Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis

Introduction - Obstructive Sleep Apnea Syndrome (OSAS) and Recurrent Tonsillitis (RA) are the main indications for performing tonsillectomy in children. Despite the growing knowledge in tissue immunology of palatine tonsils, the pathophysiology that leads to the development of OSAS or RA is not ful...

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Main Authors: Tiago Chantre, Juliana Gonçalves, Sofia A. Cerqueira, João Nascimento, Helena Soares, Inês Alpoim Moreira, Mafalda Barroso, Herédio Sousa
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Language:English
Published: Portuguese Society of Otolaryngology and Head and Neck Surgery 2023-11-01
Series:Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço
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Online Access:https://journalsporl.com/index.php/sporl/article/view/2059
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author Tiago Chantre
Juliana Gonçalves
Sofia A. Cerqueira
João Nascimento
Helena Soares
Inês Alpoim Moreira
Mafalda Barroso
Herédio Sousa
author_facet Tiago Chantre
Juliana Gonçalves
Sofia A. Cerqueira
João Nascimento
Helena Soares
Inês Alpoim Moreira
Mafalda Barroso
Herédio Sousa
author_sort Tiago Chantre
collection DOAJ
description Introduction - Obstructive Sleep Apnea Syndrome (OSAS) and Recurrent Tonsillitis (RA) are the main indications for performing tonsillectomy in children. Despite the growing knowledge in tissue immunology of palatine tonsils, the pathophysiology that leads to the development of OSAS or RA is not fully known. Objectives - Comparative immunophenotypic analysis of children with OSAS versus RA. The epidemiological study of the selected patients was also carried out. Material and Methods - Analysis by flow cytometry of palatine tonsils of children with OSAS versus RA. In processing the palatine tonsils, mononuclear cells are isolated and, from these, CD4+ T cells and follicular T cells. Cell size and viability and the Inducible T-cell costimulator (ICOS), a marker for the binding of follicular T cells to B cells, during antibody production, were also evaluated. 69 patients from Hospital Dona Estefânia, aged less than 18 years, between November 2018 and November 2022 were included. Results - Palatine tonsils were removed by extracapsular dissection of 54 children diagnosed with OSAS and 15 with RA. In patients with OSAS, the mean age was 4.7 (± 2.2) years, with 24 males and 30 females. In patients with RA, the mean age was 6.1 (± 2.5) years, with 7 males and 8 females. Children submitted to tonsillectomy for OSAS were significantly younger than those for RA (p = 0.035). There were no significant differences between genders in the two groups (p = 0.881). Significant differences were found in the grade of the palatine tonsils, according to the Brodsky Classification, between the two groups of patients (p = 0.031). Children with OSAS were more likely to have otitis media with effusion requiring myringotomy and placement of transtympanic ventilation tubes at the same surgical time (p = 0.034). There were no statistically significant differences in operative complications of tonsillectomy between the two patient groups (p = 0.456). By flow cytometry analysis, the count of MNCs and CD4 T cells was not changed between the two groups. Palatine tonsils from patients with RA showed less TFH cells when compared with tonsils from patients with OSAS, but not significantly (p = 0.07). The size of CD4 T cells did not show significant differences between groups (p=0.840), however, the viability of these cells was significantly higher in patients with RA (p=0.015). In the patients studied, there is a greater intensity in the expression of ICOS in patients with RA compared to patients with OSAS. Conclusions - Our results point to differences in the local lymphocyte response between patients with OSAS and RA, however, additional flow cytometry studies are still needed to investigate the immunological mechanisms underlying these two pathologies.
