Respiratory Department, Beijing Children's Hospital, Capital Medical University, People's Republic of China.
Int Immunopharmacol. 2012 Aug;13(4):371-6. doi: 10.1016/j.intimp.2012.05.009. Epub 2012 May 23.
Evidence suggests that increased leukotriene level and receptor protein expression emerged in the adenotonsillar tissue of children with sleep-disordered breathing (SDB). Nevertheless, few studies have investigated the contribution of disease severity in the cysteinyl leukotriene (CysLT) production and cysteinyl leukotriene receptor (CysLTR) expression. Furthermore, the relationship between local upper-airway and systemic inflammatory responses remains undefined.
A prospective, observational study that included standard questionnaires, physical examinations and overnight polysomnography. CysLTs were determined from serum, urine and tonsillar homogenate supernatant by means of enzyme-linked immunosorbent assays. The protein expressions of CysLTR were measured using Western blot analysis.
Children with SDB had increased intratonsillar CysLT levels as well as CysLT subtype 1 receptor (CysLT1-R) and CysLT subtype 2 receptor (CysLT2-R) protein expression than the control group. CysLT concentration was positively correlated with body mass index z-score and apnea-hypopnea index (r=0.454 and 0.487, p<0.001 respectively), and negatively correlated with pulse oximetric saturation nadir (r=-0.518, p<0.001). Upper-airway intratonsillar CysLT production was positively correlated with systemic production (vs. urinary LTE₄: r=0.456, p<0.001; vs. serum CysLTs: r=0.440, p<0.001). Immunoblots showed that CysLT1-R protein expressions were modestly higher in the severe group when compared to the mild group. In contrast, there were no differences in CysLT2-R protein appearing among the SDB subgroups.
Increased CysLT level and receptor expression in upper-airway tonsillar tissues are related to disease severity in SDB children. The local and systemic CysLT production were positively correlated.
有证据表明，睡眠呼吸障碍（SDB）儿童的腺样体组织中白细胞三烯水平和受体蛋白表达增加。然而，很少有研究调查疾病严重程度对半胱氨酰白三烯（CysLT）产生和半胱氨酰白三烯受体（CysLTR）表达的贡献。此外，局部上呼吸道和全身炎症反应之间的关系尚不清楚。
这是一项前瞻性观察研究，包括标准问卷、体格检查和整夜多导睡眠图。通过酶联免疫吸附试验从血清、尿液和扁桃体匀浆上清液中测定 CysLTs。使用 Western blot 分析测量 CysLTR 的蛋白表达。
与对照组相比，SDB 儿童的扁桃体组织内 CysLT 水平以及 CysLT 亚型 1 受体（CysLT1-R）和 CysLT 亚型 2 受体（CysLT2-R）蛋白表达均升高。CysLT 浓度与体重指数 z 评分和呼吸暂停低通气指数呈正相关（r=0.454 和 0.487，p<0.001），与脉搏血氧饱和度最低值呈负相关（r=-0.518，p<0.001）。上呼吸道扁桃体 CysLT 产生与全身产生呈正相关（与尿 LTE₄相比：r=0.456，p<0.001；与血清 CysLTs 相比：r=0.440，p<0.001）。免疫印迹显示，与轻度组相比，重度组 CysLT1-R 蛋白表达略高。相比之下，SDB 亚组之间 CysLT2-R 蛋白表达无差异。
上呼吸道扁桃体组织中 CysLT 水平和受体表达的增加与 SDB 儿童的疾病严重程度有关。局部和全身 CysLT 产生呈正相关。
