trial Registration ClinicalTrials.gov Identifier: NCT04653376.


Assuntos
Suscetibilidade a Doenças , Estresse do Retículo Endoplasmático , Tonsila Palatina/metabolismo , Tonsila Palatina/patologia , Tonsilite/etiologia , Tonsilite/metabolismo , Adolescente , Apoptose/genética , Biomarcadores , Criança , Pré-Escolar , Doença Crônica , Estresse do Retículo Endoplasmático/genética , Feminino , Humanos , Hipertrofia , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Tonsilite/patologia
17.
Am J Pathol ; 191(10): 1774-1786, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34303699

RESUMO

Viruses are the second leading cause of cancer worldwide, and human papillomavirus (HPV)-associated head and neck cancers are increasing in incidence in the United States. HPV preferentially infects the crypts of the tonsils rather than the surface epithelium. The present study sought to characterize the unique microenvironment within the crypts to better understand the viral tropism of HPV to a lymphoid-rich organ. Laser-capture microdissection of distinct anatomic areas (crypts, surface epithelium, and germinal centers) of the tonsil, coupled with transcriptional analysis and multiparameter immunofluorescence staining demonstrated that the tonsillar crypts are enriched with myeloid populations that co-express multiple canonical and noncanonical immune checkpoints, including PD-L1, CTLA-4, HAVCR2 (TIM-3), ADORA2A, IDO1, BTLA, LGALS3, CDH1, CEACAM1, PVR, and C10orf54 (VISTA). The resident monocytes may foster a permissive microenvironment that facilitates HPV infection and persistence. Furthermore, the myeloid populations within HPV-associated tonsil cancers co-express the same immune checkpoints, providing insight into potential novel immunotherapeutic targets for HPV-associated head and neck cancers.


Assuntos
Alphapapillomavirus/fisiologia , Células Mieloides/patologia , Células Mieloides/virologia , Tonsila Palatina/patologia , Tonsila Palatina/virologia , Tropismo Viral/fisiologia , Antígenos CD/metabolismo , Antígenos B7/metabolismo , Antígeno B7-H1/metabolismo , Moléculas de Adesão Celular/metabolismo , Epitélio/patologia , Epitélio/virologia , Centro Germinativo/patologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/virologia , Humanos , Proteínas de Checkpoint Imunológico/metabolismo , Microdissecção e Captura a Laser , Monócitos/patologia , Receptores Virais/metabolismo , Transcriptoma/genética
18.
Nat Immunol ; 22(6): 757-768, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34031614

RESUMO

Maturation of B cells within germinal centers (GCs) generates diversified B cell pools and high-affinity B cell antigen receptors (BCRs) for pathogen clearance. Increased receptor affinity is achieved by iterative cycles of T cell-dependent, affinity-based B cell positive selection and clonal expansion by mechanisms hitherto incompletely understood. Here we found that, as part of a physiologic program, GC B cells repressed expression of decay-accelerating factor (DAF/CD55) and other complement C3 convertase regulators via BCL6, but increased the expression of C5b-9 inhibitor CD59. These changes permitted C3 cleavage on GC B cell surfaces without the formation of membrane attack complex and activated C3a- and C5a-receptor signals required for positive selection. Genetic disruption of this pathway in antigen-activated B cells by conditional transgenic DAF overexpression or deletion of C3a and C5a receptors limited the activation of mechanistic target of rapamycin (mTOR) in response to BCR-CD40 signaling, causing premature GC collapse and impaired affinity maturation. These results reveal that coordinated shifts in complement regulation within the GC provide crucial signals underlying GC B cell positive selection.


Assuntos
Linfócitos B/imunologia , Ativação do Complemento , Complemento C3a/metabolismo , Complemento C5a/metabolismo , Centro Germinativo/imunologia , Animais , Animais Geneticamente Modificados , Linfócitos B/metabolismo , Antígenos CD55/genética , Antígenos CD55/metabolismo , Antígenos CD59/metabolismo , Linhagem Celular Tumoral , Hematopoiese Clonal/imunologia , Centro Germinativo/citologia , Centro Germinativo/metabolismo , Humanos , Ativação Linfocitária , Camundongos , Tonsila Palatina/citologia , Tonsila Palatina/patologia , Proteínas Proto-Oncogênicas c-bcl-6/metabolismo , Receptor da Anafilatoxina C5a/genética , Receptor da Anafilatoxina C5a/metabolismo , Receptores de Antígenos de Linfócitos B/metabolismo , Receptores de Complemento/genética , Receptores de Complemento/metabolismo , Transdução de Sinais/imunologia , Serina-Treonina Quinases TOR/metabolismo
19.
Minerva Pediatr (Torino) ; 73(3): 256-262, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34047149

