title: A role for Waldeyer's ring in immunological response to allergens.
abstract: OBJECTIVE
  Adenoids, tubal tonsil, palatine tonsil, and lingual tonsil are immunological organs included in the Waldeyer's ring, the basic function of which is the antibody production to common environmental antigens. Adenoidal hypertrophy (AH) is a major medical issue in children, and adenoidectomy is still the most used treatment worldwide. The response of adenoids to allergens is a good model to evaluate their immunological function. This report assessed the immunological changes in adenoid tissues from children with allergic rhinitis (AR) undergoing sublingual immunotherapy (SLIT).
  
  
  METHODS
  Adenoid samples from 16 children (seven males, nine females, mean age 7.12 years) with AH and clinical indication to adenoidectomy were collected. Of them, five children were not allergic and 11 had house dust mite and grass pollen-induced AR. Among allergic children, in four AR was treated by antihistamines while in seven AR was treated by high-dose SLIT during 4-6 months. The evaluation addressed the T helper 1 (Th1), Th2, and Th3 cells by performing a PCR array on mRNA extracted from adenoid samples.
  
  
  RESULTS
  In non-allergic children, a typical Th1 pattern was found. SLIT induced a strong down-regulation of genes involved in Th2 and Th1 activation and function. In particular, in SLIT-treated allergic children IL-4, CCR2, CCR3, and PTGDR2 (Th2 related genes) and CD28, IL-2, and INHA (Th1 related genes) expression was reduced, compared with children treated with antihistamines.
  
  
  CONCLUSIONS
  These preliminary findings warrant investigation in trials including larger numbers of patients, but indicate that hypertrophic adenoids of allergic children have the typical response to the specific allergen administered by SLIT. This should suggest that one should reconsider the immunological role of adenoids.
authors.affiliation: Department of Otorhinolaryngology, Sapienza University , Rome , Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Masieri
authors.forename: Daria
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: De Luca
authors.forename: Ilaria
authors.initials: I
authors.lastname: Dell'Albani
authors.forename: Gualtiero
authors.initials: G
authors.lastname: Leo
authors.forename: Franco
authors.initials: F
authors.lastname: Frati
mesh_terms: D000234:Adenoids / Q000276:immunology*; D000485:Allergens / Q000276:immunology*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D015536:Down-Regulation; D005260:Female; D005786:Gene Expression Regulation; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D014066:Palatine Tonsil / Q000276:immunology*; D011058:Pollen / Q000276:immunology; D039981:Pyroglyphidae / Q000276:immunology; D012333:RNA, Messenger / Q000235:genetics; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*; D063729:Sublingual Immunotherapy; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D000485:Allergens; D006633:Histamine Antagonists; D012333:RNA, Messenger