title: Effect of fluticasone furoate on interleukin 6 secretion from adenoid tissues in children with obstructive sleep apnea.
abstract: OBJECTIVE
  To determine the effect of intranasal corticosteroid therapy on T-regulatory cells and other inflammatory cytokines in adenoid tissues in children with obstructive sleep apnea syndrome.
  
  
  METHODS
  Randomized, prospective, exploratory study.
  
  
  METHODS
  Academic pediatric otolaryngology practice in a tertiary care children's hospital.
  
  
  METHODS
  Participants included 24 children between the ages of 2 and 12 years who were undergoing adenotonsillectomy for polysomnogram-documented obstructive sleep apnea syndrome.
  
  
  METHODS
  Children were randomized to either no treatment (n = 13) or treatment with fluticasone furoate nasal spray, 55 μg/nostril daily (n = 11), for 2 weeks before adenotonsillectomy. Adenoid tissue was obtained at the time of the procedure.
  
  
  METHODS
  The number of tissue T-regulatory cells, as determined by staining with FOXP3, CD4, and CD25, was the primary outcome measure. Staining for interleukin (IL)-10 and transforming growth factor-β protein by immunohistochemistry, and adenoid mononuclear cell spontaneous and induced release of cytokines (IL-10, IL-6, IL-12, IL-13, tumor necrosis factor, and transforming growth factor β) were secondary outcomes.
  
  
  RESULTS
  Cells isolated from fluticasone furoate nasal spray-treated adenoid tissue released significantly less IL-6 spontaneously as well as upon stimulation with anti-CD3 monoclonal antibody (P = .05) compared with nontreated adenoid tissue. There were no significant differences in the number of CD4/FOXP3-, CD25/FOXP3-, or transforming growth factor β-positive cells. Intensity of staining for IL-10 was also comparable between the groups.
  
  
  CONCLUSIONS
  In this study, we show reduction of IL-6, a proinflammatory cytokine, in adenoid tissue obtained from children with obstructive sleep apnea syndrome treated with fluticasone furoate nasal spray. This reduction could contribute to the clinical efficacy of this class of medications in the treatment of childhood obstructive sleep apnea syndrome.
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center, IL 60637, USA.
authors.forename: Rania
authors.initials: R
authors.lastname: Esteitie
authors.forename: Janaki
authors.initials: J
authors.lastname: Emani
authors.forename: Shilpy
authors.initials: S
authors.lastname: Sharma
authors.forename: Dana L
authors.initials: DL
authors.lastname: Suskind
authors.forename: Fuad M
authors.initials: FM
authors.lastname: Baroody
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000166:cytology / Q000378:metabolism*; D000281:Administration, Intranasal; D000730:Androstadienes / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007150:Immunohistochemistry; D007378:Interleukins / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000188:drug therapy* / Q000601:surgery; D013194:Staining and Labeling; D014068:Tonsillectomy; D016212:Transforming Growth Factor beta / Q000378:metabolism; D048069:Tumor Necrosis Factors / Q000378:metabolism
chemical_list: D000730:Androstadienes; D005938:Glucocorticoids; D007378:Interleukins; D016212:Transforming Growth Factor beta; D048069:Tumor Necrosis Factors; C523187:fluticasone furoate