Kaditis Athanasios G, Ioannou Maria G, Chaidas Konstantinos, Alexopoulos Emmanouel I, Apostolidou Maria, Apostolidis Theoharis, Koukoulis George, Gourgoulianis Konstantinos
Sleep Disorders Laboratory, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece.
Department of Pathology, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece.
Chest. 2008 Aug;134(2):324-331. doi: 10.1378/chest.07-2746. Epub 2008 May 19.
Increased expression of cysteinyl leukotriene receptors (cysteinyl leukotriene receptor-1 [LT1-R]; cysteinyl leukotriene receptor-2 [LT2-R]) has been detected in adenotonsillar tissue from children with sleep-disordered breathing (SDB) compared to control subjects. LT1-R has been localized in myeloperoxidase-positive cells. This phenomenon possibly contributes to lymphoid tissue enlargement and may be related to systemic inflammation.
To characterize cells expressing LT1-R and LT2-R in tonsillar tissue and assess serum C-reactive protein (CRP) levels in children with and without SDB.
Immunohistochemistry with LT1-R and LT2-R antibodies was used to examine tonsils from children who had tonsillectomy (with or without adenoidectomy) for SDB and from control subjects operated for recurrent tonsillitis/otitis. All participants underwent preoperative polysomnography and measurement of morning serum CRP.
Fifteen children with SDB (mean age +/- SD, 6.4 +/- 2.1 years; apnea-hypopnea index, 9.6 +/- 5.6 episodes per hour) and 11 control subjects (age, 7.5 +/- 2.8 years; apnea-hypopnea index, 7 +/- 0.3/h) were examined. Immunoreactivity for LT1-R and LT2-R was detected in tonsillar extrafollicular areas of all subjects with SDB but not of control subjects. Cells expressing leukotriene receptors were CD3+ lymphocytes. Children with SDB and control subjects were similar regarding CRP levels: 0.11 +/- 0.15 mg/dL vs 0.09 +/- 0.15 mg/dL, respectively (p > 0.05).
Tonsils of children with SDB but not of control subjects have enhanced expression of cysteinyl leukotriene receptors in T lymphocytes without an associated increase in serum CRP concentration. Up-regulation of LT1-R and LT2-R could potentially promote tonsillar enlargement in children with obstructive sleep apnea.
与对照组相比，在患有睡眠呼吸障碍（SDB）儿童的腺样体扁桃体组织中检测到半胱氨酰白三烯受体（半胱氨酰白三烯受体-1 [LT1-R]；半胱氨酰白三烯受体-2 [LT2-R]）表达增加。LT1-R已定位在髓过氧化物酶阳性细胞中。这种现象可能导致淋巴组织增大，并且可能与全身炎症有关。
鉴定扁桃体组织中表达LT1-R和LT2-R的细胞，并评估有和没有SDB的儿童的血清C反应蛋白（CRP）水平。
使用LT1-R和LT2-R抗体进行免疫组织化学，以检查因SDB接受扁桃体切除术（有或没有腺样体切除术）的儿童以及因复发性扁桃体炎/中耳炎接受手术的对照受试者的扁桃体。所有参与者均接受术前多导睡眠图检查和早晨血清CRP测量。
检查了15名患有SDB的儿童（平均年龄±标准差，6.4±2.1岁；呼吸暂停低通气指数，每小时9.6±5.6次发作）和11名对照受试者（年龄，7.5±2.8岁；呼吸暂停低通气指数，7±0.3/小时）。在所有患有SDB的受试者而非对照受试者的扁桃体滤泡外区域检测到LT1-R和LT2-R的免疫反应性。表达白三烯受体的细胞是CD3+淋巴细胞。患有SDB的儿童和对照受试者的CRP水平相似：分别为0.11±0.15 mg/dL和0.09±0.15 mg/dL（p>0.05）。
患有SDB的儿童而非对照受试者的扁桃体中，T淋巴细胞中的半胱氨酰白三烯受体表达增强，而血清CRP浓度没有相应增加。LT1-R和LT2-R的上调可能会促进阻塞性睡眠呼吸暂停儿童的扁桃体增大。
