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The immunology of tonsils in children: The effect of bacterial load on the presence of b‐ and t‐cell subsets
Author(s) -
Brodsky Linda,
Moore Linda,
Stanievich John F.,
Ogra Pearay L.
Publication year - 1988
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198801000-00019
Subject(s) - tonsil , tonsillitis , acute tonsillitis , palatine tonsil , streptococcus pyogenes , streptococcus , streptococcus pneumoniae , immunology , etiology , pathogenesis , microbiology and biotechnology , medicine , b cell , throat , biology , pathology , staphylococcus aureus , bacteria , anatomy , antibiotics , antibody , genetics
Tonsil core specimens of 54 children, (3 to 12 years) with clinical evidence of chronic tonsillitis and/or “idiopathic” tonsillar hypertrophy, were studied for the effect of the magnitude of aerobic bacterial load on tonsil size and the absolute numbers of B‐ and T‐cell subsets. Tonsillar core specimens obtained from ten children with no history of ear, nose, or throat infections and normal appearing tonsils served as controls. The findings of this study indicate that tonsil size was directly proportional to the mean bacterial load in colony forming units/g tonsil (CFU/g) even in the absence of a clinical history of infection ( p < 0.01). A mean bacterial load of 2.4 ± 2.1 × 10 4 CFU/g tonsil was seen in diseased tonsils as compared to 1.6 ± 2.4 × 10 4 CFU/g tonsil in normal controls ( p < 0.01). Hemophilus influenzae (type B and non‐B), Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes were the most common pathogens recovered in the largest numbers from diseased tonsils; control tonsils harbored few bacteria in their cores. The absolute number of immunocompetent cells/g tonsil including T‐helper, T‐suppressor and B‐cells (S‐Ig+), were significantly greater in diseased tonsils than in controls ( p < 0.001). Increasing microbial load (CFU/g tonsil) correlated with increased numbers of T‐helper ( p < 0.01) and B‐cells ( p < 0.01). These data strongly support a bacterial etiology for chronic tonsillitis as well as “idiopathic” tonsillar hypertrophy. Bacterial induced proliferation of immunocompetent cells may be one underlying mechanism for chronic tonsillar disease in children.