The appendix is a prominent example of gut associated lymphoepithelial tissue, whose function is to react to the wide variety of antigens present in the gastrointestinal tract. It is composed of a large number of repeating units, the lymphoid follicles, each of which is divided into an apical dome, a large basal nodule with a germinal center, and laterally extending thymus dependent areas. The dome epithelium consists mainly of columnar absorptive cells and of specialized follicle associated epithelial (FAE) cells which are efficient at transporting material from the lumen to the underlying lymphoid tissue, and may also transport macromolecules from the lymphoid follicle into the lumen. The dome epithelium normally has large numbers of lymphocytes within it, as well as smaller numbers of macrophages and plasma cells. Macrophages, and perhaps FAE cells, are capable of processing and presenting antigens to reactive lymphocytes. Lymphocyte proliferation and differentiation in response to antigenic stimulation begins in the lymphoid follicles, but most of the lymphocytes leave by the lymphatics, migrate through lymph nodes and spleen, frequently to complete differentiation into IgA-secreting plasma cells in the lamina propria of mucosal surfaces. Normal function of appendix probably helps suppress potentially destructive humoral antibody responses while promoting local immunity.
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