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Abu-Elnasr Awwad A, Hasan RA, Hablas MGA, Mohammad Mohammad Abdelhay O, Dawood YMA, Ahmed Mohamed B, Rabou KAA, Salem TMM, Elhady M, Abd El-Aal GN, Ahmed AHE, Ibrahim Mostafa Hasan A, Elmadbouly AAE, Yahia MB, Ashry WMO, El Sayed SSMM, Algendy AMM, Alkot AMF, Farag MF, El Shenawy Emara AAA, Elbayoumy FMAE, Ali HF, Aldesoky MM, Abd-Eltwab RAR, Manawy SM, Mohamed Faruk E. Impact of vitamin D in children with chronic tonsillitis (immunohistochemical study of CD68 polarisation and proinflammatory cytokines estimation). Sci Rep 2023; 13:8014. [PMID: 37198277 DOI: 10.1038/s41598-023-33970-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023] Open
Abstract
Inflammatory processes are increasingly attributed to macrophage polarization. Proinflammatory macrophages promote T helper (Th) 1 response, tissue repair, and Th2 responses. Detection of macrophages in tissue sections is facilitated by CD68. Our study is focused on the expression of CD68 and the estimation of proinflammatory cytokines in children's patients with chronic tonsillitis secondary to vitamin D supplementation. This hospital-based Randomized prospective case-control study was conducted on 80 children with chronic tonsillitis associated with vitamin D deficiency where (40 received vitamin D 50,000 IU weekly for 3-6 months and 40 received 5 ml distilled water as placebo). The serum 25-hydroxyvitamin D [25(OH)D] was measured using an Enzyme-linked immunosorbent assay on all included children. Different histological and immunohistochemical studies for the detection of CD68 were done. There was a significantly lower serum level of 25(OH)D in the placebo group versus the vitamin D group (P < 0.001). The levels of pro-inflammatory cytokines, TNFα, and IL-2 significantly increased in the placebo group as compared to the vitamin D group (P < 0.001). The increased level of IL-4 and IL-10 in the placebo group as compared to the vitamin D group was insignificant (P = 0.32, 0.82) respectively. Vitamin D supplementation alleviated the deleterious effect of chronic tonsillitis on the histological structure of the tonsil. Tonsillar tissues of the children in the control and vitamin D groups demonstrated a highly statistically significantly lower number of CD68 immunoexpressing cells compared with those in the placebo group (P < 0.001). Low vitamin D may play a role in chronic tonsillitis. Vitamin D supplementation could help reduce the occurrence of chronic tonsillitis in susceptible children.
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Affiliation(s)
- Ayat Abu-Elnasr Awwad
- Department of otorhinolaryngology, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | - Rehab A Hasan
- Department of Histology and Cell Biology, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | | | | | | | - Bothina Ahmed Mohamed
- Department of otorhinolaryngology, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | - Khadiga Abdallah Abd Rabou
- Department of otorhinolaryngology, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | | | - Marwa Elhady
- Department of Pediatrics, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | - Gehad Nabil Abd El-Aal
- Department of Pediatrics, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Cairo, Egypt
| | | | | | | | - Mohamed Basiouny Yahia
- Department of clinical pathology, Faculty of Medicine for Boys (Cairo), Al-Azhar University, Cairo, Egypt
| | - Walaa Mohamed Omar Ashry
- Department of Medical Microbiology and Immunology, Damietta Faculty of Medicine (girls), Al-Azhar University, Damietta, Egypt
| | - Said S M M El Sayed
- Department of Medical Physiology, Faculty of medicine, Al-Azhar University, Cairo, Egypt
| | - Ashraf M M Algendy
- Department of Medical Physiology, Faculty of medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmad M F Alkot
- Department of Medical Physiology, Faculty of medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed F Farag
- Department of Physiology, Armed Forces College of Medicine, Cairo, Egypt
| | | | | | - Hany Fawzy Ali
- Department of clinical pathology, Faculty of Medicine for Boys (Cairo), Al-Azhar University, Cairo, Egypt
| | - Mohamed Morshdy Aldesoky
- Department of Medical Microbiology and Immunology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Raafat Abd-Rabow Abd-Eltwab
