UP-REGULATED LOCAL CYTOKINE PRODUCTION IN RECURRENT TONSILLITIS COMPARED WITH TONSILLAR HYPERTROPHY

In children with recurrent tonsillitis there may be persistent antigen deposition in tonsil tissue, even between exacerbations. If so, upreg ulation of immunocompetent cells should occur continuously, in contras t to tonsil tissue from children with tonsillar hypertrophy. The cytok ine pattern was studied in cell suspensions prepared from tonsils obta ined from 12 children undergoing tonsillectomy. The study group compri sed 6 children with recurrent tonsillitis and 6 who had a history of t onsillar hypertrophy causing sleep apnea. Cytokine-producing cells (IL -1 alpha, IL-1 beta, TNF alpha, IL-6, IL-8, IL-2, IFN gamma, TNF beta, IL-10 and IL-4) were characterized at the single-cell level by use of cytokine-specific monoclonal antibodies and indirect immunofluorescen ce technique. A constitutive production of IL-1 alpha, IL-1 beta, TNF alpha, and IL-8 was found in both groups (10-300/10(5) cells). However , the frequency of spontaneous IL-2, IFN gamma, TNF beta, IL-6 and IL- IO was consistently low (10 +/- 10 cells) in both groups. Following re stimulation by T-cell receptor ligation, using immobilized anti-CD3 mA b, with concentrations chosen so that it did not activate resting cell s, increased frequencies of TNF alpha, IL-6, IL-8, IL-2, IFN gamma, IL -4 and IL-10 synthesizing cells were induced in the recurrent tonsilli tis group. Significantly higher incidences of IL-IP, IL-6 and IL-2 pro ducing cells were found in the recurrent tonsillitis group (60-200/10( 5) cells, p < 0.05). Microbiological evaluation in the tonsil tissue c ould not reveal any differences between the studied groups regarding b acterial or viral pathogens. However, this does not exclude persistent increased intracellular deposition of microbial antigens as a possibl e explanation for the elevated incidence of IL-1 beta, TNF alpha, IL-6 , IL-8, IL-2, IFN gamma, IL-IO and IL-4 expressing cells noticed in pa tients with recurrent tonsillitis.