Cho Kyu-Sup, Kim Seong Heon, Hong Sung-Lyong, Lee Jaeyoung, Mun Sue Jean, Roh Young Eun, Kim Young Mi, Kim Hye-Young
1 Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea.
2 Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Republic of Korea.
Am J Rhinol Allergy. 2018 May;32(3):160-166. doi: 10.1177/1945892418765003. Epub 2018 Apr 12.
Background Although the cause of adenotonsillar hypertrophy remains unknown, some studies have shown that allergy may be a risk factor. Purpose This study determined the levels of allergen-specific immunoglobulin E (sIgE) in the adenotonsillar tissues of children with adenotonsillar hypertrophy and evaluated the clinical significance of local atopy in adenotonsillar tissues. Methods We measured 21 types of specific immunoglobulin E in the serum and adenotonsillar tissues of 102 children with adenotonsillar hypertrophy and compared the sensitization patterns of the serum and local tissues. The patients were divided into three groups-atopy, local atopy, and nonatopy-according to the sensitization of serum and adenotonsillar tissues, and the clinical symptoms among the groups were analyzed. Results Seventy-two (70.6%) children with adenotonsillar hypertrophy were sensitized to more than one allergen in the serum and/or adenotonsillar tissue. Thirty (29.4%) children had no IgE positivity to any allergen in both serum and adenotonsillar tissues. Fifty-five (53.9%) were sensitized to at least one allergen in the serum. Seventy (68.6%) were sensitized to at least one allergen in the adenotonsillar tissue. Seventeen (36.2%) of 47 children with specific immunoglobulin E-negative serum had specific immunoglobulin E-positive adenotonsillar tissues. The rate of specific immunoglobulin E was significantly higher in local tissues than in serum. The rate of inhalant allergen specific immunoglobulin E was significantly higher in the adenoids than in the tonsils. However, the rate of food allergen specific immunoglobulin E was significantly higher in the tonsils than adenoids. The lifetime prevalence of asthma and allergic rhinitis, recent symptoms or treatment of allergic rhinitis, and severity of nasal symptoms (rhinorrhea, sneezing, and nasal itching) were significantly higher in children with local atopy than with nonatopy. Conclusions These results confirm that allergic response may be a risk factor for adenotonsillar hypertrophy. Local allergic inflammation may play an important role in childhood adenotonsillar hypertrophy, and local atopy in adenotonsillar tissues can cause respiratory allergic symptoms in children.
尽管腺样体扁桃体肥大的病因尚不清楚，但一些研究表明过敏可能是一个危险因素。目的：本研究测定腺样体扁桃体肥大患儿腺样体扁桃体组织中过敏原特异性免疫球蛋白E（sIgE）水平，并评估腺样体扁桃体组织局部特应性的临床意义。方法：我们检测了102例腺样体扁桃体肥大患儿血清和腺样体扁桃体组织中的21种特异性免疫球蛋白E，并比较了血清和局部组织的致敏模式。根据血清和腺样体扁桃体组织的致敏情况，将患者分为三组——特应性、局部特应性和非特应性——并分析了各组间的临床症状。结果：72例（70.6%）腺样体扁桃体肥大患儿血清和/或腺样体扁桃体组织中对一种以上过敏原致敏。30例（29.4%）患儿血清和腺样体扁桃体组织中对任何过敏原均无IgE阳性。55例（53.9%）血清中至少对一种过敏原致敏。70例（68.6%）腺样体扁桃体组织中至少对一种过敏原致敏。47例血清特异性免疫球蛋白E阴性的患儿中，17例（36.2%）腺样体扁桃体组织特异性免疫球蛋白E阳性。局部组织中特异性免疫球蛋白E的发生率显著高于血清。腺样体中吸入性过敏原特异性免疫球蛋白E的发生率显著高于扁桃体。然而，扁桃体中食物过敏原特异性免疫球蛋白E的发生率显著高于腺样体。局部特应性患儿哮喘和过敏性鼻炎的终生患病率、过敏性鼻炎的近期症状或治疗情况以及鼻部症状（流涕、打喷嚏和鼻痒）的严重程度均显著高于非特应性患儿。结论：这些结果证实过敏反应可能是腺样体扁桃体肥大的一个危险因素。局部过敏炎症可能在儿童腺样体扁桃体肥大中起重要作用，腺样体扁桃体组织中的局部特应性可导致儿童出现呼吸道过敏症状。
