Çocuklarda Oksidatif Stres ile Adenotonsiller Hipertrofi Arasındaki İlişki

Year 2023, Volume: 17 Issue: 2, 96 - 100, 22.03.2023

Gülşah Alyar , Nurinnisa Öztürk , Özgür Yörük , Özge Nur Türkeri , Nuri Bakan

https://doi.org/10.12956/tchd.1072563

Abstract

Amaç: Bu çalışmada obstrüktif adenotonsiller hipertrofisi olan çocukların ameliyat öncesi ve sonrası oksidatif stres düzeylerinin değerlendirilmesi ve elde edilen verilerin sağlıklı çocuklarla karşılaştırılması amaçlandı.

Gereç ve Yöntemler: 2015 yılı Mart-Eylül ayları arasında yapılan prospektif çalışmaya 25 hasta ve 25 sağlıklı kontrol dahil edilmiştir.
Araştırma örnekleminde hasta grubuna kronik tonsillit, horlama ve ağızdan nefes alma şikayeti ile adenotonsiller hipertrofi tanısı alan ve
adenotonsillektomi planlanan çocuklar dahil edilmiştir. Serum ve idrar örneği hasta grubundan ameliyat öncesi ve sonrası iki kez, kontrol
grubundan bir kez alındı. Tüm numunelerin 8-hidroksi-2-deoksiguanozin düzeyleri EIA yöntem, protein karbonil düzeyleri ELISA yöntem ve
malondialdehit düzeyleri manuel spektrofotometrik yöntem kullanılarak belirlenmiştir.

Bulgular: Çalışmada adenotonsiller hipertrofisi olan çocukların serum malondialdehit düzeylerinin kontrol grubuna göre anlamlı olarak
yüksek olduğu (p=0.003) ve diğer parametreler açısından fark olmadığı (p>0.05) bulunmuştur. Ameliyattan sonra değerlendirilen her üç
parametrenin de öncekine göre anlamlı düzeyde azaldığı tespit edilmiştir (p<0.05). Operasyon öncesi malondialdehit ile 8-hidroksi-2-
deoksiguanozin değerleri arasında istatistiksel olarak anlamlı ve zayıf bir korelasyon olduğu belirlenmiştir (p=0.003, r=0.566).

Sonuç: Pediatrik popülasyonda yaygın görülen hipertrofik adenotonsiller birçok klinik duruma neden olarak çocukların sağlığını ve yaşam
kalitesini olumsuz etkilemektedir. Bulgularımız doğrultusunda obstrüktif ATH’li çocuklarda serum ve idrar MDA düzeyleri ile doku PCO
düzeylerinin oksidatif hasarın değerlendirilmesinde yararlı belirteçler olduğunu ve hastalığın etyopatogenezini aydınlatmaya yardımcı olabileceğini
söyleyebiliriz. ATH sağlık üzerindeki olumsuz etkileri sebebiyle hastalığın klinik, biyokimyasal ve histopatolojik çalışmalarının daha
geniş bir örneklem grubunda incelenmesi önerilmektedir.
Anahtar Sözcükler: Adenotonsiller hipertrofi, 8-hidroksi-2-

Keywords

Adenotonsiller hipertrofi, 8-hidroksi-2-deoksiguanozin, malondialdehit, protein karbonil

The Relationship Between Oxidative Stress and Adenotonsillar Hypertrophy in Children

Abstract

Objective: In this study, it was aimed to evaluate the preoperative and postoperative oxidative stress levels of children
with obstructive adenotonsillar hypertrophy and to compare the obtained data with healthy children.

Material and Methods: 25 patients and 25 healthy controls were included in the prospective study conducted between
March and September 2015. In the study sample, children who were diagnosed with adenotonsillar hypertrophy due
to chronic tonsillitis, snoring and mouth breathing and who were planned for adenotonsillectomy were included in
the patient group. Control group included 25 healthy volunteers with the same demographic characteristics. Serum
and urine samples were collected from the patient group twice, before and after surgery, and once from the control
group. 8-hydroxy-2-deoxyguanosine levels of all samples were determined by EIA method, protein carbonyl levels were
determined by ELISA method and malondialdehyde levels were determined by manual spectrophotometric method.

Results: In the study, it was found that the serum malondialdehyde levels of children with adenotonsillar hypertrophy
were significantly higher than the control group (p=0.003) and that there was no difference in terms of other parameters
(p>0.05). After the operation, it was determined that the levels of all three parameters evaluated significantly decreased
compared to before (p<0.05). It was determined that there was a statistically significant and weak correlation between
malondialdehyde and 8-hydroxy-2-deoxyguanosine values before the operation (p=0.003, r=0.566).

Conclusion: Hypertrophic adenotonsillar, which is common in the pediatric population, causes many clinical conditions
and adversely affects the health and quality of life of children. In line with our findings, we can say that serum and urine MDA
levels and tissue PCO levels are useful markers in the evaluation of oxidative damage in children with obstructive ATH and
may help to elucidate the etiopathogenesis of the disease. Considering the effects of ATH on health, it is recommended
to be considered as an important health problem and to examine the clinical, biochemical and histopathological studies
of the disease in a larger sample group.

