Search Results (396)

Obstructive sleep apnea (OSA) is characterized by recurrent partial or complete upper airway collapse during sleep. Accurate assessment of airway anatomy is crucial for risk stratification, diagnosis, and treatment planning. While polysomnography (PSG) is considered the gold standard for OSA diagnosis, it provides limited anatomical insights. Cone-beam computed tomography (CBCT) has emerged as a valuable tool with lower radiation dose for three-dimensional (3D) assessment of the upper airway space and craniofacial structures. CBCT enables precise measurement of critical airway parameters including total airway volume and length, minimum cross-sectional area, linear dimensions of anteroposterior and lateral diameters, as well as soft tissue structures such as tongue, tonsils, and adenoids. This review aims to explore and comprehensively review the role of CBCT, primarily in upper airway assessment for OSA, with an emphasis on airway measurement parameters, anatomical reference landmarks, and the variabilities, in addition to its clinical applications in treatment planning and simulation and post-treatment efficacy evaluation. This review also highlights the technical considerations such image acquisition protocols, machine specifications and software algorithm, and patient positioning, which may affect measurement reliability and diagnostic accuracy. CBCT serves as a powerful adjunct in OSA diagnosis and management, enabling comprehensive assessment of the airway space and hard and soft tissue structures. It complements PSG by guiding personalized interventions such as maxillomandibular advancement or CPAP optimization. Standardized imaging protocols and consideration of patient positioning can further improve its clinical utility. Full article

Mycoplasma hyosynoviae is a significant pathogen in swine populations, contributing to polyarthritis and lameness in growing pigs. This study characterizes the clinical presentation, pathogen detection, immune response, and lesion development following experimental inoculation with two distinct M. hyosynoviae strains. Pigs were inoculated with either a low- or high-virulence strain and monitored for 18 days. Lameness was observed throughout the study, with affected pigs exhibiting mild to moderate clinical signs. M. hyosynoviae was often detected in the tonsils, while detection in oral fluids was transient. Serum IgG levels increased significantly in the inoculated groups. IL-1β, IL-6, and TNF-α cytokines were elevated only at 7 DPI, whereas IL-8, IL-10, and IFN-γ levels were unchanged in both inoculated groups. Notably, only pigs inoculated with the high-virulence strain developed lesions, and M. hyosynoviae was detected only in the synovial fluid by PCR from this group. These findings highlight strain-dependent differences in the pathogenesis of M. hyosynoviae. The pathological differences between these strains suggest variations in adherence factors, immune evasion capabilities, or metabolic adaptability. Further research is warranted to elucidate the genetic determinants of virulence and the protective role of humoral and cellular immune responses in M. hyosynoviae infection. Full article

Background and Clinical Significance: Lymphoepithelial cysts are uncommon benign lesions of the head and neck, rarely encountered within the oral cavity and exceedingly infrequent in the palatine tonsils. Their nonspecific clinical presentation and ability to mimic more common benign entities often render diagnosis challenging. Case Presentation: We report the case of a 68-year-old woman with a four-year history of persistent foreign-body sensation in the oropharynx despite multiple normal otolaryngologic examinations. Flexible nasoendoscopy was non-diagnostic, as the lesion was deeply concealed within the superior tonsillar pole between the palatine pillars. Targeted tonsillar manipulation ultimately revealed a small pedunculated mass and contrast-enhanced computed tomography demonstrated a well-circumscribed, non-enhancing cystic lesion confined to the tonsillar parenchyma. Surgical excision under general anesthesia confirmed an oral lymphoepithelial cyst on histopathologic analysis. The patient remained asymptomatic with no recurrence at four months. Conclusions: This case underscores the rarity of tonsillar lymphoepithelial cysts, highlights the diagnostic limitations of endoscopic evaluation for cryptic superior-pole lesions and emphasizes the importance of meticulous dynamic oropharyngeal examination. Complete surgical excision is both definitive and curative, with an excellent prognosis. Full article