RESUMO

BACKGROUND: Our aim is to determine the incidence of reflux in children older than 3 years requiring adenotonsillectomy and relationship between GER and diagnostic tests. METHODS: Forty-four patients, who were listed for adenoidectomy/tonsillectomy at Pediatric Ear Nose Throat department due to severe hypertrophy, were evaluated for accompanying GER (Group 1). GER was diagnosed as having at least one positive GER test result (including esophagitis or pH monitoring). Twenty children without reflux symptoms were used as healthy control group (Group 2) and LPR was held. RESULTS: Reflux was detected in 32 children requiring adenotonsillectomy (72.7%). LPR score was negative in all patients in Group 2. There was no correlation between pH monitoring and histopathological evaluation of esophagus. There was a correlation between the LPR score and histological esophagitis in the proximal esophagus. CONCLUSIONS: GER was high in patients with adenotonsillary hypertrophy. LPR score and the history of patients are as effective as invasive techniques like pH monitorization and endoscopy in determining GER disease.


Assuntos
Adenoidectomia , Refluxo Gastroesofágico/epidemiologia , Tonsilectomia , Tonsila Faríngea/patologia , Tonsila Faríngea/cirurgia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Monitoramento do pH Esofágico , Esofagite Péptica/diagnóstico , Feminino , Refluxo Gastroesofágico/diagnóstico , Humanos , Hipertrofia/cirurgia , Refluxo Laringofaríngeo , Laringoscopia , Masculino , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Avaliação de Sintomas
20.
Biomed Res Int ; 2021: 5550267, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33884263

RESUMO

We aimed to investigate the oral health of children in terms of the presence of dental caries, periodontal health, halitosis, and dentofacial changes in patients who had adenotonsillar hypertrophy related to mouth breathing and compared these findings with nasal breathing healthy and adenotonsillectomy-operated children. The patient group comprised 40 mouth-breathing children who were diagnosed with adenotonsillar hypertrophy, while the control group consisted of 40 nasal breathing children who had no adenotonsillar hypertrophy. Forty children who had undergone an adenotonsillectomy operation at least 1 year prior to the study were included in the treatment group. Oral examinations of all children were conducted, and the parents were asked about medical and dental anamnesis, demographic parameters, toothbrushing and nutrition habits, oral health-related quality of life (OHRQoL), and symptoms of their children. Demographic parameters, toothbrushing and nutrition habits, and the presence of bad oral habits did not differ between groups (p > 0.05). Adenotonsillectomy is associated with a remarkable improvement in symptoms; however, some symptoms persist in a small number of children. The salivary flow rate, dmft/s, DMFT/S index, plaque, and gingival index scores did not differ between groups (p > 0.05). The patient group showed higher rates of halitosis when compared with the treatment and control groups (p < 0.001). Mouth breathing due to adenotonsillar hypertrophy caused various dentofacial changes and an increase in Class II division 1 malocclusion (p < 0.001). It was shown that adenotonsillar hypertrophy does not negatively affect OHRQoL, it could be a risk factor for dental caries, periodontal diseases, and halitosis, but by ensuring adequate oral health care, it is possible to maintain oral health in children with adenotonsillar hypertrophy. Also, it is recommended that orthodontic treatment should start as soon as possible if it is required. In this context, otorhinolaryngologists, pedodontists, and orthodontists should work as a team in the treatment of children with adenotonsillar hypertrophy.


Assuntos
Tonsila Faríngea/patologia , Saúde Bucal , Tonsila Palatina/patologia , Tonsila Faríngea/fisiopatologia , Adolescente , Criança , Pré-Escolar , Cárie Dentária/patologia , Oclusão Dentária , Índice de Placa Dentária , Feminino , Halitose/complicações , Halitose/patologia , Humanos , Hipertrofia , Masculino , Fenômenos Fisiológicos da Nutrição , Tonsila Palatina/fisiopatologia , Índice Periodontal , Escovação Dentária
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