Kawaguchi M, Sakai T, Sakamaki A, Ishizawa S, Baba Y, Masuda Y, Koizumi F
Department of Pathology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Acta Otolaryngol Suppl. 1993;508:36-42. doi: 10.3109/00016489309130264.
We designed a study to investigate the morphological expression of immune responses in the palatine tonsils from patients with IgA nephropathy. To distinguish between the histological characteristics of the tonsils in habitual tonsillitis (47 patients) and IgA nephropathy (11 patients), we studied the T nodules, B-lymphoid follicles, germinal centers, areas of mixed T and B lymphocytes, lacunar epithelium and connective tissues; then we compared patients with habitual tonsillitis and IgA nephropathy. The T nodules in patients with IgA nephropathy were enlarged, and this change was not accompanied by atrophy of B-lymphoid follicles. Morphologically, primary T nodules were predominant. In reactive lymph nodes, T nodules generally play an important role in the extra-follicular maturation of stimulated B lymphocytes into Ig-secreting plasma cells. Therefore the enlarged primary T nodules remind us that this maturation may occur more frequently in the tonsils of patients with IgA nephropathy than in those with habitual tonsillitis. This suggests that some immunoregulatory dysfunction exists in the secretory immune system of mucosa-associated lymphoid tissues in patients with IgA nephropathy.
我们设计了一项研究，以调查IgA肾病患者腭扁桃体中免疫反应的形态学表现。为了区分习惯性扁桃体炎患者（47例）和IgA肾病患者（11例）扁桃体的组织学特征，我们研究了T小结、B淋巴细胞滤泡、生发中心、T和B淋巴细胞混合区域、陷窝上皮和结缔组织；然后我们对习惯性扁桃体炎患者和IgA肾病患者进行了比较。IgA肾病患者的T小结增大，且这种变化并未伴有B淋巴细胞滤泡萎缩。形态学上，原发性T小结占主导。在反应性淋巴结中，T小结通常在受刺激的B淋巴细胞向分泌Ig的浆细胞的滤泡外成熟过程中起重要作用。因此，增大的原发性T小结提示我们，这种成熟在IgA肾病患者的扁桃体中可能比在习惯性扁桃体炎患者的扁桃体中更频繁地发生。这表明IgA肾病患者黏膜相关淋巴组织的分泌免疫系统存在一些免疫调节功能障碍。
