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Selected cytokines in hypertrophic adenoids in children suffering from otitis media with effusion
Beata Zelazowska-Rutkowska1, Bozena Skotnicka2, Elzbieta Hassmann-Poznanska2
1Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Poland.
Insights
Children with adenoids and otitis media show higher levels of matrix metalloproteinase-8 (MMP-8) and MMP-9. These biomarkers may aid in diagnosing and treating pediatric adenoid hypertrophy with effusion.
Area of Science:
- Biochemistry
- Pediatric Otolaryngology
- Biomarker Discovery
Background:
- Adenoid hypertrophy is common in children, often coexisting with otitis media with effusion (OME).
- Extracellular matrix (ECM) remodeling plays a role in adenoid tissue changes and middle ear inflammation.
Purpose of the Study:
- To evaluate the levels of matrix metalloproteinase-8 (MMP-8), MMP-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) in children with adenoid hypertrophy and OME.
- To assess the diagnostic utility of these biomarkers in differentiating OME in pediatric patients.
Main Methods:
- The study involved 20 children with adenoid hypertrophy and OME, and a control group of 24 children with adenoid hypertrophy without OME.
- MMP-8, MMP-9, and TIMP-1 levels were measured in phytohemagglutinin-stimulated tonsil cell cultures using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Median concentrations of MMP-8, MMP-9, and TIMP-1 were significantly higher in the OME group compared to the control group (p < 0.05).
- Receiver operating characteristic (ROC) analysis showed high diagnostic accuracy for MMP-8 and MMP-9 (Area Under Curve [AUC] = 1), with 100% sensitivity and 95.8% specificity.
- TIMP-1 demonstrated lower diagnostic utility (AUC = 0.690).
Conclusions:
- Elevated MMP-8, MMP-9, and TIMP-1 levels suggest increased ECM remodeling in children with adenoid hypertrophy and OME.
- MMP-8 and MMP-9 show significant potential as diagnostic biomarkers for OME in pediatric patients with adenoid hypertrophy.
- These findings may assist in clinical decision-making, including patient qualification for adenoidectomy.
Objectives:
The aim of the current study was to assess the levels of MMP-8, MMP-9 and TIMP-1 in the group of children with adenoids who suffered from exudative otitis media.
Methods:
The study included 20 patients (10 females and 10 males) with adenoid hypertrophy coexisting with otitis media with effusion. The reference group included 24 patients (10 females and 14 males) with adenoid hypertrophy without otitis media. The levels of MMP-8, MMP-9 and TIMP-1 were determined in supernatants obtained from phytohemagglutinin (PHA)-stimulated cell cultures of the tonsils, using commercial enzyme-linked immunosorbent assay kits (R@D Systems, USA).
Results:
The median MMP-8, MMP-9 and TIMP-1 concentrations (220.8 ng/mL, 311.1 ng/mL, 53.5 ng/mL, respectively) in the study group were significantly higher (p = 0.000, p = 0.000, p = 0.048, respectively) than those in the reference group (93.5 ng/mL, 112.5 ng/mL, 36.95 ng/mL, respectively). ROC analysis revealed that the area under a curve (AUC) for both metalloproteinases MMP-8 and MMP-9 was 1 with a diagnostic sensitivity of 100% and diagnostic specificity of 95.8%, as compared to 0.690 for TIMP-1. Significant differences were found between the AUC for MMP-8 and TIMP-1 and MMP-9 and TIMP-1 (p < 0.001 for both comparisons).
Conclusions:
The changes in the concentrations of MMP-8, MMP-9 and TIMP-1 may indicate an increased remodeling of the extracellular matrix in children with adenoid hypertrophy and otitis media with effusion. The findings can have clinical as well as diagnostic utility. Determination of MMP-8 and MMP-9 may help qualify a child for adenoidectomy and differentiate pediatric patients affected by adenoid hypertrophy with and without otitis media.
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