Hipertrofik adenoidlerde immün CD14 reseptörünün tanımlanması

Abstract

Amaç: Tonsil ve adenoid Waldeyer halkasının bölümleridir. Temel işlevi daha sonra çok çeşitli antijenlerle reaksiyona giren antikor oluşumudur. Küçük çocuklarda adenoidektomi en sık yapılan ameliyat olmasına rağmen adenoid hipertirofisinin tam olarak nedenleri hâlâ bilinmemektedir. Bu nedenle bu çalışma adenoidektomi geçirmesi gerekli çocuklarda bir enşamasyon gösterge belirteci yerine CD14 kullanımını araştırmayı amaçlamıştır.

Yöntem: Bu çalışmaya adenoid hipertrofisi olan yüz çocuk hasta dahil edilmiştir. İnfiltratif hücrelerde CD14 ekspresyonunun yoğunluğu immünohistokimyasal olarak değerlendirilmiştir.

Bulgular: Yüz hastanın tümü adenoidlerin kronik inşamasyonu ve hipertrofileri nedeniyle adenoidektomi ameliyatı geçirmiştir. İmmünohistokimyasal analizden sonra numunelerin tümü CD14 ekspresyonu açısından pozitif (%100) boya tutmuştur. CD14’ün boyanma yoğunluğuna göre bu numunelerin sınışandırması aşağıdaki gibidir: 0, skor 0; 36, skor 1; 43 skor 2 ve 21 skor 3. Diğer taraftan CD14 düzeyi ile yaş arasında istatistiksel açıdan anlamlı bir ilişki saptadık.

Sonuç: Bu çalışmada yaşla birlikte CD14 dansitesinde artış olduğunu göstermiş olduk.

Anahtar sözcükler: Antijen, CD14, adenoidler, adenoidektomi.

Keywords

• Antijen, CD14, adenoidler, adenoidektomi

Identification of the immune receptor CD14 in hypertrophic adenoids

Abstract

Objective: Tonsils and adenoids are the parts of the Waldeyer’s ring. Their basic function is antibody formation which later reacts against a great variety of antigens. Adenoidectomy is the most common operation in small children but the exact reasons of adenoid hypertrophy remain unknown. Therefore, this study aimed at investigating CD14 as surrogate marker of inflammation in children who have to undergo adenoidectomy. Methods: One hundred pediatric patients with adenoid hypertrophy were included in this study. Intensity of CD14 expression in infiltrating cells was assessed by immunohistochemical methods. Results: All of the 100 patients underwent adenoidectomies due to chronic adenoid inflammation and hypertrophy. After immunohistochemical analysis, all the specimens were stained as positive (100%) for CD14 expression. Classification of these specimens according to CD14 staining intensity were as follows: 0 as score 0, 36 as score 1, 43 as score 2 and, 21 as score 3. On the other hand, we found statistically significant association between CD14 and age. Conclusion: In the present study, we showed an increase in the density of CD14 with increasing age.

Keywords

• Antigen,CD14,adenoids,adenoidectomy

References

1. Perry M, Whyte A. Immunology of the tonsils. Immunol Today 1998;19:414–21.
2. Yildirim N, Sahan M, Karslioğlu Y. Adenoid hypertrophy in adults: clinical and morphological characteristics. J Int Med Res 2008;36:157–62.
3. Ben-Yaakov A, Maly B, Abu-Ita R, Elidan J, Gross M. Identification and immunolocalization of the innate immune receptor CD14 in hypertrophic adenoids and tonsils. Immunol Invest 2011;40:150–9.
4. Wright SD, Ramos RA, Hermanowski-Vosatka A, Rockwell P, Detmers PA. Activation of the adhesive capacity of CR3 on neu- trophils by endotoxin: dependence on lipopolysaccharide binding protein and CD14. J Exp Med 1991;173:1281–6.
5. Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am 1989;36:1551–69.
6. Wang DY, Bernheim N, Kaufman L, Clement P. Assessment of adenoid size in children by fibreoptic examination. Clin Otolaryngol Allied Sci 1997;22:172–7.
7. Deutsch ES. Tonsillectomy and adenoidectomy. Pediatr Otolaryngol 1996;43:1319–38.
8. Richardson, MA. Sore throat, tonsillitis, and adenoiditis. Med Clin North Am 1999;83:75–83.

9. Brodsky L, Koch J. Anatomic correlates of normal and diseased adenoids in children. Laryngol 1992;102:1268–74.
10. Taylan I, Ozcan I, Mumcuoğlu I, et al. Comparison of the surface and core bacteria in tonsillar and adenoid tissue with beta-lacta- mase production. Indian J Otolaryngol Head Neck Surg 2011;63: 223–8.
11. Wiatrak BJ, Woolley AL. Pharyngitis and adenotonsillar disease. In: Cummings CW, Frederickson JM, Harker LA, Krause CJ, Schüller DE, editors. Otolaryngology – head and neck surgery. 2nd ed. St. Louis: Mosby Year Book; 1993. p. 2795–801.
12. Demain JG, Goetz DW. Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 1995;95:355–64.
13. Criscuoli G, D’Amora S, Ripa G, et al. Frequency of surgery among children who have adenotonsillar hypertrophy and improve after treatment with nasal beclomethasone. Pediatrics 2003;111:e236–8.
14. Maw AR. Chronic otitis media with effusion (glue ear) and adeno- tonsillectomy: prospective randomised controlled study. Br Med J (Clin Res Ed) 1983;287(6405):1586–8.
15. Bernstein JM, Sendor S, Wactawski-Wende J. Antigen-presenting cells in the nasopharyngeal tonsil. A quantitative immunohisto- chemical study. Adv Otorhinolaryngol 1992;47:80–90.
16. Flanagan JG, Rabbits TH. Arrangement of human immunoglob- ulin heavy chain constant region genes implies evolutionary dupli- cation of a segment containing gamma, epsilon and alpha genes. Nature 1982;300:709–13.
17. Wright SD, Tobias PS, Ulevitch RJ, Ramos RA. Lipopolysaccha- ride (LPS) binding protein opsonizes LPS-bearing particles for recognition by a novel reeptor on macrophages. J Exp Med 1989; 170:1231–41.
18. Fujiyoshi T, Watanabe T, Ichimiya I, Mogi G. Functional archi- tecture of the nasopharyngeal tonsil. Am J Otolaryngol 1989;10: 124–31.
19. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
20. NC-ND3.0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
21. tion in any medium, provided the original work is properly cited.
22. Please cite this article as: Cengiz Peker B, Acar M, Şahin M. Identification of the immune receptor CD14 in hypertrophic adenoids. ENT Updates 2015;5(3):93–96.