Fundamental study evidencing relationship between tonsillar focal diseases and palatine tonsils

免疫球蛋白肾病(IgAN)在20年内进展为终末期肾功能衰竭，预后较差。IGAN以典型的扁桃体局灶性疾病而闻名，扁桃体切除术已被报道有效地抑制了病情的发展。不幸的是，这一事实并不广为人知。我们试图通过免疫学技术建立IgAN与扁桃体的基本关系，以期对扁桃体切除术的疗效有所启发，并阐明一个预测疗效的因素。在这一系列的检查中，我们发现增殖诱导配体APRIL参与了IgA的高分泌，扁桃体T细胞上的趋化因子受体CXCR3与T细胞对肾小球病变的归巢有关。提示扁桃体不仅与IgA异常有关，而且与T细胞归巢有关。我们将继续研究，以进一步了解这两个关系。

IgA nephropathy (IgAN) has a poor prognosis because of progress to end-stage renal failure over a period of 20 years. IgAN is famous for typical tonsillar focal diseases, and tonsillectomy has been reported to be effective for inhibition of the progression. Unfortunately, this fact was not widely known. We try to establish fundamental relationship between IgAN and palatine tonsils by immunological technique in order to enlighten other doctors about the effectiveness of tonsillectomy and clarify a factor which predict the effectiveness.In this serious of examination, we found that APRIL(a proliferation-inducing ligand) was involved in hyper-production of IgA from the tonsils of IgAN patients, and that chemokine receptor CXCR3 on tonsillar T-cells was related to homing of T-cells to the lesions of glomerulus. These results indicate that tonsils are related to not only abnormality of IgA, but also T-cell homing. We will continue to study for further understanding of the relationships.