Immunology of tonsils and adenoids: everything the ENT surgeon needs to know
Immunology of tonsils and adenoids: everything the ENT surgeon needs to know
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DOI：
10.1016/j.ijporl.2003.08.018
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发表时间：
2003-12-01
影响因子：
1.5
通讯作者：
Brandtzaeg, P
中科院分区：
文献类型：
--
作者：
Brandtzaeg, P
瓦尔德耶氏环的淋巴组织，特别是鼻咽扁桃体（腺样体），似乎在功能上与啮齿动物的鼻相关淋巴组织相似。抗原刺激淋巴滤泡产生：(a)克隆b细胞扩增；(b) b细胞受体亲和成熟；(c)根据受体对抗原的亲和力选择阳性B细胞；(d)向B记忆细胞和浆细胞分化；(e)连接(J)链基因的可变诱导。b细胞分化对促进免疫球蛋白（Ig）重链常数基因的下游同型转换也很重要。对于扁桃体B细胞，这一过程主要产生IgG和IgA浆细胞，部分与j链表达相关。由于J链是分泌IgA的聚合物结构中的关键肽，扁桃体和腺样体可能为粘膜提供B细胞。效应的网站。因此，一些观察结果表明，这些淋巴器官产生表达聚合IgA （plgA）的B细胞，这些B细胞迁移到上呼吸道粘膜、泪腺和唾液腺。因此，鼻音。免疫途径诱导分泌iga依赖的区域粘膜。免疫力，还会增强全身免疫力。尽管复发性扁桃体炎儿童扁桃体B细胞产生piga的能力明显下降，但对腺扁桃体切除术的保守态度似乎是可取的，特别是在年轻年龄组。(C) 2003年英国儿科耳鼻喉科协会。爱思唯尔爱尔兰有限公司出版。版权所有。
The lymphoid tissue of Waldeyer's ring, and particularly the nasopharyngeal tonsil (adenoids), appears to be functionally comparable to nasal-associated lymphoid tissue in rodents. Antigen-stimulated lymphoid follicles give rise to: (a) clonal B-cell expansion; (b) B-cell receptor affinity maturation; (c) positive selection of B cells according to receptor affinity for antigen; (d) differentiation to B memory cells and plasma cells; and (e) variable induction of the joining (J)-chain gene. B-cell differentiation is also important to promote downstream isotype switching of the immunoglobulin (Ig) heavy chain constant genes. For tonsillar B cells, this process gives mainly rise to IgG and IgA plasma cells, partially associated with J-chain expression. Because the J chain is a key peptide in the polymer structure of secretory IgA, tonsils and adenoids may provide B cells for mucosal. effector sites. Thus, several observations suggest that these lymphoid organs generate polymeric IgA (plgA)-expressing B cells that migrate to the upper airway mucosa, lacrimal glands and salivary glands. Accordingly, the nasal. route of vaccination induces secretory IgA-dependent regional mucosal. immunity and will also enhance systemic immunity. Although the pIgA-producing capacity of tonsillar B cells is considerably decreased in children with recurrent tonsillitis, a conservative attitude towards adenotonsillectomy appears immunologically desirable, particularly in the young age group. (C) 2003 British Association for Paediatric Otorhinolaryngology. Published by Elsevier Ireland Ltd. All rights reserved.