Superoxide Production by Neutrophils in Patients with Recurrent Tonsillitis.

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Abstract
Superoxide anion (O2-) production by peripheral blood polymorphonuclear leukocytes (PMNs) stimulated with phorbol myristate acetate (PMA) was measured by the cytochrome C method in 57 patients with recurrent tonsillitis. There was no significant correlation between superoxide production and episodes of acute tonsillitis, serum C-reactive protein levels, or peripheral white blood cell count. However, the superoxide production by PMNs was inversely correlated with serum anti-streptolysin-O titers (r = -.38, p = .008). Furthermore, the mean +/- SD superoxide levels produced by PMNs from patients with high serum ASO titers (> 71 U/ml), 69.58 +/- 30.56 nM/10(6) cells, was significantly lower than that of patients with low serum ASO titers (< 71 U/ml), 89.83 +/- 38.90 nM/10(6) cells (p = 0.037), and that of healthy adult controls, 102.27 +/- 44.67 nM/10(6) cells (p = 0.012). In addition, the effect of Streptococcus pyogenes on superoxide production by PMNs was studied in vitro. Superoxide production by PMNs preincubated with 600 micrograms/ml culture supernatant of Streptococcus pyogenes T4 (not detected) and T12 (34.82 +/- 31.40 nM/10(6) cells) was significantly lower than that of PMNs preincubated with culture medium (136.09 +/- 70.41 nM/10(6) cells; p < 0.05, each). Inhibition of superoxide production by PMNs by preincubation with culture supernatant of Streptococcus was increased by the protein in the culture supernatant in a concentration-dependent manner. These findings suggest that frequent and/or persistent streptococcal infections may reduce the superoxide production by PMNs, leading to recurrent episodes of tonsillitis.

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