title: Coccoid Helicobacter pylori exists in the palatine tonsils of patients with IgA nephropathy.
abstract: OBJECTIVE
  Helicobacter pylori infection is acquired by oral ingestion. H. pylori has been reported to be present in the palatine tonsils. To clarify the route and mode of infection, the prevalence of tonsillar H. pylori was evaluated, and an attempt was made to culture tonsillar H. pylori.
  
  
  METHODS
  In a prospective study, 55 patients with recurrent pharyngotonsillitis or IgA nephropathy underwent a tonsillectomy. The carbon 13-urea breath test and enzyme-linked immunosorbent assay for the detection of H. pylori IgG antibodies in the serum were performed. Tonsillar H. pylori was cultured under conventional culture conditions for gastric H. pylori with or without the following shock methods; heat shock, hydrogen-peroxide-degrading compounds, or parasitizing amoebae. Immunofluorescence and immunoelectron microscopy using antibodies against H. pylori and cytotoxin-associated antigen A were used to identify tonsillar H. pylori.
  
  
  RESULTS
  H. pylori in the coccoid form was present in tonsillar crypts. Of 55 patients, 43 (78.2%) had tonsillar H. pylori, and 15 (27.3%) were infected with gastric H. pylori. All patients with gastric H. pylori also had tonsillar H. pylori (p < 0.01). Cytotoxin-associated antigen A was observed in 38 (88.4%) of 43 tonsillar H. pylori. Tonsillar H. pylori could not be cultured in any culture conditions. All patients with IgA nephropathy had tonsillar H. pylori (p < 0.01).
  
  
  CONCLUSIONS
  The present research might provide some insight into clarifying the route and mode of H. pylori infection. Our findings may indicate that tonsillar H. pylori is one of the antigens causative of IgAN.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. kusanok@cc.saga-u.ac.jp
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kusano
authors.forename: Akira
authors.initials: A
authors.lastname: Inokuchi
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Tokunaga
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kuratomi
authors.forename: Rintaro
authors.initials: R
authors.lastname: Shimazu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Mori
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamasaki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kidera
authors.forename: Kyoko
authors.initials: K
authors.lastname: Tsunetomi
authors.forename: Junji
authors.initials: J
authors.lastname: Miyazaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001944:Breath Tests / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D016253:Microscopy, Immunoelectron; D008875:Middle Aged; D014066:Palatine Tonsil / Q000382:microbiology* / Q000473:pathology; D010612:Pharyngitis / Q000150:complications / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D014068:Tonsillectomy / Q000379:methods; D014069:Tonsillitis / Q000150:complications / Q000382:microbiology / Q000601:surgery; D055815:Young Adult