Helicobacter pylori colonization of the adenotonsillar tissue: fact or fiction?
OBJECTIVE
The transmission of the gastric pathogen Helicobacter pylori involves the oral route. Molecular techniques have allowed the detection of H. pylori DNA in samples of the oral cavity, although culture of H. pylori from these type of samples has been sporadic. Studies have tried to demonstrate the presence of H. pylori in adenotonsillar tissue, with contradictory results. Our aim was to clarify whether the adenotonsillar tissue may constitute an extra gastric reservoir for H. pylori.


METHODS
Sixty-two children proposed for adenoidectomy or tonsillectomy were enrolled. A total of 101 surgical specimens, 55 adenoid and 46 tonsils, were obtained. Patients were characterized for the presence of anti-H. pylori antibodies by serology. On each surgical sample rapid urease test, immunohistochemistry, fluorescence in situ hybridization (FISH) with a peptide nucleic acid probe for H. pylori, and polymerase chain reaction-DNA hybridization assay (PCR-DEIA) directed to the vacA gene of H. pylori were performed.


RESULTS
Thirty-nine percent of the individuals had anti-H. pylori antibodies. Rapid urease test was positive in samples of three patients, all with positive serology. Immunohistochemistry was positive in samples of two patients, all with negative serology. All rapid urease test or immunohistochemistry positive cases were negative by FISH. All samples tested were negative when PCR-DEIA for H. pylori detection was used directly in adenotonsillar specimens.


CONCLUSIONS
The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.
Vilarinho
Sérgio
S
Serviço de Otorrinolaringologia, Hospital de São Marcos, Braga, Portugal.
Guimarães
Nuno M
NM
Ferreira
Rui M
RM
Gomes
Bárbara
B
Wen
Xiaogang
X
Vieira
Maria J
MJ
Carneiro
Fátima
F
Godinho
Tiago
T
Figueiredo
Ceu
C
D000233:Adenoidectomy; D000234:Adenoids / Q000382:microbiology*; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D015341:Nucleic Acid Probes; D014066:Palatine Tonsil / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D014068:Tonsillectomy; D014510:Urease / Q000032:analysis
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D015341:Nucleic Acid Probes; D014510:Urease