Search

Purpose: The objective of this study is to analyse the relationship between the endoscopic signs of laryngo-pharyngeal reflux, the lingual tonsil hypertrophy (LTH) and its inflammation, adopting Narrow Band Imaging (NBI) technology. Methods: We enrolled, as cases, patients with clinical diagnosis of laryngopharyngeal reflux disease (LPRD), a Reflux Symptom Index (RSI) ≥ 13, and a Reflux Finding Score (RFS) ≥ 7. Controls were enrolled among patients who underwent the same transnasal endoscopy, equipped with NBI, with a RSI < 13 and a RFS < 7. Nasopharynx, Lingual Tonsils (LT), Hypopharynx and Larynx were evaluated by two experienced otolaryngologists, who calculated the Reflux Finding Scale (RFS) score and focused their attention on the base of the tongue, observing its surface with NBI technology. Results: 82 patients with diagnosis of laryngopharyngeal reflux were enrolled as cases. Mean RFS was 11.7 (SD = 2.9). As controls, we enrolled 80 patients. Mean RFS was 2.7 (SD = 1.63). We found that RFS positivity was associated with a significant increase in LT dimension (2.5 vs 1.1, p < 0.001), with a higher LT crypt inflammation grading (1.8 vs 0.09, p < 0.001) and with a higher Roman Cobblestone pattern grading (1.48 vs 0.11, p < 0.001). A significant correlation between the crypt inflammation and the hyperemia subscore of RFS was present (r = 0.696, p < 0.0001), while it was not possible to find a correlation between crypt inflammation and either diffuse laryngeal edema (r = 0.166, p = 0.135) and posterior commissure hypertrophy (r = 0.089, p = 0.427). Conclusions: NBI allowed us to identify endoscopically the presence of enlarged lingual tonsil, crypt inflammation and superficial mucosal changes, in patients affected by LPRD. Level of evidence: 2 (prospective, case–control study). [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to evaluate the histological localization and phenotypic characteristics of infiltrating dendritic cells (DCs) and to examine the relationship between the degree of DC infiltration and the severity of inflammation in the colonic mucosa in ulcerative colitis (UC). Also explored was the expression of macrophage inflammatory protein-3α (MIP-3α), and its receptor CC-chemokine receptor 6 (CCR6), to evaluate the significance of immature DCs in the crypt inflammation evident in UC. There was a significant positive correlation between the number of infiltrating DCs and the degree of crypt inflammation, mononuclear cell infiltration, crypt atrophy, and comprehensive active inflammation. No significant correlation between the number of S-100 protein+ cells and the severity of crypt atrophy was found. S-100 protein+, MIP-3α+, and CCR6+ cells were frequently localized in or around the crypt with inflammation. MIP-3α+ neutrophils and S-100 protein+ CCR6+ cells with dendritic morphology were detected in or around the crypt inflammation. Both S-100 protein+ DCs and CCR6+ cells were frequently clustered in the surface mucosa beneath the surface epithelium when the crypt was not inflamed. CD1a+ Langerhans-cell-type DCs were not found in any of the tissues examined. These data indicate that DCs participate not only in chronic inflammation but also in active crypt inflammation. [Copyright &y& Elsevier]