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Evaluation of the local and systemic pattern of sensitization to allergens in patients with adenotonsillar hypertrophy

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Adenotonsillar hypertrophy (ATH) is a medical condition characterized by the enlargement or swelling of the tonsils. The role of allergy in ATH has not been persuasively evidenced. Therefore, we investigated the state of humoral immunity and the presence of specific immunoglobulin E (sIgE) in tissues and sera in children suffering from TH.

Methods

According to the skin prick test (SPT) result, 44 ATH children were divided into the atopic and non-atopic groups. The level of sIgE against 30 inhalants and food allergens in the sera and tissue homogenates was measured by a commercial allergy immunoblotting kit. In addition, we evaluated the following variables in both tonsillar tissue homogenates and serum: total IgE, IgA, IgM, IgG, and tissue eosinophil counts.

Results

Our results showed that 21 (47.7%) of patients with ATH were sensitized to at least one allergen in the adenotonsillar sample and/or sera. Only two patients were negative for sIgE in the atopic group, but in the non-atopic group, only one had positive sIgE results. In the atopic group, 19 (86.4%) patients had positive sIgE in tonsillar tissues, and 18 (81.8%) had sensitized serum. There were no statistical differences in the case of other antibodies except IgE levels between the two groups. The average eosinophilic count was significantly higher in atopic patients than in the non-atopic group.

Conclusion

The results of this study support the role of allergy in the pathogenesis of ATH and confirmed local allergic inflammation in tonsillar tissue.

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References

  1. Brandtzaeg P (2003) Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int Congress Series 1254:89–99

    Article  Google Scholar 

  2. Jović M, Avramović V, Vlahović P et al (2015) Ultrastructure of the human palatine tonsil and its functional significance. Rom J Morphol Embryol 56(2):371–377

    PubMed  Google Scholar 

  3. Bugova G, Uhliarova B, Jesenak M et al (2017) The presence of atopy and its effect on bacterial colonization of the upper airways in children with adenoid vegetation. Alergol Polska Polish J Allergol 4(2):46–52

    Article  Google Scholar 

  4. Kim J, Bhattacharjee R, Dayyat E et al (2009) Increased cellular proliferation and inflammatory cytokines in tonsils derived from children with obstructive sleep apnea. Pediatr Res 66(4):423–428

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chae SW, Choi G, Hwang KS et al (2000) The incidence and clinical symptoms of palatine tonsillar hypertrophy in elementary school children. Korean J Otorhinolaryngol-Head Neck Surg 43(12):1342–1345

    Google Scholar 

  6. Nuhoglu C, Nuhoglu Y, Bankaoglu M et al (2010) A retrospective analysis of adenoidal size in children with allergic rhinitis and nonallergic idiopathic rhinitis. Asian Pac J Allergy Immunol 28(2–3):136

    PubMed  Google Scholar 

  7. M. Kar, N. Altintoprak, N. B. Muluk et al., “Antileukotrienes in adenotonsillar hypertrophy: a review of the literature,” Eur Arch Otorhinolaryngol, Mar 16, 2016.

  8. Miramontes HP, Fagundes DJ, Jurgielewicz JC et al (2014) Prevalence of microorganisms and immunoglobulins in children with tonsillar hypertrophy and adenoiditis. Int Arch Otorhinolaryngol 18(3):311–315

    Article  PubMed  PubMed Central  Google Scholar 

  9. Develioglu ON, Ipek HD, Bahar H et al (2014) Bacteriological evaluation of tonsillar microbial flora according to age and tonsillar size in recurrent tonsillitis. Eur Arch Otorhinolaryngol 271(6):1661–1665

    Article  PubMed  Google Scholar 

  10. Proenca-Modena JL, Buzatto GP, Paula FE et al (2014) Respiratory viruses are continuously detected in children with chronic tonsillitis throughout the year. Int J Pediatr Otorhinolaryngol 78(10):1655–1661

    Article  PubMed  PubMed Central  Google Scholar 

  11. Günel C, Kırdar S, Ömürlü İK et al (2015) Detection of the Epstein-Barr virus, human Bocavirus and novel KI and KU polyomaviruses in adenotonsillar tissues”. Int J Pediatric Otorhinolaryngol 79(3):423–427

