Yu Lulu, Bi Jing, Xu Bin, Yu Bo, Fu Yong
Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Pediatr Otorhinolaryngol. 2024 Jul;182:111996. doi: 10.1016/j.ijporl.2024.111996. Epub 2024 May 31.
Otitis media with effusion (OME) is a prevalent and costly disease, especially in children. This article analyzed the expression patterns and clinical significance of T helper-1 (Th1)/Th2 cytokines in the peripheral blood of children with OME and allergic rhinitis (AR).
Subjects were assigned to the OME + AR group and the Control group (children with OME), with their clinical baseline data documented. The correlations between Th1/Th2 cytokines and between the total nasal symptom score (TNSS) and Th1/Th2 cytokines were analyzed. The risk factors and the predictive value of Th1/Th2 cytokines for OME + AR were analyzed using logistics multivariate regression analysis and receiver operating characteristic curve.
Significant differences were observed in tympanic pressure/speech frequency/air conduction valve/TNSS score/immunoglobulin E (IgE) level between both groups. The OME + AR children exhibited evidently elevated interleukin-2 (IL-2)/tumor necrosis factor-α (TNF-α)/IL-4/IL-10/IL-6 levels and no significant difference in interferon-γ (IFN-γ) level. Th1/Th2 cytokines were remarkably positively-correlated with the TNSS score. IL-2/TNF-α/IL-4/IL-6 were risk factors for OME with AR. The area under the curves (AUCs) of IL-6/IL-2/IL-4/TNF-α levels in predicting the occurrence of OME + AR were 0.805/0.806/0.775/0.781, with sensitivities of 75.76 %/89.39 %/72.21 %/72.73 % and specificities of 74.29 %/61.34 %/72.86 %/70.00 %, and the cut-off values were 239.600/20.300/29.880/34.800 (pg/mL). The AUC of their combination in predicting OME + AR was 0.955 (93.94 % sensitivity, 85.71 % specificity).
Th1/Th2 cytokine levels were imbalanced and obviously positively-correlated with the TNSS score in OME + AR children. IL-2, TNF-α, IL-4, and IL-6 levels had auxiliary predictive value in the occurrence of OME + AR.
中耳积液（OME）是一种常见且代价高昂的疾病，在儿童中尤为如此。本文分析了OME合并变应性鼻炎（AR）患儿外周血中辅助性T细胞1（Th1）/辅助性T细胞2（Th2）细胞因子的表达模式及临床意义。
将研究对象分为OME+AR组和对照组（OME患儿），记录其临床基线数据。分析Th1/Th2细胞因子之间以及总鼻症状评分（TNSS）与Th1/Th2细胞因子之间的相关性。采用logistic多因素回归分析和受试者工作特征曲线分析Th1/Th2细胞因子对OME+AR的危险因素及预测价值。
两组在鼓室压力/言语频率/气导阀/TNSS评分/免疫球蛋白E（IgE）水平方面存在显著差异。OME+AR患儿的白细胞介素-2（IL-2）/肿瘤坏死因子-α（TNF-α）/IL-4/IL-10/IL-6水平明显升高，而干扰素-γ（IFN-γ）水平无显著差异。Th1/Th2细胞因子与TNSS评分显著正相关。IL-2/TNF-α/IL-4/IL-6是OME合并AR的危险因素。IL-6/IL-2/IL-4/TNF-α水平预测OME+AR发生的曲线下面积（AUC）分别为0.805/0.806/0.775/0.781，灵敏度分别为75.76%/89.39%/72.21%/72.73%，特异度分别为74.29%/61.34%/72.86%/70.00%，截断值分别为239.600/20.300/29.880/34.800（pg/mL）。它们联合预测OME+AR的AUC为0.955（灵敏度93.94%，特异度85.71%）。
OME+AR患儿Th1/Th2细胞因子水平失衡，且与TNSS评分显著正相关。IL-2、TNF-α、IL-4和IL-6水平对OME+AR的发生有辅助预测价值。
