Tonsillectomy and adenoidectomy (T& A) is a frequent surgical procedure in children with obstructive sleep apnea (OSA). Many symptomatic children who do not fulfill the currently recommended criteria for T& A ...Tonsillectomy and adenoidectomy (T& A) is a frequent surgical procedure in children with obstructive sleep apnea (OSA). Many symptomatic children who do not fulfill the currently recommended criteria for T& A may benefit from topical intranasal steroid therapy. However, the expression of glucocorticoid receptor (GCR) expression in adenoid and tonsillar tissue is currently unknown. The objective of this study was to assess and compare expression patterns of the human GCR in children who undergo T& A for either recurrent throat infections (RI) or OSA. Adenotonsillar tissues from 36 children with OSA or RI were subjected to quantitative PCR using specific primers for GCR-α and GCR-β and to immunohistochemistry and Western blotting for protein expression of GCR isoforms. mRNA encoding for expression of both GCR-α and GCR-β was detected in the tonsils and adenoids of all children, with markedly higher relative abundance of the GCR-α . Furthermore,GCR-α mRNA expression was increased in OSA-derived adenoid and tonsil tissues compared with RI, whereas no differences emerged for GCR-β . Immunoblots confirmed these findings for the protein transcripts of these genes, and immunohistochemistry showed a specific topographic pattern of distribution for both receptors in tonsillar tissue. GCR-α and GCR-β are expressed in pediatric adenotonsillar tissue, are more abundant in OSA patients, and demonstrate a specific topographic pattern of expression. These findings along with the high GCR-α :GCR-β ratio suggest a favorable profile for topical steroid therapy in snoring children with adenotonsillar hypertrophy.展开更多
分泌性中耳炎(otitis media with effusion,OME)是引起听力障碍及言语发育迟缓的常见疾病,儿童的发病率明显高于成年人,病因复杂,咽鼓管功能障碍、感染等可能是导致儿童OME主要原因[1,2]。目前发现腺样体肥大除引起鼻堵、打鼾及阻塞性...分泌性中耳炎(otitis media with effusion,OME)是引起听力障碍及言语发育迟缓的常见疾病,儿童的发病率明显高于成年人,病因复杂,咽鼓管功能障碍、感染等可能是导致儿童OME主要原因[1,2]。目前发现腺样体肥大除引起鼻堵、打鼾及阻塞性睡眠呼吸低通气综合征外,也可以导致OME反复发作。目前以药物保守治疗或手术治疗为主,手术治疗包括鼓膜穿刺术、腺样体切除术联合鼓膜穿刺术、鼓膜置管术等。本文通过对一部分OME患儿病例回顾性分析,旨在探讨手术方式对儿童OME转归的影响,现报道如下。展开更多
文摘Tonsillectomy and adenoidectomy (T& A) is a frequent surgical procedure in children with obstructive sleep apnea (OSA). Many symptomatic children who do not fulfill the currently recommended criteria for T& A may benefit from topical intranasal steroid therapy. However, the expression of glucocorticoid receptor (GCR) expression in adenoid and tonsillar tissue is currently unknown. The objective of this study was to assess and compare expression patterns of the human GCR in children who undergo T& A for either recurrent throat infections (RI) or OSA. Adenotonsillar tissues from 36 children with OSA or RI were subjected to quantitative PCR using specific primers for GCR-α and GCR-β and to immunohistochemistry and Western blotting for protein expression of GCR isoforms. mRNA encoding for expression of both GCR-α and GCR-β was detected in the tonsils and adenoids of all children, with markedly higher relative abundance of the GCR-α . Furthermore,GCR-α mRNA expression was increased in OSA-derived adenoid and tonsil tissues compared with RI, whereas no differences emerged for GCR-β . Immunoblots confirmed these findings for the protein transcripts of these genes, and immunohistochemistry showed a specific topographic pattern of distribution for both receptors in tonsillar tissue. GCR-α and GCR-β are expressed in pediatric adenotonsillar tissue, are more abundant in OSA patients, and demonstrate a specific topographic pattern of expression. These findings along with the high GCR-α :GCR-β ratio suggest a favorable profile for topical steroid therapy in snoring children with adenotonsillar hypertrophy.
文摘分泌性中耳炎(otitis media with effusion,OME)是引起听力障碍及言语发育迟缓的常见疾病,儿童的发病率明显高于成年人,病因复杂,咽鼓管功能障碍、感染等可能是导致儿童OME主要原因[1,2]。目前发现腺样体肥大除引起鼻堵、打鼾及阻塞性睡眠呼吸低通气综合征外,也可以导致OME反复发作。目前以药物保守治疗或手术治疗为主,手术治疗包括鼓膜穿刺术、腺样体切除术联合鼓膜穿刺术、鼓膜置管术等。本文通过对一部分OME患儿病例回顾性分析,旨在探讨手术方式对儿童OME转归的影响,现报道如下。