Molar incisor hypomineralisation (MIH) is a developmental defect affecting permanent first molars and often the incisors too. Hypomineralised second primary molars (HSPM) have been proposed as potential early indicators of MIH. Aim: The aim was to identify potential aetiological factors associated with MIH and assess their relationship with HSPM in a pilot study. Methods: A cross-sectional case–control study was conducted with 120 patients (60 cases and 60 controls), aged 7–15 years, from the Paediatric Dentistry Postgraduate Programme. MIH was diagnosed following European Academy of Paediatric Dentistry (EAPD) guidelines. Parents completed a structured questionnaire on potential aetiological factors. Results: MIH was significantly associated with maternal smoking during pregnancy (p = 0.013), birth hypoxia (p = 0.013) and the use of amoxicillin and inhalation therapy during infancy (p < 0.001). It was also associated with tonsillitis (p = 0.022), bronchiolitis (p = 0.005) and other respiratory disorders (p = 0.049). HSPM was associated with anaemia and hypotension during pregnancy (p = 0.001), bottle-feeding (p = 0.044) and urinary tract infections (p = 0.003). No statistically significant association was found between MIH and HSPM. Conclusions: This pilot study has identified specific prenatal, perinatal, and postnatal factors associated with MIH and HSPM. The findings emphasise the clinical relevance for early diagnosis and management and highlight the need for studies with larger sample sizes to validate these associations. Full article

Psoriasis vulgaris is a T-cell-mediated skin disease that may involve an autoimmune response against melanocytes. It develops through still unexplained pathomechanisms. Streptococcal tonsillopharyngitis is a major trigger of psoriasis onset and relapses. HLA-C*06:02 is the main psoriasis risk gene. Here we find that B cells isolated from streptococci-infected tonsils or peripheral blood of HLA-C*06:02⁺ psoriasis patients stimulate an HLA-C*06:02-restricted melanocyte-reactive Vα3S1/Vβ13S1 T-cell receptor (TCR) from a lesional psoriatic CD8⁺ T cell clone in an IFN-γ-enhanced manner. Patients’ B cells furthermore induce proliferation of autologous blood CD8⁺ T cells. We identify several HLA-C*06:02-presented self-peptides in the immunopeptidomes we had isolated from four HLA-C*06:02 homozygous B-cell lines that stimulate the Vα3S1/Vβ13S1 TCR and differ from the melanocyte autoantigen recognized by this TCR. These data suggest that the proinflammatory environment of streptococcal tonsillopharyngitis may enable B cells to activate autoreactive CD8⁺ T cells that, owing to the polyspecificity of T-cell receptors, recognize several B-cell self-peptides presented by HLA-C*06:02 and subsequently cross-react against melanocytes in the skin, thereby triggering psoriasis. The capacity of B cells to stimulate a cross-reactive autoimmune response through HLA class I-presented B-cell peptides is a previously unknown mechanism in the induction of autoimmunity that could explain psoriasis onset and persistence. Full article

Wild boars, widely distributed across natural, agricultural, and urban landscapes, represent an ideal sentinel species for monitoring the emergence and spread of antimicrobial resistance (AMR) at the human–wildlife–livestock interface within the One Health framework. This review summarizes current knowledge on the prevalence, diversity, AMR, and epidemiological significance of major enteric pathogens isolated from wild boars in the European Union, with particular attention to their potential role in AMR dissemination. Numerous studies have reported variable prevalence rates for Salmonella spp., Yersinia enterocolitica, Shiga toxin-producing Escherichia coli (STEC), and Campylobacter spp. High prevalence rates has been observed in fecal samples—35% for Salmonella, 27% for Y. enterocolitica and STEC, and 66% for Campylobacter—highlighting the role of wild boars as carriers and the associated risk of carcass contamination during slaughter. Tonsils represent a key niche for Y. enterocolitica, with prevalence reaching 35%. Several studies have identified resistance to antimicrobials classified by the World Health Organization as critically important or high priority for human medicine, including fluoroquinolone-resistant non-typhoidal Salmonella spp. and third-generation cephalosporin-resistant Y. enterocolitica, raising notable public health concerns. Despite increasing interest, most available studies remain descriptive and geographically limited, providing limited insight into AMR acquisition and transmission pathways in wild boars. New approaches—such as resistome analyses and epidemiological cut-off values—offer added value to distinguish wild-type from acquired-resistant strains and to better understand AMR dissemination dynamics. Integrating wildlife into One Health surveillance systems is essential to capture the full complexity of AMR spread. Full article