- Department of Medical Microbiology and Immunology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Samia M Manawy
- Department of Anatomy and Embryology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Eman Mohamed Faruk
- Department of Anatomy, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
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Increased Risk of Inflammatory Bowel Disease in Families with Tonsillectomy: A Danish National Cohort Study. Epidemiology 2019; 30:256-262. [PMID: 30461527 DOI: 10.1097/ede.0000000000000946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The possible etiologic link between tonsillectomy and inflammatory bowel diseases remains unclear. To investigate the hereditary component, we assessed the risk of inflammatory bowel disease after own tonsillectomy as well as after tonsillectomy among family members. METHODS A nationwide Danish cohort of 7,045,288 individuals was established and linked to comprehensive national registers with data on kinship, tonsillectomy surgery, and diagnosis of inflammatory bowel disease from all health sectors. We used Poisson regression models to estimate hospital contact rate ratios (RR) for Crohn's disease and ulcerative colitis, with 95% confidence intervals (CI), between individuals with or without tonsillectomy, as well as between individuals with or without tonsillectomized relatives. RESULTS During 189 million person-years of follow-up between 1977 and 2014, 276,673 individuals were tonsillectomized, 22,015 developed Crohn's disease, and 49,550 developed ulcerative colitis. Rates of inflammatory bowel disease were elevated up to 20 years after own tonsillectomy (Crohn's disease: RR 1.52 [95% CI = 1.43, 1.61]; ulcerative colitis: RR 1.24 [95% CI = 1.18, 1.29]). RRs for Crohn's disease was 1.22 (95% CI = 1.17, 1.27) after first-degree relatives' tonsillectomy, 1.14 (95% CI = 1.08, 1.19) after second-degree relatives' tonsillectomy, and 1.08 (95% CI = 1.01, 1.15) after third-degree relatives' tonsillectomy. Corresponding RRs for ulcerative colitis were 1.10 (95% CI = 1.07, 1.13), 1.05 (95% CI = 1.01, 1.08), and 1.03 (95% CI = 0.98, 1.09). CONCLUSIONS Even individuals with tonsillectomized family members were at increased risk of inflammatory bowel disease. These findings call into question a direct influence of tonsillectomy on gastrointestinal inflammation and point instead toward shared hereditary or environmental factors. See video abstract at, http://links.lww.com/EDE/B464.
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Clark CM, Printz JN, Stahl LE, Phillips BE, Carr MM. Salivary cotinine levels in children with otolaryngological disorders. Int J Pediatr Otorhinolaryngol 2017; 102:103-107. [PMID: 29106854 DOI: 10.1016/j.ijporl.2017.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if salivary cotinine, a biomarker for tobacco smoke exposure, is elevated more often or to a higher degree in children meeting criteria for tonsillectomy or tympanostomy tube insertion. METHODS Saliva samples were obtained from 3 groups of children for salivary cotinine measurement. Group 1 served as healthy controls. Group 2 consisted of subjects meeting tympanostomy tube criteria. Group 3 consisted of patients meeting tonsillectomy criteria. Environmental tobacco smoke (ETS) exposure was defined as a salivary cotinine concentration ≥1.0 ng/mL. Demographic data, smoke exposure history, and co-morbidities were also determined. RESULTS 331 patients were included, with 112 in Group 1, 111 in Group 2, and 108 in Group 3. No differences were encountered for smoke exposure by history or smoker's identity, salivary cotinine level, or frequency of positive cotinine results. 42.6% of Group 1 had positive salivary cotinine compared to 51.8% of Group 2 and 47.7% of Group 3. Group 1 had a mean salivary cotinine level of 2.42 ng/mL compared to 2.54 ng/mL in Group 2 and 2.60 ng/mL in Group 3. The frequency of positive cotinine levels was higher than expected based on parental history. Among subjects with positive cotinine levels, 93 had no ETS exposure, and 64 had ETS exposure by history. CONCLUSION Approximately 50% of children who undergo tonsillectomy and tympanostomy tube insertion have objective evidence of ETS exposure. Parental history underestimates passive smoke exposure, which can impact perioperative care.
