tonsils and adenoids that are removed by snoring, it turns out that they play a role in strengthening COVID immunity
Sep 08, 2024
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The tonsils and adenoids are the first target tissues for viruses to infect the human body, and they are widely recognized as frequent infection-causing organs and as a cause of snoring and sleep apnea by narrowing the upper airways as they grow in size. Therefore, thousands of tonsil and adenoid resection are performed in Korea per year.
However, given that the histological morphology of tonsils and adenoids is similar to the lymph nodes in which memory immune cells are made after vaccination, understanding was needed as an immune organ conducive to the human body, not subject to surgical removal.
In response, the La Jolla Immunization Institute in the United States conducted a study on memory immune cells activated in adult tonsils and adenoids in 2022. As a result, it was confirmed that acquired immune cells were activated in adenoids after COVID-19 vaccination, and after vaccination, memory immune cells were present in adenoids for more than a year and immune function was maintained longer than blood.
Professor Kim Hyun-jik of Seoul National University Hospital, a co-researcher of the study, emphasized that the tonsils and adenoids are important immune organs responsible for immune mechanisms that resist respiratory viruses in our bodies, as virus-memory immune cells are produced in the tonsils and adenoids of patients infected with COVID-19 or those who have received COVID-19 vaccines and are maintained longer than blood, and innate immune mechanisms can also be activated early in infection to induce virus death.
Since then, a research team led by professors Kim Hyun-jik (obstetricians of otolaryngology) and Park Wan-beom (infectious medicine) has conducted a follow-up study to analyze the immune response in adenoids of COVID-19 patients during the Omicron variant epidemic (May 2022 to January 2023) to determine the relationship with clinical results.
The research team took nasopharyngeal samples from mild and severe COVID-19 patients and healthy controls, and used RNA sequencing and molecular biological techniques to analyze the effect of interferon and interferon stimulation gene (ISGs) expression in the nasopharynx on patients' clinical outcomes. Interferon is a key element of innate immune response that is importantly involved in early immune defense, and the course of the disease and treatment outcome may vary depending on the level of expression and response persistence.
The analysis revealed that the expression of interferon and interferon-inducible genes (ISGs) in adenoids of mild COVID-19 patients was increased, which was closely linked to positive clinical outcomes, and that stronger interferon responses inhibited the spread of the virus and the patient recovered in a short period of time. On the other hand, the adenoids of severely ill patients also showed an interferon response, but the level of expression was lower than that of mild patients, and it was found that the intensity and timing of the immune response affect the severity of the disease.
In addition, we confirmed that activated macrophages (M1) and dendritic cells (DCs) and CD4+ memory T cells play a major role in interferon activation in adenoids of COVID-19 patients.
This study is a systematic analysis of how the increase in interferon in adenoids and the resulting immune response affect the clinical course of COVID-19, suggesting that innate immune responses and memory immune cell activation in adenoids may play an important role in preventing progression to severe diseases. It was published in the latest online issue of the international journal 『Cellular and Molecular Life Science』.
Professor Kim Hyun-jik (obstetricians and otolaryngologists) stated, "This study will serve as an important research basis for the development of new vaccines and treatments to be delivered to the upper respiratory tract to suppress COVID-19 infection. People without unilateral and adenoids are relatively likely to develop severe COVID-19, and they cannot play a role as a viral memory immune cell active space, so tonsil and adenoid resection should be carefully decided in consideration of snoring and sleep apnea symptoms."
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