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Characterisation of the local inflammatory response in appendicitis
1Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Journal of Pediatric Gastroenterology and Nutrition
|January 1, 1993
Summary
Researchers analyzed the inflammatory response in appendicitis, finding distinct immune cell patterns. Focal appendicitis shows a specific lymphocyte and plasma cell response, potentially indicating a reaction to an unknown luminal antigen.
Area of Science:
- Immunology
- Gastroenterology
- Pathology
Background:
- Appendicitis involves inflammation of the appendix.
- Understanding the local immune response is crucial for diagnosis and treatment.
- Distinguishing between different types of appendicitis may reveal underlying mechanisms.
Purpose of the Study:
- To characterize the local inflammatory infiltrate in acute suppurative appendicitis, focal appendicitis, and normal appendices.
- To compare the cellular composition of the lamina propria in these conditions.
- To investigate potential differences in immune responses that could explain appendicitis etiology.
Main Methods:
- Immunoperoxidase staining was used to enumerate immune cells in appendiceal specimens.
- Analysis included lymphocyte subpopulations, IL-2 receptor expression, natural killer (NK) cells, monocytes, and plasma cell isotypes (IgG, IgA).
- Statistical comparisons were made between acute suppurative appendicitis, focal appendicitis, and control groups.
Main Results:
- Total T cells and IL-2 receptor-expressing cells were significantly increased in both acute and focal appendicitis compared to controls.
- IgG and IgA plasma cell isotypes were elevated in all appendicitis specimens (acute and focal).
- Monocyte and NK cell increases were specific to acute suppurative appendicitis, while focal appendicitis showed a broader lymphocyte and plasma cell infiltration.
Conclusions:
- A differential pattern of cellular infiltration exists between focal and acute suppurative appendicitis.
- Focal appendicitis exhibits a selective lymphocyte and plasma cell infiltrate in the lamina propria.
- This pattern in focal appendicitis may suggest a specific immune response to an unidentified luminal antigen, potentially contributing to appendicitis.