Immunoregulatory cytokines and chronic tonsillitis

Abstract

The purposes of the present study were to determine the distribution of cells producing cytokines: tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in different morphological sections of tonsils in patients with tonsillar hypertrophy (TH) and recurrent tonsillitis (RT), to analyze the level of production of these cytokines in TH and RT and evaluate the potential of peripheral blood lymphocytes for production of interferon-γ (IFN-γ) and interleukin 4 (IL-4). Analyzed materials consisted of the tonsils after tonsillectomy and blood taken from patients right before tonsillectomy (study group) and blood taken from healthy donors (control group).We used histological and immunohistochemical method, morphometric methods for the quantification of TNF-α and IL- 6 producing cells and immunological methods for determining the concentration of IFN-γ and IL-4. Most of TNF-α producing cells are settled in the subepithelial region (55%). Numerical density of TNF-α producing cells in the crypt epithelium, subepithelial and interfollicular region was significantly higher in RT compared with TH. The concentration of IFN-γ is three times higher in RT then in TH. After the stimulation of peripheral blood lymphocytes in culture there was no significant increase in concentrations of IL- 4. The index of stimulation of IFN-γ was the highest in the RT, and of IL- 4 in TH. The production of Th1-type cytokines (TNF-α and IFN-γ) is higher in RT compared with TH. In both forms of tonsillitis, production of Th1-type cytokines is higher in relation to the production of Th2-type cytokines (IL-6 and IL-4).

Impact of adenotonsillectomy on the evolution of inflammatory markers

“…The production of Th1‐type cytokines is dominant . In chronic tonsillitis, elevated values of proinflammatory cytokines and cytokine‐producing cells have been detected at the site of inflammation . However, this situation does not translate into greater efficiency of the immune response but generates activation and proliferation of endothelial cells and fibroblasts, altering the immunologically active tissue and favouring the recurrence of inflammatory processes .…”

“…2 In chronic tonsillitis, elevated values of proinflammatory cytokines and cytokine-producing cells have been detected at the site of inflammation. 3 However, this situation does not translate into greater efficiency of the immune response but generates activation and proliferation of endothelial cells and fibroblasts, altering the immunologically active tissue and favouring the recurrence of inflammatory processes. 4 In addition, in both adults and paediatric populations there is clear evidence of the association between obstructive sleep apnoea-hypopnea syndrome (OSAS) linked to tonsillar hypertrophy and systemic inflammatory phenomena, as well as an increased risk of cardiovascular disease in adulthood.…”

Immunobiology of the Tonsils and Adenoids

“…It is unknown how the tonsillar cytokine profiles and other microenvironmental factors impact on isotype differentiation and coexpression of J chain in local B cells (Todorović and Zvrko, 2013). According to the "decreasing potential" hypothesis (Ahmed and Gray, 1996) it seems that clonal B-cell maturation in the course of several proliferative GC cycles results in down-regulation of J-chain expression, thus promoting monomer production by the resulting IgA + PCs rather than pIgA for secretory immunity .…”

Evaluation of IFN-γ polymorphism+874 T/A in patients with recurrent tonsillitis by PCR Real Time Mismatch Amplification Mutation Assay (MAMA Real Time PCR)

“…Treatment of recurrent tonsillitis is mainly based on administration of antibiotics or tonsillectomy [18]. The recurrent tonsillitis illness is orchestrated by the sequential elaboration of proinflammatory cytokines, including tumour necrosis factor a (TNFa), and interferon c (IFNc), and it is probable that the severity of illness is related to the overproduction of those cytokines or, conversely, the underproduction of anti-inflammatory cytokines such as transforming growth factor (TGF)-b and IL-10 [19]. In that regard, polymorphisms in the regulator regions of genes for cytokine production have been described and can influence the protein production.…”