Sore throat, commonly associated with pharyngitis and tonsillitis, is primarily caused by bacterial pathogens. Conventional therapies rely on antibiotics and anti-inflammatory drugs; however, concerns about adverse effects, antibiotic resistance, and drug interactions have encouraged the search for alternative remedies. Cannabis sativa L. (CS) has demonstrated potential in relieving sore throat and inflammation, while propolis, a bee-derived natural product, exhibits notable antibacterial and anti-inflammatory activities. This study aimed to investigate the enhanced antibacterial and anti-inflammatory effects of combining CS and propolis extracts (PE). Results found that CS and PE exhibited antibacterial effects against Streptococcus pyogenes DMST 4369, Staphylococcus aureus ATCC 25923, and Pseudomonas aeruginosa ATCC 9027. Their combination produced additive antibacterial effects against S. pyogenes and S. aureus. Cannabidiol (CBD) was identified as an active antibacterial constituent against S. pyogenes. Additionally, the PE-CBD in CS solution combination at concentration 625:0.125 µg/mL significantly reduced NO production and suppressed proinflammatory cytokines in LPS-stimulated macrophages. This study highlights the enhanced antibacterial and anti-inflammatory potential of the C. sativa and propolis combination, emphasizing the need to verify synergistic effects and determine the appropriate ratio for rational product development. Further research is needed to investigate the underlying mechanisms of action, particularly the anti-inflammatory pathways, in animal models. In addition, studies on hepatotoxicity should be conducted to ensure safety. Full article

The attachment–invasion locus protein Ail of pathogenic Yersinia strains is an important virulence factor, both for invasion of eucaryotic cells and for serum resistance. In other Yersinia strains, e.g., those belonging to biotype (BT) 1A of Yersinia enterocolitica, ail has only occasionally been described. Sequence analysis of 370 BT 1A isolates in our laboratory revealed 41 (11.1%) which were ail-positive. Most of these isolates were recovered from minced meat and tonsils of wild boars, and belonged to 17 MLST allele profiles. A closer look at DNA sequences surrounding ail disclosed that the gene in most isolates is embedded in DNA regions encoding phage proteins. The genomes of four prophages belonging to four different phylogenetic clusters were determined and analyzed by in silico studies. These have sizes of 34.9 and 50.7 kb, and are closely related to each other but not to known phages. Unlike other regions of the prophages, the integrases and attachment sites of some of them diverge, leading to different integration sites in the isolates. In a fifth cluster, ail is relocated at a position on the Y. enterocolitica chromosome that is several hundred kilobases apart from those of the other clusters, but surrounded by prophage-related sequences. In addition, highly pathogenic 1B/O:8 strains contain a DNA segment which includes ail and is 65 to 94% identical to the prophage sequences determined in this study. Full article

Current therapeutic strategies for IgE-mediated diseases are limited. The drawbacks include adverse reactions, ineffectiveness, and relapses. Natural compound berberine (BBR) may combat this therapeutic gap through sustained transcriptional regulation of IgE. Human tonsil cells were cultured in the presence or absence of BBR to establish dose-dependent effects on IgE, IgG, and cell viability. IgE-producing plasma cells (U266, IgE plasma cells) and IgG-producing plasma cells (ARH-77, IgG plasma cells) were used as surrogate cells to validate dose-dependent effects on IgE and IgG production, respectively. At 10 μg/mL BBR, cell viability and proliferation were determined, and cells were harvested for protein, RNA, and miRNA and analyzed by Western blot and qPCR. BBR treatment of human tonsil samples resulted in reduced IgE production (p < 0.001) with no effect on IgG levels or cell viability. BBR demonstrated sustained, dose-dependent inhibition of IgE production by IgE plasma cells (p < 0.001), without affecting IgG production by IgG plasma cells. There was no significant reduction in cell viability of either cell type. Proliferation was reduced in IgE plasma cells (p = 0.02), but not IgG plasma cells. Assessment of IgE regulation and cell cycle at the RNA level revealed that BBR reduced IgE heavy chain expression and CCND1 (p < 0.01), with increased the GADD45A expression of IgE plasma cells, only (p = 0.016). At the protein level, BBR increased p53 (p = 0.02) and CDKN1C (p = 0.03), and decreased CDK2 (p = 0.01) expression of IgE plasma cells, only. Investigation of miRNAs implicated in B cell and p53 regulation demonstrated increased p53 and GADD45A activator, miR-34a (p = 0.04). miRNAs that are present in IgE plasma cells allow for specific effects on B cells and cell cycle genes by BBR, that are not present in IgG plasma cells. A novel mechanism for specific suppression of IgE by BBR highlights miR-34a, involved in the p53 pathway and B cell development, and may be crucial to pathological IgE production. Full article

