Reflux changes in adenoidal hyperplasia: a controlled prospective study to investigate its aetiology.
OBJECTIVE
To compare pepsin, carbonic anhydrase III (CAIII), cyclooxygenase-2 (COX-2) and mucin 5AC (MUC5AC) expression in children with adenoid hypertrophy and normal controls.


METHODS
A non-randomised, controlled prospective study.


METHODS
Two paediatric hospitals in Adelaide, South Australia.


METHODS
Children aged 2-10 years, 21 undergoing adenoidectomy and 12 controls undergoing routine dental surgery.


METHODS
We measured expression of pepsin, CAIII, COX-2 and MUC5AC levels by real-time RT-PCR, immunohistochemistry, and Western blot to determine any difference between children with hyperplastic adenoids and controls.


RESULTS
Pepsin was not detected in any study or control adenoid by immunohistochemistry or Western blot. Real-time RT-PCR analysis showed a statistically significant difference between groups with respect to COX-2 (P = 0.027) and MUC5AC (P = 0.02) but no difference in CAIII expression (P = 0.414). A significant correlation was also found between COX-2 and MUC5AC expression (Kendall Tau = 0.4, P = 0.005).


CONCLUSIONS
Our results suggest that the biochemical changes seen in adenoid hypertrophy are different to those seen in reflux-affected tissues. The decreased COX-2 and MUC5AC expression may be due to squamous metaplasia and other inflammatory changes associated with adenoid hypertrophy. Our findings infer there is little evidence of reflux being a major contributory factor in the pathophysiology of adenoidal hypertrophy.
ENT Unit, Flinders Medical Centre, Adelaide, Australia.
P K
PK
Harris
D J
DJ
Hussey
D I
DI
Watson
G C
GC
Mayne
A
A
Bradshaw
S
S
Joniau
L W
LW
Tan
P J
PJ
Wormald
A S
AS
Carney
D000233:Adenoidectomy; D000234:Adenoids / Q000473:pathology*; D001706:Biopsy; D024403:Carbonic Anhydrase III / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D051546:Cyclooxygenase 2 / Q000235:genetics; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000235:genetics / Q000473:pathology; D015870:Gene Expression / Q000235:genetics; D006801:Humans; D006965:Hyperplasia / Q000235:genetics / Q000473:pathology; D008297:Male; D055271:Mucin 5AC / Q000235:genetics; D010434:Pepsin A / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D013223:Statistics as Topic
C524678:MUC5AC protein, human; D055271:Mucin 5AC; D051546:Cyclooxygenase 2; D010434:Pepsin A; D024403:Carbonic Anhydrase III