Immunologic、 Virologic、 and Bacteriologec Studies of Tonsillar Focal Infections and Their Clinical Applications

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1) Soluble immune complexes were determined by a anti-C3 solid-phase enzyme-linked immunosorbent assay (anti-C3 ELISA) and were found to be significantly higher on average in patients with pustulosis palmaris et plantaris (PPP) and/or stemo-cost-clavicular hyperostosis (SCCH) than in normal controls. There was a close relationship between the degree of improvement in the skin lesions in PPP patients and in pains in SCCH Patients and the changes in soluble immune complexes after tonsillectomy.2) Titers of anti-keratin antibodies (AKA) involving IgG and IgM fractions were determined by ELISA and found to be significantly higher on average in patients with PPP than normal controls. Positive rates of IgG-AKA and IgM-AKA in sera of PPP patients were 50% and 66%, respectively. Following tonsillectomies, patients with high IaM-AKA titers that decreased after surgery were found to benefit by a marked improvement in their skin lesions. There was a close relationship between the degree of improv … More ement in the skin lesions and the changes in IgM-AKA titers after the operation.3) Epstein-Barr virus (EBV) transformed tonsillar lymphocytes were found to produce autoantibodies against nuclear envelope and cytoskeletal filaments, nucleolus and cytoskeletal filaments of human squamous cell carcinoma cell line (Hep2 cell).4) Bacteriologic studies on tonsil of patients with PPP, chronic tonsillitis (CT), and healthy controls revealed that Streptococcus sanguis was isolated in significantly higher rate in PPP patients than in CT patients and healthy controls, and that IgG-antibody titer against bacterial antigen of Streptococcus salvarius was significantly lower in PPP patients than in CT patients and healthy controls.5) Quantitative immunohistologic study on tonsil by the image analysis revealed that IgM-, IgG-and IgD-positive B cells were significantly increased in PPP patients than in CT patients and healthy controls, and that IgM-and IgD-positive B cells and CD4-positive T cells were significantly increased in patients with improvement of skin lesions after tonsillectomy.6) Measurements of soluble immune complexes and IgM-anti-keratin antibody titer in sera of patients in combination with the conventioual tests were thought to be very useful for the preoperative diagnosis of tonsillar focal infections and for the post-operative counseling. Less