Shin Seung-Youp, Choi Gil-Soon, Park Hae-Sim, Lee Kun-Hee, Kim Sung-Wan, Cho Joong-Saeng
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyunghee University, Seoul, Korea.
Otolaryngol Head Neck Surg. 2009 Jul;141(1):91-6. doi: 10.1016/j.otohns.2009.03.023.
Chronic rhinosinusitis (CRS) is characterized by persistent inflammation and tissue remodeling of the nasal mucosa. Adenoidectomy is an effective surgical treatment in pediatric CRS. To evaluate the effect of pediatric CRS on the severity and characteristics of adenoid inflammation, the authors evaluated the expressions of inflammatory cell activation markers and tissue remodeling in adenoid tissues associated with cytokines tissue-remodeling-associated cytokines in adenoid tissues.
A prospective controlled study on 40 pediatric patients admitting for adenotonsillectomy.
Immunoassays were performed on adenoid tissues homogenates from 16 children with CRS and from 24 children without CRS to quantify the levels of inflammatory cell activation markers, such as soluble interleukin (IL)-2 receptor (sIL-2R), soluble CD23 (sCD23), IL-6, eosinophilic cationic protein (ECP), and tryptase, and the levels of cytokines associated with tissue remodeling, such as transforming growth factor (TGF)-beta1, matrix metalloproteinase (MMP) 2 and 9, and tissue inhibitor of metalloproteinase (TIMP)-1.
The mean levels (the ratio to albumin level) of sIL-2R, TGF-beta1, MMP-2, MMP-9, and TIMP-1 were significantly higher in adenoid tissues of patients with CRS (27.31+/-30.32, 4894.65+/-2388.77, 500.13+/-604.59, and 23.06+/-10.37, respectively) than those without it (16.27+/-10.93, 2635.51+/-1448.63, 120.87+/-321.50, 16.74+/-11.10, and 7.39+/-3.12, respectively; all P<0.05). Regarding the severity of CRS, ECP level was significantly higher in patients with severe CRS than in those with mild to moderate CRS (P=0.033).
Adenoid tissues in pediatric CRS patients had higher levels of tissue-remodeling-associated cytokines, which may explain the relationship between pediatric CRS and adenoid inflammation.
慢性鼻-鼻窦炎（CRS）的特征为鼻黏膜持续炎症和组织重塑。腺样体切除术是小儿CRS的一种有效外科治疗方法。为评估小儿CRS对腺样体炎症严重程度和特征的影响，作者评估了腺样体组织中炎症细胞活化标志物及与细胞因子相关的组织重塑的表达情况，这些细胞因子与腺样体组织中的组织重塑相关。
一项对40例接受腺样体扁桃体切除术的小儿患者进行的前瞻性对照研究。
对16例CRS患儿和24例非CRS患儿的腺样体组织匀浆进行免疫测定，以量化炎症细胞活化标志物水平，如可溶性白细胞介素（IL）-2受体（sIL-2R）、可溶性CD23（sCD23）、IL-6、嗜酸性粒细胞阳离子蛋白（ECP）和类胰蛋白酶，以及与组织重塑相关的细胞因子水平，如转化生长因子（TGF）-β1、基质金属蛋白酶（MMP）2和9以及金属蛋白酶组织抑制剂（TIMP）-1。
CRS患者腺样体组织中sIL-2R、TGF-β1、MMP-2、MMP-9和TIMP-1的平均水平（与白蛋白水平的比值）（分别为27.31±30.32、4894.65±2388.77、500.13±604.59和23.06±10.37）显著高于非CRS患者（分别为16.27±10.93、2635.51±1448.63、120.87±321.50、16.74±11.10和7.39±3.12；所有P<0.05）。关于CRS的严重程度，重度CRS患者的ECP水平显著高于轻度至中度CRS患者（P = 0.033）。
小儿CRS患者的腺样体组织中与组织重塑相关的细胞因子水平较高，这可能解释了小儿CRS与腺样体炎症之间的关系。
