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Impact of adenotonsillectomy on the evolution of inflammatory markers.

Abstract

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-γ, and tumor necrosis factor-α (TNF-α)] and anti-inflammatory Th2-type cytokines [interleukin-4, -5, -6, -10 and -13] were measured. Levels of transforming growth factor-beta (TGF-β) 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-γ, TNF-α 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-α 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.

Authors+Show Affiliations

Department of Ear Nose & Throat (ENT), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Dr. Peset University Hospital, Valencia, Spain.Department of Ear Nose & Throat (ENT), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Dr. Peset University Hospital, Valencia, Spain.Department of Pediatrics, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Dr. Peset University Hospital, Valencia, Spain. Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain.Department of Ear Nose & Throat (ENT), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Dr. Peset University Hospital, Valencia, Spain.Department of Pediatrics, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Dr. Peset University Hospital, Valencia, Spain. Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31461789

Citation

Marcano-Acuña, Martín E., et al. "Impact of Adenotonsillectomy On the Evolution of Inflammatory Markers." Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2019.
Marcano-Acuña ME, Carrasco-Llatas M, Tortajada-Girbés M, et al. Impact of adenotonsillectomy on the evolution of inflammatory markers. Clin Otolaryngol. 2019.
Marcano-Acuña, M. E., Carrasco-Llatas, M., Tortajada-Girbés, M., Dalmau-Galofre, J., & Codoñer-Franch, P. (2019). Impact of adenotonsillectomy on the evolution of inflammatory markers. Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, doi:10.1111/coa.13423.
Marcano-Acuña ME, et al. Impact of Adenotonsillectomy On the Evolution of Inflammatory Markers. Clin Otolaryngol. 2019 Aug 28; PubMed PMID: 31461789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of adenotonsillectomy on the evolution of inflammatory markers. AU - Marcano-Acuña,Martín E, AU - Carrasco-Llatas,Marina, AU - Tortajada-Girbés,Miguel, AU - Dalmau-Galofre,José, AU - Codoñer-Franch,Pilar, Y1 - 2019/08/28/ PY - 2019/06/26/received PY - 2019/08/06/revised PY - 2019/08/26/accepted PY - 2019/8/29/pubmed PY - 2019/8/29/medline PY - 2019/8/29/entrez KW - Otorhinolaryngology KW - adenoids KW - immunology KW - obstructive sleep apnoea KW - rhinology KW - sleep disordered breathing KW - tonsils ORL JF - Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery JO - Clin Otolaryngol N2 - 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-γ, and tumor necrosis factor-α (TNF-α)] and anti-inflammatory Th2-type cytokines [interleukin-4, -5, -6, -10 and -13] were measured. Levels of transforming growth factor-beta (TGF-β) 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-γ, TNF-α 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-α 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. SN - 1749-4486 UR - https://www.unboundmedicine.com/medline/citation/31461789/Impact_of_adenotonsillectomy_on_the_evolution_of_inflammatory_markers L2 - https://doi.org/10.1111/coa.13423 DB - PRIME DP - Unbound Medicine ER -