Cytokine production by tonsillar lymphocytes stimulated with alpha-streptococci in patients with pustulosis palmaris et plantaris.

To clarify the cellular immune response to alpha-streptococci in tonsillar lymphocytes from patients with pustulosis palmaris et plantaris (PPP) we have investigated cytokine production of tonsillar lymphocytes from patients with PPP recurrent tonsillitis (RT). Interleukin (IL)-1 alpha, IL-2, IL-4, IL-5, IL-6, interferon (IFN)-gamma and tumor necrotizing factor (TNF)-alpha were measured. The stimulation index of IFN-gamma production was significantly higher in tonsillar lymphocytes from PPP than that from RT when cultured with alpha-streptococci (stimulation index: the ratio of cytokine level produced by tonsillar lymphocytes with bacterial antigens to that without antigens). The same results were seen in the case of TNF-alpha, but IL-4 and IL-5 were not detected in any supernatants. These data suggest that increased production of IFN-gamma and TNF-alpha in tonsillar lymphocytes may play a key role in this kind of immunologic abnormalities.