title: CD4(+)T-lymphocyte subsets in nonobese children with obstructive sleep apnea syndrome.
abstract: BACKGROUND
  To characterize the distribution of both tonsillar and circulating CD4(+)T-lymphocyte subsets, and to explore their clinical relevance in nonobese children with obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  A total of 53 children who underwent tonsillectomy for either OSAS (n = 25) or primary snoring (PS, n = 28) were prospectively enrolled. Nineteen healthy children without any symptoms were recruited as controls. We quantified the frequencies of CD4(+)T-lymphocyte subpopulations using flow cytometry, serum-related cytokines using enzyme-linked immunosorbent assay, and key transcription factors using quantitative polymerase chain reaction (qPCR).
  
  
  RESULTS
  Tonsillar distributions of CD4(+)T-lymphocyte subsets were comparable in the OSAS and PS subjects. The peripheral Th17/Treg ratio was positively correlated to severity as measured by apnea/hypopnea index (AHI), serum C-reactive protein and hypoxia-inducible factor-1α mRNA in the OSAS children (P < 0.05). And AHI was independently associated with the peripheral Th17/Treg ratio (P < 0.05). Furthermore, the response to surgery was associated with a significant reversal of the Th17/Treg imbalance and a concomitant relief of the proinflammatory profile in the OSAS subjects.
  
  
  CONCLUSIONS
  Pediatric OSAS was associated with an altered Th17:Treg balance toward Th17 predominance. The changes in lymphocytic phenotypes that correlated with recurrent intermittent hypoxia in sleep apnea may contribute to the variance in systemic inflammation and downstream morbidities of pediatric OSAS.
authors: Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Jin
authors: J
authors: Ye
authors: Department of Internal Medicine, Division of Pulmonary and Critical Care, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Hui
authors: H
authors: Liu
authors: Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Peng
authors: P
authors: Li
authors: Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Zhuang-gui
authors: ZG
authors: Chen
authors: Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Ge-hua
authors: GH
authors: Zhang
authors: Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Qin-tai
authors: QT
authors: Yang
authors: Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Yuan
authors: Y
authors: Li
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000166:cytology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000601:surgery; D016176:T-Lymphocyte Subsets; D014068:Tonsillectomy