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

Abstract

Objective: In this study, CD23, low affinity immunoglobu­lin E receptor, expression in the adenoid tissue was inves­tigated immunohistochemically and evaluated with regard to upper respiratory tract infection complaints and allergy. Methods: This retrospective study was performed by the selection of 100 patients aged 2-13 years who underwent adenoidectomy/adenotonsillectomy and in whom the ad­enoid tissue pathological studies were reported as “lym­phoid hyperplasia and chronic infection” were evaluated. Immunohistochemical evaluation of CD23 expression was scored semiquantitatively between 0-3 in the tissue samples. Results: The mean age in the study group was 70.7 months; 46% were female; 30% of patients had adenoid­ectomy only. Following the operation, the infection fre­quency 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 sensitiv­ity (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 under­lying mechanism for the recurrence of respiratory tract complaints in these children, despite adenoidectomy. J Clin Exp Invest 2013; 4 (1): 1-7

Keywords

• CD23 expression, adenoid tissue, atopy

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

Abstract

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 yaş arasında değişen adenoidekromi ve adenoidektomi/ ton­sillektomi operasyonu geçiren 100 hasta alındı. Patoloji raporları 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. Operas­yon 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.

Keywords

• CD23 ekspresyonu, adenoid doku, atopi

References

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.