Bacteriology and immunology of normal and diseased adenoids in children
L. Brodsky and R. J. Koch
Department of Otolaryngology, State University of New York, School of Medicine and Biomedical Sciences, Buffalo.
Adenoid physiology as reflected in the qualitative and quantitative
bacteriology and immune cell distribution was correlated with clinical
presentation in 69 children (16 to 130 months of age) undergoing
adenoidectomy for obstructive adenoid hyperplasia (n = 38) or chronic
adenoid infection (n = 31) and in 16 adenoid core biopsy specimens from 16
nondiseased controls. In the control adenoids, few potentially pathogenic
bacteria were found as the dominant bacteria in the adenoid core (25%), and
significantly greater concentrations of nonpathogens (commensals) were
isolated (P < .01). Potential pathogens as the dominant bacteria were
found twice as often in obstructive adenoid hyperplasia (62%) and in
chronic adenoid infection (55%) (P < .05). Haemophilus influenzae was
most common in the diseased adenoids, 53% in obstructive adenoid
hyperplasia and 48% in chronic adenoid infection, compared with only 19% in
the controls (P < .05). No significant differences in lymphocyte
density, B and T cells, as well as T-helper subsets, were found between
clinical classifications. However, T-suppressor cells,
monocytes-macrophages, and natural killer cells were significantly
increased in chronic adenoid infection only (P < .05). The findings in
this study support roles for both alterations in bacterial homeostasis and
an altered immune profile in the etiology of chronic adenoid disease in
children.