The current knowledge on the histological structure of the gastrointestinal tract (GIT) in cetaceans is based on general descriptions. The aim of this study was to characterize the histology and expression of immune cell markers in samples from the GIT and lymph nodes (LNs) in a harbour porpoise (Phocoena phocoena) bycaught in the Cantabrian Sea. The thickness of the histological layers of the GIT was measured, being greater in the stomach and anal canal, although no significant differences were found among any intestinal segment (p = 0.448). Variation in thickness, morphology of the folds, and the presence of Peyer’s patches allowed the duodenal ampulla and the distal segments to be distinguished from the rest of the intestine. An immunohistochemical technique was performed to identify the following markers: IBA1 for macrophages, CD3 for T lymphocytes, and CD20 for B lymphocytes. The distribution of immune cells varied significantly along the GIT, with higher percentages of all three cell types in the distal intestine and the anal tonsil. Within the LNs, B lymphocytes represented the predominant cell population. This study provides the first description of the histological structure of the GIT and associated lymphoid tissue in a harbour porpoise, which will be useful for future research studies. Full article

Background: Celiac disease (CD) is a gluten-sensitive immune-related enteropathy of the small intestine characterized by villus atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes (IELs). Objectives: To characterize the phenotype of IELs and immune cells of the lamina propria of small intestine control using immuno-oncology and immune-phenotype markers and test the most relevant marker, an immune checkpoint co-inhibitory receptor, leukocyte-associated immunoglobulin-like receptor 1 (LAIR1), in CD. Methods: Immunohistochemical analysis of CD3 (CD3E), CD4, CD8, CD103 (ITGAE), Granzyme B (GZMB), TCR beta (β), TCR delta (δ), CD56 (NCAM), CD16 (FCGR3A), LAIR1 (CD305), PD-L1 (CD274), PD1 (CD279), BTLA (CD272), TOX2, HVEM (TNFRSF14), CD163, HLA-DP-DQ-DR, IL4I1, and FOXP3 was performed using histological analysis. Gene expression analysis was performed using an independent dataset to expand and confirm the findings. Results: IELs exhibited a cytotoxic T-cell phenotype and were CD3+, CD8+, CD103+, TCR beta+, and LAIR1+. The lamina propria (LP) was abundant in CD163+, HLA-DP-DQ-DR+, BTLA+, PD-L1+, CD103+, CD56+, and LAIR1+ cells corresponding to macrophages and T- and B-lymphocytes. In CD, IELs and part of the inflammatory cells of the lamina propria cells were LAIR1+. CD was characterized by higher quantity of LAIR1+ IELs and LP immune cells than the small intestine control (p = 0.004). Higher intestinal lesions evaluated by Marsh scoring were correlated with higher LAIR1 (p < 0.001). Gene expression analysis confirmed the overexpression of the LAIR1 pathway in CD and highlighted BTLA. At the protein level, BTLA overexpression was confirmed in CD. Finally, as a proof-of-concept AI analysis, a convolutional neural network classified LAIR1-stained image patches between the three diagnoses of small intestine control, CD, and reactive tonsils with high accuracy (99.6%). Conclusions: IELs exhibit a cytotoxic T-cell phenotype and were found to be CD3+, CD8+, CD103+, TCR beta+, and LAIR1+ in the small intestine control. Increased numbers of LAIR1+ IELs and lamina propria immune cells characterize CD. Full article

Background: Tularemia is a zoonotic infection caused by Francisella tularensis, transmitted to humans through direct contact with infected animals, arthropod bites, or by ingesting contaminated water. It commonly presents with fever, lymphadenopathy, and oropharyngeal symptoms. In Turkey, where waterborne outbreaks are frequent, tularemia remains a significant public health concern. This study aimed to compare the clinical, epidemiological, and laboratory characteristics of patients diagnosed with tularemia and those with similar clinical features but seronegative results, with the goal of identifying parameters that may assist in differential diagnosis. Methods: This retrospective study included adults (≥18 years) who presented to the Infectious Diseases Outpatient Clinic between 2016 and 2024 with suspected tularemia and were tested using a microagglutination test (MAT). Patients with a positive MAT (≥1:160) or a fourfold titre increase were classified as tularemia cases, while seronegative patients were defined as tularemia-like cases. Demographic data, clinical symptoms, epidemiological risk factors, and laboratory findings were compared between the two groups. Results: A total of 105 patients were included, 54 (51.4%) of whom were diagnosed with tularemia. The duration from symptom onset to healthcare presentation was significantly longer in tularemia cases (20.3 ± 5.7 vs. 15.7 ± 6.2 days; p < 0.001). Sore throat (66.7% vs. 43.1%; p = 0.026) and tonsillitis/pharyngitis (55.6% vs. 21.6%; p = 0.001) were significantly more prevalent in the tularemia group. Epidemiological risk factors, including rural residence (92.6%), animal husbandry (74.1%), agricultural activity (72.2%), and contact with lake or stream water, were significantly more prevalent among tularemia cases (all p < 0.001). Alanine aminotransaminase (p = 0.019) and C-reactive protein levels (p = 0.027) were significantly lower in the tularemia group. Conclusions: Tularemia cases are associated with particular epidemiological risk factors and oropharyngeal symptoms. A thorough epidemiological evaluation is crucial for diagnosis, and enhancing awareness among healthcare providers and the public may facilitate earlier recognition and management. Full article

