title: Expression of Fas ligand and CTLA4 in adenoids has a predictive value for allergic rhinitis development in children.
abstract: BACKGROUND
  The balance of CD28/CTLA4-derived signals and Fas-dependent apoptosis activity is determined by the peripheral defense mechanisms and might play a role in the pathogenesis of allergy.
  
  
  OBJECTIVE
  The aim of the study was to investigate the expression of costimulatory and pro- and antiapoptotic molecules in adenoid T cells of children suffering from allergic rhinitis and to find out which of these molecules have a predictive value in the development of allergic rhinitis.
  
  
  METHODS
  The adenoids of 60 children, removed because of nasal obstruction, chronic rhinitis and recurrent respiratory infection, were evaluated. Patients were divided into two groups: group 1, suffering from chronic allergic rhinitis, and group 2, suffering from chronic rhinitis, where no specific IgE was detected, including children with a positive family history of allergy (group 2a) and children with neither a personal nor a family history of allergy (group 2b). For immunohistochemical stainings anti-CD3, anti-CD19, anti-CD4, anti-CD8, anti-CD25, anti-CD28, anti-CTLA4 (CD152), anti-bcl-2, anti-Fas, and anti-FasL antibodies were used. The number of cells expressing these molecules was identified in adenoid interfollicular spaces. The results were then analyzed in allergic and nonallergic children. During a 24-month follow-up children were re-examined for allergy and results were compared to previous immunohistochemical evaluations.
  
  
  RESULTS
  The expression of CD4, CD25, CD28, FasL, and CTLA4 was significantly increased in group 1 compared to group 2 (p < 0.05). However, the discriminant analysis confirmed that only CTLA4 and FasL expression fully discriminated allergic subjects from the others. During a 24-month period of observation 8 children from group 2a were also diagnosed with allergic rhinitis. All of them, especially those sensitized to mites, had an increased number of FasL+ and CTLA4+ in previously removed adenoids.
  
  
  CONCLUSIONS
  An increased number of cells with intracellular expression of FasL and CTLA4, in interfollicular spaces of adenoids, seems to be a predictive factor of the development of allergic rhinitis.
authors: Department of Pediatric Otolaryngology, Medical University of Lodz, Lodz, Poland. a.m.zakrzewska@wp.pl
authors: Anna
authors: A
authors: Zakrzewska
authors: Danuta
authors: D
authors: Gryczyńska
authors: Józef
authors: J
authors: Kobos
authors: Paweł
authors: P
authors: Górski