    Article  Google Scholar 

  12. Karaca CT, Toros SZ, Noseri H et al (2012) Role of allergy in children with adenotonsillar hypertrophy. J Craniofac Surg 23(6):e611–e613

    Article  PubMed  Google Scholar 

  13. Cho KS, Kim SH, Hong SL et al (2018) Local atopy in childhood adenotonsillar hypertrophy. Am J Rhinol Allergy 32(3):160–166

    Article  PubMed  Google Scholar 

  14. Zhang X, Sun B, Li S et al (2013) Local atopy is more relevant than serum sIgE in reflecting allergy in childhood adenotonsillar hypertrophy. Pediatr Allergy Immunol 24(5):422–426

    Article  PubMed  Google Scholar 

  15. Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H (2011) Is there any correlation between allergy and adenotonsillar tissue hypertrophy? Int J Pediatric Otorhinolaryngol 75(4):589–591

    Article  CAS  Google Scholar 

  16. Carr E, Obholzer R, Caulfield H (2007) A prospective study to determine the incidence of atopy in children undergoing adenotonsillectomy for obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 71(1):19–22

    Article  CAS  PubMed  Google Scholar 

  17. Ameli F, Brocchetti F, Tosca MA et al (2014) Tonsil volume and allergic rhinitis in children. Allergy Rhinol 5(3):e137

    Article  Google Scholar 

  18. Eryaman E, Ozkul A, Ozker BY (2013) Skin prick test and tonsil size in children: any relation? Indian J Otolaryngol Head Neck Surg 65(4):371–374

    Article  CAS  PubMed  Google Scholar 

  19. Kam ST, Wicher K, Arbesman CE (1970) IgE antibodies in nasal secretions of ragweed-allergic subjects. J Allergy 46(6):352–358

    Article  Google Scholar 

  20. Hoffmann-Sommergruber K, Ferreira F, Ebner C et al (1996) Detection of allergen-specific IgE in tears of grass pollen-allergic patients with allergic rhinoconjunctivitis. Clin Exp Allergy 26(1):79–87

    Article  CAS  PubMed  Google Scholar 

  21. Takhar P, Corrigan CJ, Smurthwaite L et al (2007) Class switch recombination to IgE in the bronchial mucosa of atopic and nonatopic patients with asthma. J Allergy Clin Immunol 119(1):213–218

    Article  CAS  PubMed  Google Scholar 

  22. Bakhshaee M, Fereidouni M, Nourollahian M et al (2014) The presence of fungal-specific IgE in serum and sinonasal tissue among patients with sinonasal polyposis. Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-014-2882-0

    Article  PubMed  Google Scholar 

  23. Costa EC Jr, Sabino HA, Miura CS et al (2013) Atopy and adenotonsillar hypertrophy in mouth breathers from a reference center. Braz J Otorhinolaryngol 79(6):663–7

    Article  PubMed  Google Scholar 

  24. Shin SY, Choi SJ, Hur GY et al (2009) Local production of total IgE and specific antibodies to the house dust mite in adenoid tissue. Pediatr Allergy Immunol 20(2):134–141

    Article  PubMed  Google Scholar 

  25. Shin SY, Ye YM, Eun YG et al (2012) Local IgE-mediated hypersensitivity to Alternaria in pediatric adenoid tissue. Int J Pediatr Otorhinolaryngol 76(10):1423–1428

    Article  PubMed  Google Scholar 

  26. Nguyen LH, Manoukian JJ, Tewfik TL et al (2004) Evidence of allergic inflammation in the middle ear and nasopharynx in atopic children with otitis media with effusion. J Otolaryngol 33(6):345–351

    Article  PubMed  Google Scholar 

  27. Brodsky L, Moore L, Stanievich JF (1987) A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pediatric Otorhinolaryngol 13(2):149–156

    Article  CAS  Google Scholar 

  28. Cassano P, Gelardi M, Cassano M et al (2003) Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatric Otorhinolaryngol 67(12):1303–1309

    Article  Google Scholar 

  29. Reisacher WR (2016) Total and allergen-specific immunoglobulin E in the serum and nasal mucosa of a nonallergic population. Int Forum Allergy Rhinol 6(6):618–623

