No5(5) 2022
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DOI 10.37219/2528-8253-2022-5-36 |
Melnikov OF, Zabolotny DI, Sambur MB, Zabolotnа DD,
Timchenko MD, Faraon IV, Zayets TA
The role of the palatine tonsils in the regulation of the state of humoral
local immunity in patients with chronic inflammatory diseases of the nose
and perinasal sinuses when infected with viruses of the respiratory group |
Melnikov Oleg F.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Head of the Laboratory of Pathophysiology and Immunology (with a group of
pathomorphology)
Doctor of Medical Sciences, Professor
E-mail: elenamelnykova@gmail.com
ORCID ID: https://orcid.org/0000-0002-1261-8647
https://www.scopus.com/authid/detail.uri?authorId=7006385903
https://www.scopus.com/authid/detail.uri?authorId=7003452154
Zabolotnyi Dmitry I
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine. Director
Doctor of Medical Sciences, Professor, Academician of the National Academy
of Medical Sciences of Ukraine
E-mail: amtc@kndio.kiev.ua
https://www.scopus.com/authid/detail.uri?authorId=6701512931
ORCID ID: https://orcid.org/0000-0001-9429-4414
Sambur Marina Borisovna
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Deputy Director for Research
Doctor of Medical Sciences
Email: mbsambur@gmail.com
ORCID ID: http://orcid.org/0000-0002-9347-2829
Zabolotna Diana D
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Head of Department of Rhinology and Allergology with a group of radiology
Doctor of Medical Sciences, Professor
E-mail: dianazab@ukr.net
ORCID ID: https://orcid.org/0000-0001-7807-8148
Timchenko Мarina D.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Senior Researcher
Laboratory of Pathophysiology and Immunology (with a group of
pathomorphology)
PhD
E-mail: svtim@i.ua
https://orcid.org/0000-0002-7889-1152
Faraon Inna V
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Pathophysiology and Immunology (with a group of
pathomorphology)
Junior Researcher
E-mail: amtc@kndio.kiev.ua
ORCID ID: 0000-0003-1010-4308
Zayets Tetiana A.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Pathophysiology and Immunology (with a group of
pathomorphology)
Researcher
E-mail: amtc@kndio.kiev.ua
ORCID ID: https://orcid.org/0000-0002-4377-4810 |
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Abstract
Topicality: Acute respiratory diseases of the upper respiratory
tract, which in the vast majority of cases are caused by viruses, especially
with frequent recurrences of diseases, reduce local and system immunity,
which often leads to the accumulation of bacterial infection due to the
activation of endogenous microflora or exogenous infection and causes the
development of viral-bacterial diseases. Recurrent respiratory diseases
contribute to the formation of chronic pathology of the oro- and nasopharynx,
which in turn supports the violation of the body's protective mechanisms.
Previous studies have shown that the tonsils of the lymphadenoid pharyngeal
ring perform the function of immunological protection, and the absence of
palatine tonsils (PT) negatively affects the state of both local and system
immunity.
Aim: to determine the role of the palatine tonsils in the realization
of local humoral reactions in patients with chronic inflammatory diseases of
nose and paranasal sinuses when infected with viruses of the respiratory
group.
Materials and methods: Studies were conducted in 134 patients with
chronic inflammatory diseases (CID) of nose and paranasal sinuses (PNS) in
remission, among whom 93 had a diagnosis of chronic rhinosinusitis, 27 –
chronic catarrhal rhinitis, 14 – allergic rhinitis with chronic bronchitis.
The control group consisted of 47 practically healthy persons without
pathology from the ENT organs.
The examined persons were divided into those who had PT and those from whom
they were surgically removed no earlier than five years ago.
All examinees were divided into those who had anamnestic antibodies in their
blood to one or more of the respiratory viruses, such as: adenovirus,
respiratory syncytial virus and influenza A virus in a clinically
significant titer, and those in whom antibodies were not detected.
The local humoral immunity state of patients was assessed by the content of
immune complexes (IC) and concentrations of secretory immunoglobulin A (sIgA),
interferons alpha- (α-IFN) and gamma- (γ-IFN) in the oropharyngeal secretion
(OS), which were determined by the immunoenzymatic method using sets of
reagents for enzyme-linked immunosorbent assays ("Cytokin", RF) and the Stat
Fax-2100 analyzer (USA).
All examined patients had a healthy state of the oral cavity.
Results: The presence or absence of palatine tonsils changes the
levels of number of humoral factors of local immunity in oropharyngeal
secretion in practically healthy donors and in patients with chronic
inflammatory diseases of the nose and PNS. The production of sIgA and α-IFN
in OS depends on PM, decreasing in practically healthy persons of the
control group who underwent tonsillectomy.
Chronic inflammatory diseases of the nose and PNS caused a decrease in the
concentration of IC and α-IFN in the OS of patients of both groups- with or
without PT. In patients with normal PMs who got sick with viral infections,
in contrast to those with removed PMs, α-IFN level in OS increased and
practically did not differ from those in healthy donors. The greatest
suppression of α-IFN production was determined in patients with CID of the
nose and PNS with removed PM and with the absence of clinically significant
titers of antiviral antibodies.
The level of γ-IFN production did not reliably change in the OS of patients
with CID of nose and PNS in the remission phase both with normal PT and
after tonsillectomy, but depended to a greater extent on the transferred
infectious disease caused by viruses of the respiratory group.
Conclusion: PTs play a significant role in the formation of a number
of reactions of local immunity in the naso- and oropharynx, both in
practically healthy individuals and in patients with chronic inflammatory
disease of nose and paranasal sinuses. Therefore, the determination of local
immunity indices in patients with chronic inflammatory diseases of the upper
respiratory tract with different status of the palatine tonsils, who are in
contact or had contact with respiratory viruses, provides an opportunity to
identify the most vulnerable links in the system of their anti-infective
protection, which should first of all be paid attention to during
examination and treatment of patients with chronic inflammatory diseases of
the upper respiratory tract, especially in cases of frequent recurrence of
acute respiratory diseases. |
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Keywords
chronic inflammatory diseases of the nose and paranasal sinuses, palatine
tonsils, local humoral immunity, antiviral antibodies. |
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