Immunology of ENT Disorders PDF
Preview Immunology of ENT Disorders
Immunology of ENT Disorders IMMUNOLOGY AND MEDICINE SERIES International Advisory Board Nicolas E. Bianco, Caracas, Venezuela Stefano Bombardieri, Pisa, Italy Manfred P. Dierich, Innsbruck, Austria Janos Gergely, God, Hungary Hidechika Okada, Nagoya, Japan Ronald Penny, Sydney, Australia Norman Talal, San Antonio, Texas, USA IMMUNOLOGY =SE--RIE:':'"""S· -=SE=RIE~S. SERIES· SERIES AND SERIES· SERIES ·--SE--RIE-S·- =SE--RIE--S MEDICINE Volume 23 Immunology of ENT Disorders Edited by G. K. Scadding Consultant Rhinologist Royal National Throat, Nose & Ear Hospital Gray's Inn Road, London, UK Series Editor: K. Whaley SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. Library of Congress Cataloging-in-Publication Data Immunology of ENT disorders / edited by G.K. Scadding. p. cm.-(Immunology and medicine series; v. 23) Includes bibliographical references and index. ISBN 978-94-010-4629-9 ISBN 978-94-011-1436-3 (eBook) DOI 10.1007/978-94-011-1436-3 1. Ear-Diseases-Immunological aspects. 2. Nose-Diseases Immunological aspects. 3. Throat-Diseases-Immunological aspects. I. Scadding, G.K. 11. Series. [DNLM: 1. Otorhinolaryngologic Diseases-immunology. 2. Otorhinolaryngologic Diseases-therapy. Wl IM53BI v. 24 1994/ WV 150 133 1994] RF46.5.I464 1994 617.5'1079-dc20 DNLM/DLC for Library of Congress 94-20882 CIP Copyright © 1994 by Springer Science+8usiness Media Dordrecht Originally published by Kluwer Academic Publishers 1994 Softcover reprint of the hardcover 1s t edition 1994 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from the publishers, Springer-Science+Business Media, B.V .. Typeset by Lasertext Ltd, Stretford, Manchester, UK. Contents Series Editor's Note VB Preface viii List ofContributors ix Basic immunology P. Fitzharris 2 The ENT presentation ofHIV infection and the acquired immunodeficiency syndrome 31 J. M. Parkin 3 The immunology ofthe tonsil 45 G. K. Scadding 4 Fungal infections 57 R. J. Hay 5 Immunocytochemistry in the diagnosis ofpathological conditions ofthe ear, nose and throat 73 L. Michaels 6 Allergic rhinitis 93 G. K. Scadding 7 Food and allergic rhinitis 117 L. J. Hawk 8 Wegener's disease 123 V. J. Lund 9 Sarcoidosis 135 V. J. Lund v IMMUNOLOGY OF ENT DISORDERS 10 Nasal polyps 151 A. B. Drake-Lee 11 Inner ear disorders 169 G. B. Brookes 12 Middle ear disorders 199 G. B. Brookes 13 Future prospects for immunological involvement in ENT disorders 217 G. K. Scadding Index 225 vi Series Editor's Note The interface between clinical immunology and other branches of medical practice is frequently blurred and the general physician is often faced with clinical problems with an immunological basis and is expected to diagnose and manage such patients. The rapid expansion of basic and clinical immunology over the past two decades has resulted in the appearance of increasing numbers ofimmunologyjournals and it is impossible for a non specialistto keepapace with thisinformationoverload. TheImmunology and Medicine series is designed to present individual topics ofimmunology in a condensed package ofinformation which can be readily assimilated by the busy clinician or pathologist. K. Whaley, Leicester August 1994 vii Preface Until recently, the contribution ofimmunological knowledge to the under standingandmanagementofENTdisorderswasslight,beinglargelyconfined to the appreciation that many rhinitic patients were allergic. Happily, this situation is rapidly changing: the immunological basis ofmany disorders of the ears, nose and throat is becoming recognized and the mechanisms ofthe reactions involved are being elucidated. From this, rational therapy should evolve. This book aims to highlight some of the areas in which immunological mechanisms are involved in otorhinolaryngology. It is written by experts in their respective fields of immunology and allergy, otology, rhinology and pathology.Itopenswithanoverviewofthepathwaysoftheimmuneresponse and the cells and molecules involved, leading to an appreciation of the normaldefence mechanismsofthe upper respiratory tractand possibleareas offailure. Thereis thenachapteronHIVinfectionand how thismay present to otorhinolaryngologists. The normal function of the tonsil and the immunologicaleffectsoftonsillectomyarethenconsidered.Thevaryingroles of fungi in ENT disorders ranging from commensal through allergen to invasive organisms is assessed by Professor R. J. Hay. Perhaps the most obvious immunological contribution to management thusfar liesin theimmunocytochemicaldiagnosis ofpathologicalconditions of the ears, nose and throat and this is covered in a chapter by Professor Leslie Michaels. Diseasesinwhichimmunemechanismsappeartobeharmfulordestructive rather than protective are then considered. These include Wegener's granu lomatosis and sarcoidosis. An update on the rapidly changing information on allergic rhinitis, on the effects offood and on nasal polyposis are given in three further chapters. The final chapter deals with future prospects for immunological involvement in ENT disorders. This volume should provide interesting insights, with possible novel therapeutic approaches, not only to otorhinolaryngologists, but also to audiologists, allergists and respiratory physicians. It should also provide an up-to-date background for any immunological researcher in this field. viii List of Contributors G. B. Brookes R. J. Hay Consultant ENTand Neuro-Otological StJohn's Instituteof Dermatology Surgeon Guy's Hospital, UMDS The Royal National Throat, Nose and Ear London Bridge Hospital London Gray's Inn Road; SE1 9RT UK National Hospital for Neurologyand Neurosurgery Queen Square; Honorary Senior Lecturer V.J. Lund Instituteof Laryngologyand Otology and Reader in Rhinology Institute ofNeurology Professorial Unit Universityof London; Institute ofLaryngology and Otology London UK UniversityCollege London; HonoraryConsultant in Otorinolaryngology The Royal National Throat, Noseand Ear Hospital A. B. Drake-Lee Gray's Inn Road; Consultant ENTSurgeon and Moorfields Eye Hospital Queen Elizabeth Hospital London UK Birmingham B152TH UK L. Michaels Departmentof Pathology P. Fitzharris The Royal NationalThroat, Noseand Ear Consultant Allergist Hospital Departmentof Medicine Gray's Inn Road Wellington School of Medicine London Mein St, Newtown, Wellington WC1X8DA UK PO Box7343, Wellington South NewZealand J. M.Parkin L.J.Hawk Departmentof Immunology PrincessChristian's Hospital StBartholomew's Hospital 12Clarence Road 38Little Britain Windsor London Berkshire EC1A7BE UK UK ix IMMUNOLOGY OF ENT DISORDERS G. K. Scadding Consultant Rhinologist The Royal National Throat, Nose and Ear Hospital Gray's Inn Road London WC1XBOA UK x
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