Tonsillectomy is one of the most common surgical procedures and, given the limited efficacy of conservative treatment, remains the primary approach for managing palatine tonsillitis (PT) and palatine tonsillar hypertrophy (PTH). Both conditions negatively affect quality of life (QoL), increase healthcare costs, and contribute to work absenteeism. Objectives: The primary aim of this study is to assess QoL following tonsillectomy and uvulopalatopharyngoplasty (UPPP) in patients qualified for surgical treatment due to PT and PTH. Methods: A prospective cohort study was conducted among 89 adults (85% follow-up) who had undergone tonsillectomy and UPPP. QoL was assessed 6 years post-op using the Glasgow Benefit Inventory (GBI), the Schwentner questionnaire, and VAS. The study group included 89 patients (85% of those who underwent surgery), including 26 women (29%) and 63 men (71%). Results: Patients with PT and PTH showed significant QoL improvement after palatine tonsillectomy. The mean GBI score indicated QoL improvement after both tonsillectomy (+25.7) and UPPP (+15.8), with the most pronounced improvements in physical and general health. Overall, GBI scores were higher in PT compared to PTH (26.6 compared to 15.5), mainly due to better results in the physical health domain (55.9 compared to 12.9). Conclusions: Palatine tonsillectomy has a positive impact on QoL in both PT and PTH patients, with higher questionnaire scores observed in the PT group. Tonsillectomy contributed more significantly to the improvement in QoL than UPPP, as measured by the GBI, the Schwentner questionnaire, and the Visual Analogue Scale (VAS). Furthermore, our study demonstrated that, when evaluating and qualifying patients for tonsillectomy, a more comprehensive otolaryngological assessment should be conducted, including evaluation of the nasal cavity and nasopharynx, as comorbid conditions in these regions are correlated with postoperative QoL outcomes. Full article

Y. enterocolitica is a cold-tolerant, foodborne pathogen that poses a significant risk to public health, with pigs identified as its main reservoir. This review explores the current knowledge on the epidemiology, transmission, and virulence of Y. enterocolitica in pigs, highlighting their central role in spreading the bacterium to humans—primarily through the consumption of raw or undercooked pork. The pathogen is frequently found in pig tonsils and intestines and can contaminate meat during slaughter. Among the various strains, bioserotype 4/O:3 is the most common cause of human illness. Y. enterocolitica carries a diverse set of virulence genes, such as ail, yst, inv, and yad, and evades immune responses. The review also covers major outbreaks, risk factors on farms and in slaughterhouses, and the limitations of current surveillance systems. Reducing the impact of Y. enterocolitica requires a One Health approach linking animal health, food safety, and public health. Full article

This study evaluated zinc glycinate (ZG) on necrotic enteritis (NE) in chickens through two in vivo experiments and one in vitro experiment. In vivo, ZG was supplemented (study 1: 40–120 mg/kg; study 2: 100–160 mg/kg). In total, 192 (exp. 1) and 240 Cobb male birds (exp. 2) (n = 6) were studied for 28 days. ZG at 120 mg/kg significantly improved BWG by day 28 (p < 0.05), while 140 mg/kg reduced FCR (p < 0.05). Lesions were significantly reduced by 120 mg/kg (p < 0.01), and mortality was lowered by 80 mg/kg (study 1, p < 0.05) and 120 mg/kg (study 2, p < 0.01). ZG at 160 mg/kg increased IFN-γ expression in the spleen (p < 0.01), and 140 mg/kg decreased Zn/Cu SOD1 in the cecal tonsils (p < 0.05). In vitro, zinc (10–1000 µM) enhanced intestinal cell viability under Clostridium perfringens challenge. Cytotoxicity in HD-11 cells decreased significantly at concentrations ≥100 µM after 12 h (p < 0.001) and ≥10 µM after 24 h (p < 0.001), with the lowest levels observed at 100 µM (p < 0.001). We recommend increasing zinc to 120 mg/kg as ZG in poultry feed against NE infection. Full article