Impact of adenotonsillectomy on the evolution of inflammatory markers
Por:
Marcano-Acuña ME, Carrasco-Llatas M, Tortajada-Girbés M, Dalmau-Galofre J and Codoñer-Franch P
Publicada:
1 nov 2019
Ahead of Print:
1 oct 2019
Resumen:
Background Tonsils are first-line host defence organs against pathogenic agents and participate in local and systemic immunity. Persistent increases in systemic inflammatory responses may contribute to associated morbidity. The aim of this study was to verify the short- and long-term impact of adenotonsillectomy on the evolution of inflammatory markers in 3- to 9-year-old children. Methods A prospective and longitudinal study was conducted over 1 year in 29 children who underwent tonsillectomy due to either chronic tonsillitis or adenotonsillar hypertrophy. Measurements of high-sensitivity C-reactive protein (hs-CRP) levels were taken. Levels of Th1-type cytokines [interleukin-1, interferon-gamma, and tumor necrosis factor-i +/- (TNF-alpha)] and anti-inflammatory Th2-type cytokines [interleukin-4, -5, -6, -10 and -13] were measured. Levels of transforming growth factor-beta (TGF-beta) and intercellular adhesion molecule-1 (ICAM-1) were also determined. The results were compared to those of 29 control children. Results At baseline, children with surgery indications presented with higher levels of hs-CRP, interleukin-1 and -10, interferon-gamma, TNF-alpha and ICAM-1, whereas values of interleukin-4 were significantly lower than in control children. Children with severe tonsillar obstruction had higher values of interleukin-1, -4, and -5 and lower values of interleukin-10 compared with children with recurrent tonsillitis. One year after surgery, the levels except IL-4 did not show a significant difference from those obtained in the control group. The levels of hs-CRP and TNF-alpha decreased significantly in the first month. Conclusion Children with chronic tonsillitis and/or adenotonsillar hypertrophy have significantly elevated levels of proinflammatory cytokines. Adenotonsillectomy restores the normal values of these parameters 1 year after surgery.
Filiaciones:
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Department of Ear Nose Throat (ENT), Dr. Peset University Hospital. Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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Department of Ear Nose Throat (ENT), Dr. Peset University Hospital. Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
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Department of Ear Nose Throat (ENT), Dr. Peset University Hospital. Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
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