Innate lymphoid cells: a paradigm for low SSI in cleft lip repair.
Cleft lip and palate reconstructions demonstrate significantly lower surgical site infection rates compared with clean-contaminated cases, prompting investigation into the pathophysiology causing this discrepancy. Recent studies have identified a new group of innate lymphocytes called innate lymphoid cells (ILCs), located in barrier surfaces of the skin, airways, and intestine. Our objectives were to explore for the first time the presence of ILCs in the vermillion of neonates and young children undergoing cleft lip reconstruction and characterize their composition by measuring the three classes of ILCs.



Lip tissue samples were collected from 13 subjects undergoing vermillion resection during cleft lip reconstructive surgery. Preparative, transmission electron microscopy, and analytical flow cytometry were performed. The functionality of ILCs was tested in terms of their capacity to produce type 1 (IFN-γ/TNF-α), type 2 (IL-5/IL-13), and type 3 (IL-17/IL-22) cytokines. Data were analyzed using Student t test or the analysis of variance to establish significance (P < 0.05) among groups for all other data.



All three classes of ILCs were detected and visualized in the tissue samples. In all samples, the level of ILC2 subset was significantly higher than the other two ILC subsets (P < 0.01), followed by the ILC1 subset, which was present in significantly higher levels than the ILC3 subset (P < 0.05).



Our data place ILCs for the first time in the interface of oral mucosal immunity, tissue microenvironment, and homeostasis during and after tissue development, possibly explaining lower infection rates in cleft lip or palate reconstructions.
Department of Oral Biology, Augusta University, Augusta, Georgia; Department of Surgery, Division of Plastic Surgery, Augusta University, Augusta, Georgia.
Erika
E
Simmerman
Department of Oral Biology, Augusta University, Augusta, Georgia.
Xu
X
Qin
Department of Cellular Biology/Electron Microscopy and Histology Core, Augusta University, Augusta, Georgia.
Brendan
B
Marshall
Department of Cellular Biology/Electron Microscopy and Histology Core, Augusta University, Augusta, Georgia.
Libby
L
Perry
Department of Oral Biology, Augusta University, Augusta, Georgia.
Lei
L
Cai
Department of Oral Biology, Augusta University, Augusta, Georgia.
Tailing
T
Wang
Department of Oral Biology, Augusta University, Augusta, Georgia; Department of Surgery, Division of Plastic Surgery, Augusta University, Augusta, Georgia.
Jack
J
Yu
Department of Microbiology and Immunology, University of Southern California, Los Angeles, California.
Omid
O
Akbari
Department of Oral Biology, Augusta University, Augusta, Georgia. Electronic address: bbaban@augusta.edu.
Babak
B
Baban
D015415:Biomarkers / Q000378:metabolism; D002971:Cleft Lip / Q000276:immunology / Q000601:surgery*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007113:Immunity, Innate; D007223:Infant; D008046:Lip / Q000276:immunology* / Q000378:metabolism; D008214:Lymphocytes / Q000276:immunology* / Q000378:metabolism; D008297:Male; D046529:Microscopy, Electron, Transmission; D009061:Mouth Mucosa / Q000276:immunology* / Q000378:metabolism; D019651:Plastic Surgery Procedures; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000276:immunology*
D015415:Biomarkers; D016207:Cytokines
Cleft lip reconstruction; Cleft palate reconstruction; Innate immunity; Innate lymphoid cells; Oral mucosa immunity; Oral tissue microenvironment