Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Münster, Germany.
Institute of Immunology, University Hospital Münster, Münster, Germany.
Dis Markers. 2017;2017:9126560. doi: 10.1155/2017/9126560. Epub 2017 Oct 17.
Peritonsillar abscess (PTA) is a very frequent reason for urgent outpatient consultation and otolaryngological hospital admission. Early, correct diagnosis and therapy of peritonsillar abscess are important to prevent possible life-threatening complications. Based on physical examinations, a reliable differentiation between peritonsillar cellulitis and peritonsillar abscess is restricted. A heterodimeric complex called calprotectin consists of the S100 proteins A8 and A9 (S100A8/A9) and is predominantly expressed not only in monocytes and neutrophils but also in epithelial cells. Due to its release by activated phagocytes at local sites of inflammation, we assumed S100A8/A9 to be a potential biomarker for peritonsillar abscess. We examined serum and saliva of patients with peritonsillitis, acute tonsillitis, peritonsillar abscess, and healthy controls and found significantly increased levels of S100A8/A9 in patients with PTA. Furthermore, we could identify halitosis, trismus, uvula edema, and unilateral swelling of the arched palate to be characteristic symptoms for PTA. Using a combination of these characteristic symptoms and S100A8/A9 levels, we developed a PTA score as an objective and appropriate tool to differentiate between peritonsillitis and peritonsillar abscess with a sensitivity of 92% and specificity of 93%.
扁桃体周脓肿（PTA）是紧急门诊咨询和耳鼻喉科医院入院的常见原因。早期、正确的诊断和治疗扁桃体周脓肿对于预防潜在的危及生命的并发症非常重要。基于体格检查，对扁桃体周炎和扁桃体周脓肿进行可靠的区分受到限制。一种称为钙卫蛋白的异二聚体复合物由 S100 蛋白 A8 和 A9（S100A8/A9）组成，不仅在单核细胞和中性粒细胞中，而且在上皮细胞中都有强烈表达。由于其被局部炎症部位的活化吞噬细胞释放，我们假设 S100A8/A9 是扁桃体周脓肿的潜在生物标志物。我们检查了患有扁桃体周炎、急性扁桃体炎、扁桃体周脓肿和健康对照组的患者的血清和唾液，发现 PTA 患者的 S100A8/A9 水平显著升高。此外，我们还发现口臭、牙关紧闭、悬雍垂水肿和拱形腭单侧肿胀是 PTA 的特征性症状。使用这些特征性症状和 S100A8/A9 水平的组合，我们开发了一种 PTA 评分，作为区分扁桃体周炎和扁桃体周脓肿的客观和适当的工具，其灵敏度为 92%，特异性为 93%。
