title: Novel pharmacological approaches for treatment of obstructive sleep apnea in children.
abstract: BACKGROUND
  The lymphadenoid tissues in the upper airway are sparse and organized lympho-epithelial structures playing an important role against foreign pathogens, with the palatine tonsils being the major components of the lymphoid tissues contained in the Waldeyer's ring. Obstructive sleep apnea (OSA) has emerged as a very frequent condition in the pediatric age range that is associated with substantial neurobehavioral, cardiovascular and metabolic morbidities. Adenotonsillar hypertrophy is the major pathophysiological contributor to OSA occurrence in children.
  
  
  METHODS
  Here, the authors provide a systematic review and summary of some of the known histological and pathological features of human lymphadenoid tissues and their fundamental immunological functions, provide insights into the pathophysiology of pediatric OSA, particularly focusing on inflammatory pathways and the available outcomes associated with targeting such pathways with compounds such as corticosteroids and leukotriene modifiers. Furthermore, they present findings from an unbiased approach to discovery of therapeutic targets and formulate constructs toward putative future interventional approaches for this highly prevalent condition.
  
  
  CONCLUSIONS
  Surgical approaches for pediatric OSA may not be as effective as previously anticipated. Accordingly, expanded use of existing systemic or topical anti-inflammatory agents or development of novel compounds targeting selected immune cell populations underlying pathophysiological determinants of OSA is needed.
authors.affiliation: University of Chicago, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, Department of Pediatrics, Chicago, IL 60637, USA.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.forename: Jinkwan
authors.initials: J
authors.lastname: Kim
authors.forename: Aviv D
authors.initials: AD
authors.lastname: Goldbart
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000276:immunology; D015289:Leukotrienes / Q000276:immunology; D008221:Lymphoid Tissue / Q000276:immunology; D018077:Receptors, Leukotriene / Q000276:immunology; D020181:Sleep Apnea, Obstructive / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D015289:Leukotrienes; D018077:Receptors, Leukotriene