\s=b\The distribution and number of lymphocytes, monocytes/macrophages, and cells expressing HLA-DR antigen were studied in frozen biopsy sections of nasal mucosa from 40 healthy adults, using monoclonal antibody avidin-biotin immunoperoxidase techniques. The lymphocyte to monocyte/macrophage ratio was estimated to be 10:1; the T cell to B cell ratio was 3:1; and the T helper/inducer cell to T suppressor/cytotoxic cell ratio averaged 2.5:1. Regional differences were observed with a relatively increased number of T suppressor /cytotoxic cells around submucosal glands, and a relatively large number of B cells in lymphocyte aggregates in the lamina propria. The HLA-DR antigen was expressed in epithelial cells, suggesting involvement of surface epithelium of human airway in local immune responses. (Arch Otolaryngol Head Neck Surg 1987;113:59-62) Lymphocytes are a normal cell pop-J ulation in the airway mucosa from the nose to the alveoli12; howev¬ er, a clear distinction between lym¬ phocytes and other mononuclear cells, or identification of lymphocyte sub¬ sets, cannot be made by ordinary staining methods. The availability of monoclonal antibodies against lym¬ phocyte surface antigens34 makes it possible to identify and quantify lym¬ phocyte subpopulations by immunohistochemical methods; this has been done in blood, lymph nodes,5 tonsils,6·7 salivary glands,8 gastrointestinal tract,912 kidney,'3 middle ear,14 and skin.15 Lymphocyte subsets have also been characterized in bronchoalveolar lavage fluid,1618 but, to our knowledge, there has been no report on the lymphocyte types and distribution in the normal airway mucosa.We describe the use of monoclonal antibodies to characterize the lym¬ phocyte and monocyte/macrophage populations of the normal human nasal mucosa. This mucous membrane is structurally similar to that of the tracheobronchial tree,19 and the nose provides a readily accessible source of biopsy specimens, sufficient for quan¬ titative characterization of the human airway mucosa.
PATIENTS AND METHODS
ParticipantsForty healthy adult volunteers older than age 18 years with normal rhinologic examinations and complete blood cell counts were recruited from the Charlottes¬ ville, Va, community (29 women and 11 men; mean age, 31 years; range, 21 to 45 years). Individuals with upper-respiratory illness or fever within one week prior to the study were excluded, as were individu¬ als using intranasal sprays or other drugs, and those with chronic allergic rhinitis, nasal polyps, or asthma.
Nasal Biopsy Collection and
FixationBiopsy specimens were taken from the anterior part of the inferior turbinate with a 4-mm double-ring biopsy forceps. The biopsy site was anesthetized with a 4% cocaine solution applied on cotton-wool. Hemostasis was obtained by silver nitrate cautery. The biopsy specimens were placed
