Toll-like receptor 2 expression on monocytes from patients with BCG vaccine-associated suppurative lymphadenitis / 소아과

PURPOSE: Toll-like receptor 2 (TLR2) is critical in the immune response to mycobacterial infections. The purpose of this study was to analyze TLR2 surface expressions and TLR2-mediated tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) production in patients with BCG vaccine-associated suppurative lymphadenitis. METHODS: Peripheral monocytes were separated from 16 patients with BCG vaccine-associated suppurative lymphadenitis and 10 healthy controls using a magnet cell isolation kit. Monocytes (1x10(6) cells/well) were incubated with a constant amount of Pam(3)CSK(4) (100 microgram/mL) for 24 hours. TLR2 surface expression on monocytes was analyzed by FACS analysis and TLR-2 mRNA expression was determined by RT-PCR. TLR2-mediated TNF-alpha and IL-6 production were measured by ELISA. RESULTS: In patients with BCG vaccine-associated suppurative lymphadenitis, low TLR2 expression on monocytes (3.39+/-1.2% versus 4.64+/-2.6%) together with significantly lower TLR2 mRNA expression than in the healthy controls was seen after Pam(3)CSK(4) stimulation. TLR2-mediated TNF-alpha and IL-6 production in patients with BCG vaccine-associated suppurative lymphadenitis (TNF-alpha, 775.5+/-60.8 pg/mL; IL-6, 4,645.8+/-583.9 pg/mL) were also lesser than that in healthy controls (TNF-alpha, 1,098.5+/-94.3 pg/mL; IL-6, 6,696.3+/-544.3 pg/mL). CONCLUSION: These findings suggest that low TLR2 expression on monocytes might be associated with increased susceptibility to BCG vaccine-associated suppurative lymphadenitis.

The Results of Surgical Treatment for Suppurative Cervical Lymphadenitis in Children

PURPOSE: The results of surgical treatment for acute suppurative cervical lymphadenitis in children were evaluated with literature reviews. METHODS: Children under 15-year old who required operative management for acute suppurative cervical lymphadenitis between January 1996 and December 2000 were evaluated with retrospective manner. The clinical characteristics, pathologic results and microbiologic studies were reviewed. RESULTS: 37 patients were treated with surgical methods. 36 patients recovered fully after surgical intervention without any recurrence and one patient expired of sepsis. CONCLUSION: The classical treatment, incision and drainage, is one of the treatment of choice for the recovery from suppurative cervical lymphadenitis in children.