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Zur Morphologie und Bedeutung des Mononukleären-Phagozyten-Systems (MPS) bei der chronischen Rhinosinusitis

Eine licht- und elektronenmikroskopische Untersuchung

Structure and function of the mononuclear phagocytic system (MPS) in chronic rhinosinusitis

A light and electron microscopic investigation

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Summary

Neither the concept of the Reticulo-Endothelial-System (RES) Aschoff's (1924) nor that of the Reticulo-Histiocyte-System (RHS) provides a satisfactory framework into which the present knowledge of the phagocytic mononuclear cells can be fitted. Current knowledge concerning morphology, histochemistry (peroxydase and esterase activity), immunology (specific surface antigens, receptors on the cell membranes), function (immune phagocytosis, pinocytosis), kinetics (3H-thymidine labelling) and culture makes it possible to place all highly phagocytic mononuclear cells and their precursors in one system, which is called the Mononuclear-Phagocytic-System (MPS) (Langevoort, Conn, Hirsch, Humphrey, Spector, van Furth, 1969).

Kinetic studies with labelled cells have shown, that mononuclear phagocytes originate from precursor cells in the bone marrow (stem cell → monoblasts → promonocytes), than are circulating in the peripheral blood as monocytes and are transformed to tissue macrophages entering tissues. The MPS comprises following cells in following organs: connective tissue (histiocytes resp. macrophages); liver (Kupffer-cells); lung (alveolar macrophages); lymph nodes (free and fixed macrophages); bone marrow (macrophages); serous cavities (pleural and peritoneal macrophages); bone tissue (osteoclasts?); nervous system (microglial cells) (see Table 1).

The reticular cells, endothelial cells and fibroblasts (fibrocytes) can therefore not be included in the MPS. Besides differences in morphology, histochemistry and function, they derive from mesenchymal cells and not from the bone marrow as the MPS.

The present investigation demonstrates the structure and significance of the MPS in various kinds of chronic-specific and non-specific rhinosinusitis. On semithin sections two kinds of macrophages can be distinguished light-microscopically:

  1. 1.

    Larger macrophages with many phagosomes (storage cells) (Fig. 1A), which can exhibit sometimes a ring-shape on sections embracing greater parts of the interstitium (Fig. 1B). Such forms are mainly found in chronic (maxillary) sinusitis and are interpretated as “scavenger” macrophages.

  2. 2.

    The second type consists of smaller macrophages with extremely ruffling of the cell surface, wich is interpretated as an expression of highly (specific?) stimulated states. These later macrophages can be seen mainly in edematous nasal polyps, which might be caused by allergic reactions of the anaphylactic type.

The fine structure of the phagocytes is to some extend dependent on the actual development and functional state: there are “immature” macrophages, which are practically indistinguishable from blood monocytes (Fig. 2A); some of them can be stimulated and can therefore show many surface foldings and projections (Fig. 2B). The “mature” macrophage shows a well developped Golgi-area and many secondary lysosomes (Fig. 3). The storage type of the macrophages, which can predominate in some cases of chronic maxillary sinusitis, is characterized by many electron-lucent vacuoles (Fig. 4).

The macrophages can transform unspecifically to epitheloid- and giant-cells, as it is shown in foreign bodys- and cholesterol-granulomas in maxillary sinusitis (Fig. 5A and 5B). This tranformation to epitheloid and giant-cells might also be induced specifically by stimulated T-lymphocytes in immunological reaction of the delayed type, for example in sarcoidosis (Fig. 6A) and tuberculosis (Fig. 6B) of the nose.

The macrophage is not only of great importance as the carrier of the cellular immunity in the sense of Metschnikoff (1905), but he is also involved in the initiation and regulation of the specific humoral and cellular immune responses. These facts and the phagocytic and synthetic properties of the macrophages are discussed in regard to their significance for the etiology and course of chronic rhinosinusitis.

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Die elektronenmikroskopischen Untersuchungen, die im Zentrum für Elektronenmikroskopie Graz (Leiter: w. Hofrat Dr. F. Grasenick) durchgeführt wurden, sind durch den Fonds zur Förderung der wissenschaftlichen Forschung in Österreich ermöglicht worden

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Albegger, K.W. Zur Morphologie und Bedeutung des Mononukleären-Phagozyten-Systems (MPS) bei der chronischen Rhinosinusitis. Arch Otorhinolaryngol 214, 27–48 (1976). https://doi.org/10.1007/BF00455107

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