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Squamous metaplasia and BCL-6 in pediatric adenoid accompanied by otitis media with effusion
Seung Geun Yeo1, Dong Choon Park, Jae Hak Choo
1Department of Otolaryngology, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea.
Insights
Squamous metaplasia and reduced BCL-6 expression in adenoids are linked to increased susceptibility to otitis media with effusion (OME). These findings highlight potential factors contributing to OME development in children.
Area of Science:
- Pediatric Otolaryngology
- Immunology of the Respiratory Tract
Background:
- Local adenoid immunity may be compromised, increasing susceptibility to infections causing otitis media with effusion (OME).
- Understanding adenoid tissue changes is crucial for identifying OME risk factors.
Purpose of the Study:
- To investigate the association between adenoid characteristics and otitis media with effusion.
- To evaluate adenoid size, mucosal barrier integrity, squamous changes, IgA secretion, and BCL-6 expression in relation to OME.
Main Methods:
- Comparative analysis of adenoids from 17 children with OME and 20 healthy controls.
- Assessment of adenoid size via X-ray and histological examination for squamous metaplasia.
- Immunohistochemical staining for cytokeratin, IgA, and BCL-6 to evaluate mucosal barriers and protein expression.
Main Results:
- Children with OME exhibited significantly higher rates of squamous metaplasia and lower BCL-6 expression in adenoids (p < 0.05).
- A trend towards mucosal barrier deterioration was observed in the OME group (p > 0.05).
- No significant differences in IgA secretion or adenoid size were found between the OME and control groups.
Conclusions:
- Increased squamous metaplasia and diminished BCL-6 expression in adenoids are potential risk factors for developing otitis media with effusion.
- These adenoid alterations may contribute to the pathophysiology of OME.
Purpose:
Deterioration of local immunity in the adenoids may make them vulnerable to infection by microorganisms, resulting in otitis media with effusion. To determine the factors associated with this condition, we evaluated adenoid size, mucosal barrier, squamous changes of ciliated epithelium, IgA secretion, and BCL-6 expression in adenoids.
Materials And Methods:
Seventeen children diagnosed with otitis media with effusion (OME group) and 20 children without any history of OME (control group) were enrolled. Their adenoids were sized by lateral view X-ray and stained with hematoxylin and eosin to detect squamous metaplasia. The adenoids were also stained with cytokeratin to evaluate mucosal barriers, and with anti- IgA antibody and anti- BCL-6 antibody to determine expression of IgA and BCL-6.
Results:
The OME group showed greater incidence of squamous metaplasia, fewer ciliated cells, and lower expression of BCL-6 (p < 0.05 each). Deterioration of the mucosal barrier was detected in the OME group (p > 0.05). IgA secretion and adenoid size were the same for the OME and the control groups.
Conclusion:
These results suggest that increased squamous metaplasia and lower BCL-6 expression in adenoids may be associated with increased susceptibility to OME.
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