Abstract
Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.
Highlights
Tonsils are collections of incompletely encapsulated lymphoid tissues located beneath, but in contact with the epithelium of the upper aero-digestive tract [1]
Left and right tonsil samples were obtained from a cohort of 111 Swedish patients who underwent tonsillectomy or tonsillotomy due to diagnosed tonsillar hypertrophy (55 patients) or chronic/recurrent tonsillitis (56 patients)
A significant difference was observed between the gender ratio in tonsillar hypertrophy compared to chronic/recurrent tonsillitis group
Summary
Tonsils are collections of incompletely encapsulated lymphoid tissues located beneath, but in contact with the epithelium of the upper aero-digestive tract [1]. The palatine tonsils accommodate T cells, which are mainly located in the extrafollicular regions (T-cell areas) [1,2,3]. Children with tonsillar hypertrophy commonly display complications like nasal obstruction, obstructive sleep apnea, snoring, and may even experience psychosocial problems [6]. These complications can be treated by complete or partial removal of the tonsils, known as tonsillectomy and tonsillotomy, respectively [6, 7]
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