Chosen factors of T and B cell apoptosis in hypertrophic adenoid in children with otitis media with effusion.

Evaluation of lymphocyte homeostasis within the chronically inflamed adenoid, closely related to the functioning of the immune system, may have a role in qualifying children for adenoidectomy. Apoptosis is a major process maintaining balance between tonsillar lymphocytes. The Fas receptor and Bcl-2 protein family which show pro-apoptotic and anti-apoptotic actions are of particular significance in apoptosis induction. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. Flow cytometry was used to assess the percentages of apoptotic lymphocytes and CD4(+), CD8(+), CD19(+) cells with CD95(+) antigen and Bcl-2 protein in the group of children who underwent adenoidectomy due to adenoid hypertrophy and accompanying otitis media with effusion. The percentages of CD4(+)Bcl-2(+), CD8(+)Bcl-2(+) and CD19(+)Bcl-2(+) lymphocytes in the group of children with adenoid hypertrophy and acute otitis media were lower as compared to the reference group. However, the percentages of CD4(+), CD8(+) and CD19(+) cells with CD95(+) antigen were higher in the study group comparing to the reference group. The tendency of reduced percentages of T and B lymphocytes with Bcl-2 expression and elevated percentages of these cells with CD95(+) expression within the adenoid may reflect local immunity disorders.