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腺样体扁桃体切除术对血清特异性免疫球蛋白 E 的长期影响。

Long-term effects of adenotonsillectomy on serum-specific immunoglobulin E.

机构信息

State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Department of Oncology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

Pediatr Res. 2017 Nov;82(5):801-805. doi: 10.1038/pr.2017.165. Epub 2017 Aug 2.

DOI:10.1038/pr.2017.165
PMID:28700564
Abstract

BackgroundThe biased immune reactions of the adenotonsillar tissues are not always reflected by the serum immunoglobulin E (IgE); thus, we hypothesize that the systemic atopic status may not be changed after the adenotonsillectomy (AT) in children.MethodsTwenty-five children with AT and 23 age-matched healthy children were enrolled into this study, and followed up for ~4 years. Nasal Symptoms Scores (NSS), Quality of Life Scores (QOLS), specific IgE (sIgE), cytokines, and inflammatory cell were documented in all the subjects before and after study.ResultsFourteen patients and three healthy controls had positive serum sIgE levels (>0.35 kU/l) at the study-start that was not changed by the study-end. Two patients and two sIgE-negative healthy controls showed the Dermatophagoidespteronyssinus sensitization at the study-end. NSS and QOLS showed significant improvement after the surgery in the sIgE-positive patients (P<0.05), whereas no significant changes were found in the sIgE-negative patients (P=1.00). In addition, the serum sIgE-negative patients showed significant increases in interleukin (IL)-4, IL-5, and IL-10 levels in the serum (P<0.001), although no significant differences were found post surgery (P=0.667, 0.408, and 0.714, respectively).ConclusionsOur study showed that AT did not affect the pediatric atopic status. The systemic atopy may be independent of the tonsillar and adenoid tissues in children.

摘要

背景

腺样体和扁桃体组织的免疫反应偏倚并不总是反映在血清免疫球蛋白 E(IgE)中;因此,我们假设儿童腺样体扁桃体切除术后(AT)全身过敏状态可能不会改变。

方法

本研究纳入了 25 名接受 AT 的儿童和 23 名年龄匹配的健康儿童,并进行了~4 年的随访。所有受试者在研究前后均记录了鼻部症状评分(NSS)、生活质量评分(QOLS)、特异性 IgE(sIgE)、细胞因子和炎症细胞。

结果

14 名患者和 3 名健康对照者在研究开始时血清 sIgE 水平(>0.35 kU/l)呈阳性,在研究结束时未发生变化。2 名患者和 2 名 sIgE 阴性健康对照者在研究结束时对尘螨过敏。sIgE 阳性患者手术后 NSS 和 QOLS 明显改善(P<0.05),而 sIgE 阴性患者无明显变化(P=1.00)。此外,sIgE 阴性患者血清中白细胞介素(IL)-4、IL-5 和 IL-10 水平显著升高(P<0.001),尽管术后无显著差异(P=0.667、0.408 和 0.714)。

结论

我们的研究表明 AT 不会影响儿童的特应性状态。儿童的全身过敏可能与扁桃体和腺样体组织无关。

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Long-term effects of adenotonsillectomy on serum-specific immunoglobulin E.腺样体扁桃体切除术对血清特异性免疫球蛋白 E 的长期影响。
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Nasal IL-4(+)CXCR5(+)CD4(+) T follicular helper cell counts correlate with local IgE production in eosinophilic nasal polyps.鼻内 IL-4(+)CXCR5(+)CD4(+)滤泡辅助性 T 细胞计数与嗜酸性鼻息肉局部 IgE 产生相关。
J Allergy Clin Immunol. 2016 Feb;137(2):462-73. doi: 10.1016/j.jaci.2015.07.025. Epub 2015 Aug 30.
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The effect of tonsillectomy on the immune system: A systematic review and meta-analysis.扁桃体切除术对免疫系统的影响:一项系统评价与荟萃分析。
Int J Pediatr Otorhinolaryngol. 2015 Aug;79(8):1184-91. doi: 10.1016/j.ijporl.2015.05.016. Epub 2015 May 27.
3
Impact of allergic rhinitis on quality of life after adenotonsillectomy for pediatric sleep-disordered breathing.
变应性鼻炎对小儿睡眠呼吸障碍行腺样体扁桃体切除术后生活质量的影响。
Int Forum Allergy Rhinol. 2015 Aug;5(8):741-6. doi: 10.1002/alr.21529. Epub 2015 Apr 21.
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Association of adenotonsillectomy with asthma outcomes in children: a longitudinal database analysis.儿童腺样体扁桃体切除术与哮喘结局的关联:一项纵向数据库分析
PLoS Med. 2014 Nov 4;11(11):e1001753. doi: 10.1371/journal.pmed.1001753. eCollection 2014 Nov.
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Increased local IgE production induced by common aeroallergens and phenotypic alteration of mast cells in Chinese eosinophilic, but not non-eosinophilic, chronic rhinosinusitis with nasal polyps.常见气传变应原诱导的局部IgE产生增加以及中国嗜酸性粒细胞性(而非非嗜酸性粒细胞性)慢性鼻-鼻窦炎伴鼻息肉患者肥大细胞的表型改变。
Clin Exp Allergy. 2014;44(5):690-700. doi: 10.1111/cea.12304.
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Improvement in asthma control and inflammation in children undergoing adenotonsillectomy.腺样体扁桃体切除术对儿童哮喘控制和炎症的改善作用。
Pediatr Res. 2014 Mar;75(3):403-8. doi: 10.1038/pr.2013.237. Epub 2013 Dec 12.
7
Local atopy is more relevant than serum sIgE in reflecting allergy in childhood adenotonsillar hypertrophy.局部过敏症比血清 sIgE 更能反映儿童腺样体扁桃体肥大中的过敏反应。
Pediatr Allergy Immunol. 2013 Aug;24(5):422-6. doi: 10.1111/pai.12089. Epub 2013 Jun 3.
8
Local IgE-mediated hypersensitivity to Alternaria in pediatric adenoid tissue.小儿腺样体组织中对链格孢属的局部IgE介导的超敏反应。
Int J Pediatr Otorhinolaryngol. 2012 Oct;76(10):1423-8. doi: 10.1016/j.ijporl.2012.06.015. Epub 2012 Jul 6.
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Age-specific prevalence of outdoor and indoor aeroallergen sensitization in Boston.波士顿室外和室内空气变应原致敏的年龄特异性患病率。
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