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Peripheral blood immunological parameters of children with adenoid hypertrophy with otitis media with effusion:
Insights
Elevated serum C3 levels are linked to otitis media with effusion (OME) in children with adenoid hypertrophy, particularly in younger children and girls. Other immune markers showed no significant differences, suggesting C3 activation may play a role in OME development.
Area of Science:
- Pediatric Immunology
- Otolaryngology
- Biochemistry
Background:
- Adenoid hypertrophy is common in children and can be associated with otitis media with effusion (OME).
- Understanding the immunological underpinnings of OME in children with adenoid hypertrophy is crucial for diagnosis and management.
Purpose of the Study:
- To investigate peripheral blood immunological parameters in children with adenoid hypertrophy and OME.
- To explore correlations between these parameters and factors like age, gender, and adenoid size.
Main Methods:
- Propensity score matching (PSM) was used to select 80 children with OME and 157 controls with adenoid hypertrophy but no OME.
- Peripheral blood samples were analyzed for immunological parameters including serum C3, immunoglobulins, T cell subsets, lymphocytes, and monocytes.
- Statistical analyses compared parameters between the OME and control groups, with subgroup analyses by age and gender.
Main Results:
- Serum C3 levels were significantly higher in children with OME compared to controls (p=0.014).
- Elevated C3 was the sole independent risk factor for OME (OR 13.58, p=0.032).
- In children ≤5 years old, C3 was higher in the OME group (p=0.023). In girls with OME, C3 was higher and CD3+/CD4+ T cells were lower (p<0.05). No other significant differences were observed for other immune markers or in relation to adenoid size.
Conclusions:
- While most cellular and humoral immune indicators did not differ significantly, elevated serum C3 levels in OME patients suggest complement system activation.
- Higher C3 in younger children (≤5 years) with OME indicates its potential role in this age group.
- In girls, the combination of higher C3 and lower T cell counts may be associated with OME pathogenesis.
Purpose:
To evaluate peripheral blood immunological parameters and the possible correlation with age, gender and adenoid size in children with adenoid hypertrophy with OME.
Methods:
A total of 664 children with adenoid hypertrophy were initially enrolled in our study, of which 83 had concomitant OME. To minimize selection bias, we performed one to two propensity score matching (PSM) between children with and without OME. After PSM, 80 children with OME (OME group) and 157 children without OME (adenoid hypertrophy [AH] group) were selected. The patients' peripheral blood samples were prepared prior to surgery and their immunological parameters were compared between groups.
Results:
Compared to the AH group, the serum level of C3 was significantly higher in the OME group (0.88 ± 0.01 g/L vs. 0.94 ± 0.02 g/L; p = 0.014), which was the only independent risk factor for OME (odds ratio 13.58, 95% confidence interval 1.25-147.99; p = 0.032). However, no such difference was seen for serum immunoglobulin (IgG, IgA, IgM, IgE), T cell subsets (CD3+, CD4+ and CD8+ T cells), or lymphocytes and monocytes. Further subgroup analyses showed that in children ≤ 5 years old, the C3 level was significantly higher in OME patients (p = 0.023). A subgroup analysis based on sex indicated that there was a significantly higher level of serum C3 (p = 0.009) and lower CD3+ and CD4+ T cells (p = 0.010 and p = 0.021, respectively) in girls with OME compared to those without OME. No association between immunological parameters and adenoid size was found.
Conclusions:
There were no significant differences in cellular immunology and humoral immune indicators in children with adenoid hypertrophy with or without OME. In children ≤ 5 years old, significantly higher serum C3 levels in patients with OME demonstrate excessively activated C3 in comparison to patients without OME. For girls, a higher serum level of C3 with a lower amount of CD3+ and CD4+ T cells may be associated with OME.
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