[The implications of nasal associated lymphoid tissue in development of respiratory allergic diseases in children].
OBJECTIVE
to asses the connection between the expression of costimulatory proteins associated with apoptosis of t lymphocytes of the adenoid in children with allergic rhinitis. To establish the usefulness of using the results of adenoid tissue immunohistochemical studies for prognosis in chronic respiratory allergic disease.


METHODS
prospective studies were carried out in 70 children with indications for adenectomy according to the European Pediatric ENT Association. These children had recurrent or chronic rhinitis. Two study groups were identified: Group I- 30 children with allergic rhinitis and group II- 40 children without specific IgE. Group II was subdivided according to family history of atopy: group IIa with positive family history and group IIb with negative family history. Children from group II were followed up for allergic symptoms during 36 months after adenectomy. Histopathologic and immunnohistochemical study of the adenoid tissue (from adectomy) was carried out. The expression of CD4, CD8, CD25, CD28, Cdl52 (CTLA4), Fas, FasL, bel-2 was investigated. The results were analysed statistically.


RESULTS
statistically significant differences between the studies group concerned the number of cells witch showed expression of CD28, CTLAL (CD152) and Fas-L (p<0.05). For CD25 expression statistically significant differences were evident between group I and IIb. No statistically evident differences were found in expression of Cd95 and bel-2 (p>0.05) - three years follow up of children after adenectomy and repeated investigations (every 6 months), allowed to identify specific IgE (for examined allergens) in 11 children from group IIa. These were not present before adenectomy. 3 year study results after adenectomy in children compared with immunnohistochemical investigations of adenoid tissue confirmed the correlation between CTLA4 and FasL expression in children with allergic rhinitis.


CONCLUSIONS
Intracellular expression of CTLA4 and FasL in T lymphocyts of the adenoid tissue may be a predictive factor in the development of respiratory allergy in children. Further studies are needed.
Zakrzewska
Anna
A
Klinika Otolaryngologii, Audiologii i Foniatrii Dzieciecej, Katedra Pediatrii Zabiegowej, Uniwersytet Medyczny, ul. Warnenska 15, 94-215 Łodz, Poland. a.m.zakrzewska@wp.pl.
Kobos
Józef
J
Górski
Pawel
P
D000233:Adenoidectomy; D000234:Adenoids / Q000276:immunology* / Q000473:pathology* / Q000601:surgery; D015703:Antigens, CD / Q000276:immunology; D000943:Antigens, Differentiation / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D060908:CTLA-4 Antigen; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D053222:Fas Ligand Protein / Q000276:immunology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009305:Nasopharynx / Q000276:immunology* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012220:Rhinitis / Q000276:immunology* / Q000473:pathology* / Q000601:surgery
D015703:Antigens, CD; D000943:Antigens, Differentiation; D015415:Biomarkers; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D053222:Fas Ligand Protein