Mehtat ÜNLÜ, Semih SUTAY, Özkan KARAMAN, Özden ANAL, Demet ALAYGUT

Adenoidal tissue expression of CD23 (FcεRII): An evaluation with reference to recurrent upper respiratory tract complaints and allergy in children

Amaç: Bu çalışmada, CD23, IgE’nin düşük afiniteli reseptörü immunohistokimyasal yöntemle değerlendirildi ve üst solunum yolu enfeksiyonu ve alerji semptomlarının varlığına göre analiz edildi. Yöntemler: Bu retrospektif çalışmaya yaşları 2-13 yaşarasında değişen adenoidekromi ve adenoidektomi/ tonsillektomi operasyonu geçiren 100 hasta alındı. Patolojiraporları lenfoid hiperplazi ve kronik enfeksiyon şeklinde olanlar çalışmaya dahil edildi. Immunohistokimyasal olarak CD23 ekspresyonu semikantitatif metodla (0-3) arasında değerlendirildi. Bulgular: Çalışma grubunun ortalama yaşı 70,7 ay, % 46’sı kız hastalardan oluşmaktaydı ve hastaların % 30’u sadece adenoidektomi operasyonu geçirmişti. Operas- yon sonrası, enfeksiyon sıklığı % 91 oranında azalmakla birlikte, alerji semptomları %84 oranında değişmemişti. CD23 ekspresyonu özellikle ürtiker yakınması olanlarda (p=0,037), ilaç alerjisi olanlarda (p= 0.035) ve polen alerjisi (p= 0.041) olanlarda anlamlı olarak düşük bulundu. Sonuç: Atopik hastalarda adenoid dokuda CD23 yüzey ekspresyonunun azalacağı tezini destekler şekilde ürtiker, ilaç allerjisi ve polen allerjisi olan hastalarda CD23 yoğunluğunu anlamlı olarak azalmış saptandı. Bu sonuçlar, adenoidektomiye rağmen tekrarlayan solunum yolu semptomları olan çocuklarda altta yatan mekanizmayı açıklamak açısından değerlendirilebilir.

Adenoid doku CD23 (FcεRII) ekspresyonu: Çocuklarda tekrarlayan üst solunum yolu enfeksiyonu yakınmaları ve allerji temelinde bir değerlendirme

Objective: In this study, CD23, low affinity immunoglobu-lin E receptor, expression in the adenoid tissue was inves-tigated immunohistochemically and evaluated with regardto upper respiratory tract infection complaints and allergy.Methods: This retrospective study was performed by theselection of 100 patients aged 2-13 years who underwentadenoidectomy/adenotonsillectomy and in whom the ad-enoid tissue pathological studies were reported as “lym- phoid hyperplasia and chronic infection” were evaluated.Immunohistochemical evaluation of CD23 expressionwas scored semiquantitatively between 0-3 in the tissuesamples.Results: The mean age in the study group was 70.7 months; 46% were female; 30% of patients had adenoid- ectomy only. Following the operation, the infection fre- quency decreased in 91% of patients, whereas allergy symptoms were unchanged in 84%. CD23 expression was found significantly lower in patients who had allergic manifestations, namely urticaria (p=0.041), drug sensitiv- ity (p=0.035) and pollen allergy (p=0.037). Conclusion: A significantly reduced CD23 expression was found in adenoidal tissue in patients with allergic symptoms. These results can be assessed as an under- lying mechanism for the recurrence of respiratory tract complaints in these children, despite adenoidectomy. J Clin Exp Invest 2013; 4 (1): 1-7