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spelling doaj-art-64e43478298e4f8ab0fa708bd166eebf2025-08-20T03:23:27ZengPortuguese Society of Otolaryngology and Head and Neck SurgeryRevista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço2184-64992023-11-0161310.34631/sporl.2059Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitisTiago Chantre0Juliana Gonçalves1Sofia A. Cerqueira2João Nascimento3Helena Soares4Inês Alpoim Moreira5Mafalda BarrosoHerédio Sousa6Serviço de Otorrinolaringologia, Centro Hospitalar Universitário Lisboa Central, PortugalHuman Immunobiology and Pathogenesis Laboratory, iNOVA4Health, Nova Medical School, PortugalHuman Immunobiology and Pathogenesis Laboratory, iNOVA4Health, Nova Medical School, PortugalHuman Immunobiology and Pathogenesis Laboratory, iNOVA4Health, Nova Medical School, PortugalHuman Immunobiology and Pathogenesis Laboratory, iNOVA4Health, Nova Medical School, PortugalCentro Hospitalar Universitário Lisboa Central, PortugalServiço de Otorrinolaringologia, Centro Hospitalar Universitário Lisboa Central, Portugal Introduction - Obstructive Sleep Apnea Syndrome (OSAS) and Recurrent Tonsillitis (RA) are the main indications for performing tonsillectomy in children. Despite the growing knowledge in tissue immunology of palatine tonsils, the pathophysiology that leads to the development of OSAS or RA is not fully known. Objectives - Comparative immunophenotypic analysis of children with OSAS versus RA. The epidemiological study of the selected patients was also carried out. Material and Methods - Analysis by flow cytometry of palatine tonsils of children with OSAS versus RA. In processing the palatine tonsils, mononuclear cells are isolated and, from these, CD4+ T cells and follicular T cells. Cell size and viability and the Inducible T-cell costimulator (ICOS), a marker for the binding of follicular T cells to B cells, during antibody production, were also evaluated. 69 patients from Hospital Dona Estefânia, aged less than 18 years, between November 2018 and November 2022 were included. Results - Palatine tonsils were removed by extracapsular dissection of 54 children diagnosed with OSAS and 15 with RA. In patients with OSAS, the mean age was 4.7 (± 2.2) years, with 24 males and 30 females. In patients with RA, the mean age was 6.1 (± 2.5) years, with 7 males and 8 females. Children submitted to tonsillectomy for OSAS were significantly younger than those for RA (p = 0.035). There were no significant differences between genders in the two groups (p = 0.881). Significant differences were found in the grade of the palatine tonsils, according to the Brodsky Classification, between the two groups of patients (p = 0.031). Children with OSAS were more likely to have otitis media with effusion requiring myringotomy and placement of transtympanic ventilation tubes at the same surgical time (p = 0.034). There were no statistically significant differences in operative complications of tonsillectomy between the two patient groups (p = 0.456). By flow cytometry analysis, the count of MNCs and CD4 T cells was not changed between the two groups. Palatine tonsils from patients with RA showed less TFH cells when compared with tonsils from patients with OSAS, but not significantly (p = 0.07). The size of CD4 T cells did not show significant differences between groups (p=0.840), however, the viability of these cells was significantly higher in patients with RA (p=0.015). In the patients studied, there is a greater intensity in the expression of ICOS in patients with RA compared to patients with OSAS. Conclusions - Our results point to differences in the local lymphocyte response between patients with OSAS and RA, however, additional flow cytometry studies are still needed to investigate the immunological mechanisms underlying these two pathologies. https://journalsporl.com/index.php/sporl/article/view/2059Obstructive sleep apnea syndromerecurrent tonsillitispalatine tonsilsimmunophenotypingpediatrics
spellingShingle Tiago Chantre
Juliana Gonçalves
Sofia A. Cerqueira
João Nascimento
Helena Soares
Inês Alpoim Moreira
Mafalda Barroso
Herédio Sousa
Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço
Obstructive sleep apnea syndrome
recurrent tonsillitis
palatine tonsils
immunophenotyping
pediatrics
title Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
title_full Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
title_fullStr Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
title_full_unstemmed Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
title_short Immunophenotyping of palatine tonsils in children with OSAS versus recurrent tonsillitis
title_sort immunophenotyping of palatine tonsils in children with osas versus recurrent tonsillitis
topic Obstructive sleep apnea syndrome
recurrent tonsillitis
palatine tonsils
immunophenotyping
pediatrics
url https://journalsporl.com/index.php/sporl/article/view/2059
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