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Affiliation(s)
- Christine M Clark
- The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA
| | - Jillian N Printz
- The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA
| | - Lauren E Stahl
- Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA
| | - Brett E Phillips
- Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA
| | - Michele M Carr
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26501, USA.
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Vanker A, Gie R, Zar H. The association between environmental tobacco smoke exposure and childhood respiratory disease: a review. Expert Rev Respir Med 2017; 11:661-673. [PMID: 28580865 PMCID: PMC6176766 DOI: 10.1080/17476348.2017.1338949] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 06/02/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Childhood respiratory illness is a major cause of morbidity and mortality particularly in low and middle-income countries. Environmental tobacco smoke (ETS) exposure is a recognised risk factor for both acute and chronic respiratory illness. Areas covered: The aim of this paper was to review the epidemiology of ETS exposure and impact on respiratory health in children. We conducted a search of 3 electronic databases of publications on ETS and childhood respiratory illness from 1990-2015. Key findings were that up to 70% of children are exposed to ETS globally, but under-reporting may mask the true prevalence. Maternal smoking and ETS exposure influence infant lung development and are associated with childhood upper and lower respiratory tract infection, wheezing or asthma. Further, exposure to ETS is associated with more severe respiratory disease. ETS exposure reduces lung function early in life, establishing an increased lifelong risk of poor lung health. Expert commentary: Urgent and effective strategies are needed to decrease ETS exposure in young children to improve child and long-term lung health in adults especially in low and middle income countries where ETS exposure is increasing.
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Affiliation(s)
- A. Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - R.P. Gie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - H.J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
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Li’e C, Juan C, Dongying J, Guiling F, Tihua Z, Yanfei W. The role of environmental tobacco exposure and Helicobacter pylori infection in the risk of chronic tonsillitis in children. SAO PAULO MED J 2017; 135:29-33. [PMID: 28380174 PMCID: PMC9969719 DOI: 10.1590/1516-3180.2016.023602102016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE: Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. This study investigated the interaction between environmental tobacco exposure and H. pylori infection on the incidence of chronic tonsillitis in Chinese children. DESIGN AND SETTING: Cross-sectional study performed in an outpatient clinic in China. METHODS: Pediatric patients with chronic tonsillitis were enrolled. H. pylori infection was determined according to the presence of H. pylori CagA IgG antibodies. Serum cotinine levels and environmental tobacco smoke (ETS) exposure were determined for all participants. RESULTS: There was no significant difference in H. pylori infection between the children with chronic tonsillitis and children free of disease, but there was a significant difference in ETS between the two groups (P = 0.011). We next studied the association between ETS and chronic tonsillitis based on H. pylori infection status. In the patients with H. pylori infection, there was a significant difference in ETS distribution between the chronic tonsillitis and control groups (P = 0.022). Taking the participants without ETS as the reference, multivariate logistic regression analysis showed that those with high ETS had higher susceptibility to chronic tonsillitis (adjusted OR = 2.33; 95% CI: 1.67-3.25; adjusted P < 0.001). However, among those without H. pylori infection, ETS did not predispose towards chronic tonsillitis. CONCLUSION: Our findings suggest that tobacco exposure should be a putative mediator risk factor to chronic tonsillitis among children with H. pylori infection.
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Affiliation(s)
- Chen Li’e
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Che Juan
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Jiang Dongying
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Feng Guiling
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Zheng Tihua
- MD. Attending Physician, College of Special Education, Binzhou Medical University, Yantai, Shandong, China.
| | - Wang Yanfei
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
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