    Article  PubMed  Google Scholar 

  30. Åström K, Papatziamos G, Magnusson CGM et al (2000) Analysis of epsilon germline transcripts and IL-4mRNA expression in the adenoids suggests local IgE switching. Allergy 55(11):1049–1055

    Article  PubMed  Google Scholar 

  31. Payne SC, Chen PG, Borish L (2011) Local class switching in nonallergic rhinitis. Curr Opin Otolaryngol Head Neck Surg 19(3):193–198

    Article  PubMed  Google Scholar 

  32. Durham SR, Smurthwaite L, Gould HJ (2000) Local IgE production. Am J Rhinol 14(5):305–308

    Article  CAS  PubMed  Google Scholar 

  33. Fokkens WJ, Vinke JG, Jong SSD et al (1998) Differences in cellular infiltrates in the adenoid of allergic children compared with age- and gender-matched controls. Clin Exp Allergy 28(2):187–195

    Article  CAS  PubMed  Google Scholar 

  34. Ahanchian H, Jafari S, Behmanesh F et al (2016) Epidemiological survey of pediatric food allergy in Mashhad in Northeast Iran. Electron Physician 8(1):1727–1732

    Article  PubMed  PubMed Central  Google Scholar 

  35. Arbes SJ Jr, Gergen PJ, Elliott L et al (2005) Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol 116(2):377–383

    Article  PubMed  Google Scholar 

  36. Fereidouni M, Fereidouni F, Hadian M et al (2014) The level of mite dermatophagoides’ allergens (Der-p 1 and Der-f 1) in Birjand. Zahedan J Res Med Sci 16(4):38–40

    Google Scholar 

  37. Moghtaderi M, Hosseini Teshnizi S, Farjadian S (2017) Sensitization to common allergens among patients with allergies in major Iranian cities: a systematic review and meta-analysis. Epidemiol Health 39:e2017007

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ekici NY, Gorgulu O, Yucel G et al (2018) Can the number of eosinophils in adenoid and tonsil tissue determine the allergy in children? Int J Pediatr Otorhinolaryngol 108:35–39

    Article  PubMed  Google Scholar 

  39. Vinke J, Fokken W (1999) The role of the adenoid in allergic sensitisation. Int J Pediatr Otorhinolaryngol 49:S145–S149

    Article  PubMed  Google Scholar 

  40. Song L, Guo J, Liao W et al (2017) Long-term effects of adenotonsillectomy on serum-specific immunoglobulin E. Pediatr Res 82(5):801–805

    Article  CAS  PubMed  Google Scholar 

  41. Hwang MS, Forman SN, Kanter JA et al (2015) Tonsillar Helicobacter pylori colonization in chronic tonsillitis: systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 141(3):245–249

    Article  PubMed  Google Scholar 

  42. Eun YG, Park DC, Kim SG et al (2009) Immunoglobulins and transcription factors in adenoids of children with otitis media with effusion and chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol 73(10):1412–1416

    Article  PubMed  Google Scholar 

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Acknowledgements

We are thankful to the patients and their families for participating in this research. We would also like to thank the staff of Valiasr Hospital for their help in collecting the samples.

Funding

The authors have no relevant financial or non-financial interests to disclose.

Author information

Authors and Affiliations

  1. Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran

    Neda Mahavar

  2. Department of ENT, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

    Masoud Asghari & Mohammadreza Mofatteh

  3. Department of Animal Science, Birjand University, Birjand, Iran

    Sanaz Jaberi

  4. Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran

    Nafiseh Erfanian

  5. Department of Pathology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

    Mahboobeh Chahkandi

  6. Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran

    Mohammad Fereidouni

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We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

Corresponding author

Correspondence to Mohammad Fereidouni.

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The authors declare no competing interests.

Ethical approval

Approval was obtained from the ethics committee (ir.bums.REC.1396.93) of university of medical sciences. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Mahavar, N., Asghari, M., Mofatteh, M. et al. Evaluation of the local and systemic pattern of sensitization to allergens in patients with adenotonsillar hypertrophy. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08550-y

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