Abstract

BackgroundTonsil hypertrophy has negative impact on children’s health, but its pathogenesis remains obscure despite the fact that numerous bacteriological studies have been carried out. Understanding the innate immune and inflammatory states of hypertrophic tonsils with different clinical manifestations is of great significance for defining the pathogenesis of tonsil hypertrophy and establishing treatment strategies. The present study was undertaken to examine the characteristics of innate immunity and inflammation in children with hypertrophic palatine tonsils and different clinical manifestations.MethodsTonsil tissues were surgically removed from the patients and classified based on the patients’ clinical manifestations. The patients were divided into three groups: 1) Control group; 2) Tonsil Hypertrophy (TH) group; and 3) Tonsil Hypertrophy combined with Recurrent Infection (TH + RI) group. The immune and inflammatory statuses of these tissues were characterized using qRT-PCR and ELISA methods.ResultsViral protein 1 (VP1) was highly expressed in TH group, but not in TH + RI group. In TH group, elevated expression was observed in the innate immune mediators, including retinoic acid-inducible gene I (RIG-I), interferon alpha (IFN-α), mitochondrial antiviral-signaling protein (MAVS), NLR family pyrin domain containing 3 (NLRP3), toll-like receptor (TLR) 4 and TLR7. Consistent with the innate immune profile, the expression of inflammatory markers (IL-1β, NF-κB and IL-7) was also significantly elevated in TH group. Meanwhile, the COX-2/PGE2/EP4 signaling pathway was found to be involved in the inflammatory response and the formation of fibroblasts.ConclusionsInnate immune and inflammatory responses are more active in simple hypertrophic tonsils, rather than hypertrophic tonsils with recurrent inflammation. A local relative immune deficiency in the hypertrophic tonsils may be a causative factor for recurrent tonsillitis in TH + RI. These differences, together with the patient’s clinical manifestations, suggest that tonsillar hypertrophy might be regulated by diverse immune and/or inflammatory mechanism through which novel therapeutic strategies might be created.

Highlights

  • Tonsil hypertrophy has negative impact on children’s health, but its pathogenesis remains obscure despite the fact that numerous bacteriological studies have been carried out

  • Viral infection and innate immune response in each group With qRT-PCR, we found that the expression levels of Viral protein 1 (VP1) and IFN-α in TH group were significantly higher than that in the control group, but that in TH + Recurrent tonsillitis (RI) group was significantly lower than that in the TH group (Fig. 2a&b)

  • We found that the mRNA levels of retinoic acid-inducible gene I (RIG-I) and mitochondrial antiviral-signaling protein (MAVS) in TH group were significantly higher than that in the control group, while the mRNA levels of RIG-I and MAVS in TH + RI group were lower than that in TH group (Fig. 2c&d)

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Summary

Introduction

Tonsil hypertrophy has negative impact on children’s health, but its pathogenesis remains obscure despite the fact that numerous bacteriological studies have been carried out. Understanding the innate immune and inflammatory states of hypertrophic tonsils with different clinical manifestations is of great significance for defining the pathogenesis of tonsil hypertrophy and establishing treatment strategies. The present study was undertaken to examine the characteristics of innate immunity and inflammation in children with hypertrophic palatine tonsils and different clinical manifestations. The tonsil is an independent organ constructed by mucosal-associated lymphoid tissue (MALT). Simple tonsil hypertrophy refers to the enlargement of the tonsil uncomplicated with inflammation. Recurrent tonsillitis (RI) is diagnosed when tonsillitis relapses as sympomized by ≥7 episodes of throat infection (well-documented, clinically important, adequately treated) in the preceding year, or ≥ 5 episodes in each of the preceding 2 years, or ≥ 3 episodes in each of the preceding 3 years [8]

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