PDF

___

1. Lack G, MD Pediatric Allergic Rhinitis and comorbid disorders. J Allergy Clin Immunol 2001;12:9-15.
2. Bluestone CD.Eustachian tube function: physiology, pathophysiology, and role of allergy in pathogenesis of otitis media. J Allergy Clin Immunol 1983;72:242- 245.1
3. Shapiro GG. Role of allergy in sinusitis. Pediatr Infect Dis J 1985;4:55-59.
4. Bluestone CD. Eustachian tube function: Physiology, pathophysiology, and role of allergy in pathogenesis of otitis media. J Allergy Clin Immunol 1983;72:242- 251.
5. Siegel G. Theoretical and clinical aspects of the tonsil- lar function. Int J Pediatr Otorhinolaryngol 1983;6:61- 66.
6. Capron A, Dessaint JP, Capron M, et al. From parasites to allergy: a second receptor for IgE. Immunol Today 1986;7:15-20.
7. Aubry JP, Pochon S, Graber P, et al. Nature 1992;358:505-507.
8. Liu YJ, Cairns JA, Holder MJ, et al. Recombinant 25- kDa CD23 and interleukin 1 alpha promote the sur- vival of germinal center B cells: evidence for bifurca- tion in the development of centrocytes rescued from apoptosis. Eur J Immunol 1991;21:1107-1114.
9. Hertl M, Asada H, Katz SI. Murine epidermal Langer- hans cells do not express the low-affinity receptor for immunoglobulin E, FcEpsilonRII (CD23). J Invest Der- matol 1996;106:221-224.
10. Maesano AI, Didier A, Klossek M, et al. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies Allergy 2002;57:1007- 1014.
11. Modrzynski M, Zawisza E, Rapiejko P, et al. The oc- currence of atopic hypersensitivity in children with adenoid hypertrophy Przegl Lek 2002; 59:1003-1006.
12. Huang SW, Giannoni C. The risk of adenoid hyper- trophy in children with allergic rhinitis. Ann Allergy Asthma Immunol 2001;87:350-355.
13. Becker S, Koch T, Philipp A. Allergic origin of recurrent middle ear effusion and adenoids in young children. HNO 1991;39:182-4.
14. Tomonaga K, Krono Y, Mogig. The role of nasal al- lergy in otitis media with effusion: a clinical study. Acta Otolaringol Suppl 1988;458:41-47.
15. Doner F, Yarıktas M, Demirci M. The role of allergy in recurrent otitis media with effusion. Otolaringol Head Neck Surg 2004;130: 95-118.
16. Nguyen LHP, Manoukian JJ, Tewfik TL, et al. Evi- dence of Allergic Inflammation in the middle ears of children with otitis media with effusion. Laryngo- scope1999;109:471-477.
17. Hurst DS, Amin K, Seveus L, et al. Evidence of mast cell activity in the middle ears of children with otitis media with effusion. Laryngoscope 1999;109:471- 477.
18. Juntti IJ, Tikkanen S, Kokkonen J, et al. Cow’s milk allergy is associated with recurrent otitis media during childhood. Acta Otolaringol 1999;119:867-873.
19. Yenigün A. Çocukluk Çağında allerjik rinit, allerjik rinitte klinik ve laboratuar bulguları, tanı ve ayırıcı tanı. Güncel Pediatri Dergisi, 2007;1:26-231.
20. Dost P. Histological examination following adenoidec- tomy and tonsillectomy in children. Surprising results are very rare. HNO 2006;54:16-19.
21. Sekerel BE, Saraclar Y, Sanal O, et al. IgG subclass- es in children with recurrent respiratory tract infections in an allergy practice. Acta Paediatr Jpn 1996;38:124- 127.
22. Tuijnman WB, Van Wichen DF, Schuurman HJ. Tissue distribution of human IgG Fc receptors CD16, CD32 and CD64: an immunohistochemical study. APMIS 1993101:319-329.
23. Özbaş-Gerçeker F. Tezcan I, Berkel AI. The effect of mannose-binding protein gene polymorphisms in re- current respiratory system infections in children and lung tuberculosis. Turk J Pediatr 2003;45:95-98.
24. Roever AC, Heine G, Zuberbier T, et al. Allergen-me- diated modulation of CD23 expression is interferon- and interleukin-10 dependent in allergic and nonaller- gic individuals Clin Exp Allergy 2003;33:1568–1575.
25. Corominos M, Mestre M, Bos J. Distinct modulation by interferon-gamma(IFN-g) of CD23 expression on B and T lymphocytes of atopic subjects. Clin Exp Immu- nol 1998;112;276-280.