Reduced Lymphocyte Activation in Repeatedly Inflamed Human Tonsils

Abstract

Tonsils of 20 patients with recurrent tonsillitis were investigated. Activated lymphocytes, that is lymphocytes with increased nuclear birefringence, were found in only 3 cases. The lack of lymphocyte activation is supposedly due to reduced antigen stimulation. Since antigens arrive at the tonsillar lymphoid tissue via the follicle-associated cells of the crypt epithelium, the ultrastructure of this epithelium was also studied in 5 cases. Tonsils of three dogs were used for comparison. In the repeatedly inflamed human tonsils the follicle-associated, so-called M cells contained fewer intracytoplasmic tubules and vesicles than those of the dogs. Moreover the frequency of these cells seemed to be reduced. Most of the crypts of inflamed tonsils were lined with a non-reticulated, stratified squamous epithelium. A hypothesis is presented on the pathomechanism of recurrent tonsillitis and suggestions are put forward about its pathohistology. Résumé En cas des inflammation répetées des amygdales humaines lˆépithelium réticulaire se transforme sur la plupart des surfaces des cryptes en épithelium stratifié et les cellules particulières /cellules M/ sont pratiquement absentes. Les cellules M persistantes renforment moins de vesicules de transport comme les cellules analogues normaux. Dans les amygdales humaines montrantes des signes de lˆinflammation répetée le nombre de lymphocytes activées est diminué. Zusammenfassung Die Verminderung der Retikulierung des Kryptenepithels ist eine Antwort des Tonsillengewebes auf entzündliche Reize. Die Zahl der antigenrezeptorischen Epithelzellen (M-Zellen) ist also verringert. Das Zytoplasma der restlichen M-Zellen enthält nur wenige Pinozytosebläschen. Die Zahl der aktivierten Lymphozyten ist in entzünd-lichen menschlichen Gaumenmandeln auch vermindert.