Keywords

Adenotonsillar hypertrophy, 8-hydroxy-2-deoxyguanosine, malondialdehyde, protein carbonyl

References

• Gray LP. The T’s and A’s problem—Assessment and reassessment. J Laryngol Otol 1977;1: 11-32.
• Verma SP, Stoddard T, Gonzalez-Gomez I, Koempel JA. Histologic analysis of pediatric tonsil and adenoid specimens: is it really necessary? Int J Pediatr Otorhinolaryngol 2009; 73.4: 547-50. Arambula A, Brown JR, Neff L. Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils. World J Otorhinolaryngol Head Neck Surg 2021;3: 155-60.
• Li H, Ji CY, Zong XN, Zhang YQ. Height and weight standardized growth charts for Chinese children and adolescents aged 0 to 18 years. Zhonghua Er Ke Za Zhi 2009;7: 487-92.
• Abuhandan M, Bozkuş F, Demir N, Eren E, Koca B, Guler OK, Selek S. The preoperative and postoperative oxidative status of children with chronic adenotonsillar hypertrophy. Clin Ter 2013;3: e163-7. Özcan O, Erdal H, Çakırca G, Yönden Z. Oxidative stress and its impacts on intracellular lipids, proteins and DNA. J Clin Exp Invest 2015;3: 331-6.
• Yılmaz T, Koçan EG, Besler HT. The role of oxidants and antioxidants in chronic tonsillitis and adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 2004;8: 1053-8.
• Cho JH, Suh JD, Kim YW, Hong SC, Kim IT, Kim JK. Reduction in oxidative stress biomarkers after adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2015;9: 1408-11.
• Eken A. Rat kan ve doku örneklerinde oksidatif stres parametreleri. J Clin Anal Med 2017; 69-73.
• Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea. PloS one 2013;10: e78666.
• Tagaya M, Nakata S, Yasuma F, Miyazaki S, Sasaki F, Morinaga M, et al. Relationship between adenoid size and severity of obstructive sleep apnea in preschool children. Int J Pediatr Otorhinolaryngol 2012;12:1827-30.
• Doğruer ZN, Ünal M, Eskandari G, Pata YS, Akbaş Y, Çevik T, et al. Malondialdehyde and antioxidant enzymes in children with obstructive adenotonsillar hypertrophy. Clin Biochem 2004;8: 718-21.
• Ekinci A, Dağıstan H, Aksoy A, Ekinci H. Comparison of Preoperative and Postoperative Antioxidant Levels in Patients with Adenotonsillar Hypertrophy. Allergy 2020;2: 34-8.
• Breen AP, Murphy JA. Reactions of oxyl radicals with DNA. Adv Redox Res 1995;6: 1033-77.
• Helbock HJ, Beckman KB, Ames BN. 8-Hydroxydeoxyguanosine and 8-hydroxyguanine as biomarkers of oxidative DNA damage. Methods Enzymol 1999;300:156-66.
• Gonzalez-Hunt CP, Wadhwa M, Sanders LH. DNA damage by oxidative stress: Measurement strategies for two genomes. Curr Opin Toxicol 2018;7:87-94.
• Özbilgic T, Suslu AE, Aykan HH, Pehlivanoglu B, Onal D, Kasikci M, et al. The impact of the Adenotonsillectomy on cardiac functions and oxidative stress. Int J Pediatr Otorhinolaryngol 2022; 111039.
• Yoruk O, Alp H, Yuksel S, Bakan E. DNA damage in children with obstructive adenotonsillar hypertrophy. J Craniofac Surg 2014; 6: 2156-9.
• Cemek M, Dede S, Bayiroğlu F, Çaksen H, Cemek F, Yuca K. Oxidant and antioxidant levels in children with acute otitis media and tonsillitis: a comparative study. Int J Pediatr Otorhinolaryngol 2005;6: 823-7.
• Kaygusuz N, İlhan T, Karlıdağ E, Keleş Ş, Yalçın HÇ. Adenoid Hipertrofisinde Serbest Oksijen Radikallerinin Rolü. Turk Arch Otorhinolaryngol 2003; 41:146- 50.
• Chethana R, Devan PP, Sushmitha K. The Role of Oxidants and Antioxidants in Chronic Tonsillitis. Indian J Otolaryngol Head Neck Surg 2020; 1-6.
• Cvetković T, Vlahović P, Todorović M, Stanković M. Investigation of oxidative stress in patients with chronic tonsillitis. Auris Nasus Larynx 2009; 36: 340-4.
• Levine RL. Carbonyl modified proteins in cellular regulation, aging, and disease. Adv Redox Res 2002;9:790-6.
• Reznick AZ, Packer L. Oxidative damage to proteins: spectrophotometric method for carbonyl assay. In: Methods in enzymology. Academic press 1994;357-63.
• Levine RL, Garland D, Oliver CN, Amici A, Climent I, Lenz AG, et al. Determination of carbonyl content in oxidatively modified proteins. In: Methods in enzymology. Academic Press 1990;464-78.
• Dalle-Donne I, Rossi R, Giustarini D, Milzani A, Colombo, R. Protein carbonyl groups as biomarkers of oxidative stress. Clin Chim Acta 2003;2: 23-38.
• Horiuchi F, Oka Y, Komori K, Tokui Y, Matsumoto T, Kawabe K, et al. Effects of adenotonsillectomy on neurocognitive function in pediatric obstructive sleep apnea syndrome. Neurocase 2014; 2014.
• Aksu H, Günel C, Özgür BG, Toka A, Başak S. Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children. Int J Pediatr Otorhinolaryngol 2015; 7: 1030-3.
• Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea. PloS one 2013; 8.10: e78666.