Spiekermann Christoph, Seethaler Alicia, McNally Annika, Stenner Markus, Rudack Claudia, Roth Johannes, Vogl Thomas
Institute of Immunology, University Hospital Münster, Münster, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany.
J Inflamm (Lond). 2021 Jun 29;18(1):24. doi: 10.1186/s12950-021-00290-8.
Acute tonsillitis represents one of the most frequent reasons patients seek primary medical care and otorhinolaryngology consultation. Therefore, recurrent episodes of acute tonsillitis (RAT), also called chronic tonsillitis, exhaust a substantial amount of medical and financial resources. Diagnosis of tonsillitis depends on a physical examination, which therefore does not allow for a reliable differentiation between viral and bacterial infection. However, the frequency of bacterial infections during the previous three years is currently being used as the major deciding factor in patient selection for tonsillectomy. The aim of the present study was to determine an objective biomarker to help in the identification of patients suffering from recurrent tonsillitis.
By analyzing a panel of cytokines and chemokines in serum and saliva of patients with RAT compared to healthy controls, increased levels of IL-1ß (153.7 ± 48.5 pg/ml vs 23.3 ± 6.6 pg/ml, p = 0.021), IL-18 (120.2 ± 16.5 vs 50.6 ± 9.3 pg/ml, p = 0.007) and/or S100A8/A9 (996 ± 102 ng/ml vs 546 ± 86 ng/ml, p = 0.042) could be observed in patients suffering from RAT. Cut-off values of these parameters were determined and combined to a new RAT-score allowing for reliable identification of patients suffering from recurrent tonsillitis with a sensitivity of 95% and a specificity of 88%.
The RAT-score represents the first objective criterion as a tool for the diagnosis of recurrent tonsillitis and it also improves patient selection for tonsillectomy.
急性扁桃体炎是患者寻求初级医疗护理和耳鼻喉科会诊的最常见原因之一。因此，复发性急性扁桃体炎（RAT），也称为慢性扁桃体炎，消耗了大量的医疗和财政资源。扁桃体炎的诊断依赖于体格检查，因此无法可靠地区分病毒感染和细菌感染。然而，过去三年中细菌感染的频率目前被用作扁桃体切除术患者选择的主要决定因素。本研究的目的是确定一种客观的生物标志物，以帮助识别患有复发性扁桃体炎的患者。
通过分析RAT患者与健康对照者血清和唾液中的一组细胞因子和趋化因子，发现RAT患者中白细胞介素-1β（IL-1β）水平升高（153.7±48.5 pg/ml对23.3±6.6 pg/ml，p = 0.021）、白细胞介素-18（IL-18）水平升高（120.2±16.5对50.6±9.3 pg/ml，p = 0.007）和/或S100A8/A9水平升高（996±102 ng/ml对546±86 ng/ml，p = 0.042）。确定了这些参数的临界值，并将其组合成一个新的RAT评分，该评分能够以95%的灵敏度和88%的特异性可靠地识别患有复发性扁桃体炎的患者。
RAT评分是诊断复发性扁桃体炎的首个客观标准，也改善了扁桃体切除术的患者选择。
