title: Adenoidectomy in young children and serum IgG antibodies to pneumococcal surface protein A and choline binding protein A.
abstract: OBJECTIVE
  We have previously reported that surgical removal of the nasopharyngeal adenoid in young children resulted in increased risk of nasopharyngeal colonization by pneumococci. We now investigated whether adenoidectomy influences the development of serum IgG antibodies to pneumococcal choline-binding protein A (CbpA) and pneumococcal surface protein A (PspA).
  
  
  METHODS
  Altogether 217 children aged 12-48 months who had recurrent or persistent otitis media were randomized to undergo or not to undergo adenoidectomy. All the children underwent insertion of tympanostomy tubes. 166 children were followed-up for 3 years. The main outcome measures were concentrations of serum IgG antibodies to CbpA and PspA three years after randomization. Nasopharyngeal colonization by pneumococci was assessed 1, 2, and 3 years after randomization.
  
  
  RESULTS
  Adenoidectomy decreased concentrations of CbpA antibodies by ca. 25% independently of the observed increase in pneumococcal carriage (OR of log(10) transformed concentrations 0.74, 95% CI 0.58-0.94, P=0.016). Concentrations of PspA antibodies were lower and they seemed not to be influenced by adenoidectomy.
  
  
  CONCLUSIONS
  Adenoidectomy in young children causes a small but detectable impairment in the development of serum IgG antibodies to pneumococcal CbpA. The adenoid seems to have a role in augmenting systemic immunity against pneumococci.
authors: Department of Otorhinolaryngology, Helsinki University Central Hospital, Finland. petri.mattila@hus.fi
authors: Petri S
authors: PS
authors: Mattila
authors: Sari
authors: S
authors: Hammarén-Malmi
authors: Harri
authors: H
authors: Saxen
authors: Tarja
authors: T
authors: Kaijalainen
authors: Helena
authors: H
authors: Käyhty
authors: Jussi
authors: J
authors: Tarkkanen
mesh_terms: D000233:Adenoidectomy; D000907:Antibodies, Bacterial / Q000097:blood*; D001426:Bacterial Proteins / Q000276:immunology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007223:Infant; D016015:Logistic Models; D008297:Male; D008876:Middle Ear Ventilation; D009305:Nasopharynx / Q000382:microbiology; D010033:Otitis Media / Q000601:surgery; D013296:Streptococcus pneumoniae / Q000276:immunology* / Q000302:isolation & purification
chemical_list: D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; C110344:SpsA protein, Streptococcus pneumoniae; C051592:pneumococcal surface protein A