CD23 expression in adenoid tissue assesment of children with recurrent upper tract infection and allergy

SUMMARYUpper respiratory tract disorders associated with adenotonsillary tissue are some of themost common health problems in childhood. Adenoid and tonsillary tissue act as the firstlocal defense especially against inhaler allergens. Upper respiratory tract infections caused bymicroorganisms and respiratory tract symptoms related to allergic causes are sometimesindistinguishable from each other.Aim:To show immunohystochemically the expression of CD 23 (FcεRII) in adenoid tissues ofchildren who underwent adenoidectomy/adenotonsillectomy because of recurrent upperrespiratory tract infection, upper respiratory tract complaints, or obstruction of respiratorytract and compare the clinical signs of patients, retrospectively.Material and method:This retrospective study was performed by the selection of patients aged 2-13 years whounderwent adenoidectomy/adenotonsillectomy at Department of Otolaringology, Dokuz EylülUniversity, Faculty of Medicine between January 2004 and March 2005. The data wereobtained from Department of Pathology. Pathology reports of 168 patients were found. Thematerials reported as ?lymphoid hyperplasia and chronic infection? were evaluated. Apathologist who is unaware of the questionnaire results histologicaly examined the tissuessaved in the parafin blocks of 100 patients who met the study inclusion criteria and who wereavailable by phone. İmmunohystochemical evaluation CD 23 Immun staining score, Thepositive staining for CD 23 was accepted as brown colored staining of cytoplasm ormembrane of follicular germinal centers. The staining density and distribution was scoredsemiquantitatively between 0-3 (0 = No staining, 1+ =thin staining, 2+ = mild staining, 3+ =strong staining, >90% diffuse staining of the folliculs.) The data were analyzed by SPSS 11.0version and qi square and Fisher exact tests were used where appropriate. p< 0.05 wasaccepted for significance12Results:The 46% of the study group was female and 54% was male. Mean age was 70,7 months ( min26,0 max 237,0 months). The mean birth weight was 3212,89 gr ( min 1300, max 3800gr)The mean gestational age was 38,9 weeks. The 30% of patients had only adenoidectomywhereas 70% of them had adenotonsillectomy. The 77% of patients had gone to day-carecenters. The distribution of allergic diseases of parents were as follows: 17% mothers allergicrhinitis, 8% mothers urticaria, 3% mothers egzema and asthma, 6% fathers allergic rhinitis,4% fathers urticaria, egzema, and asthma. The 41% of mothers were smokers. After theoperation the infection frequency was found reduced in 91% of patients whereas allergicsymptoms reduced in 11%, unchanged in 84% and increased in 5% of patients. Gender, theexistence of systemic disease, history of day-care, parental allergic diseases, and maternalsmoking had no significant effect on CD 23 expression. The previous infections such asrecurrent tonsillitis, otitis, sinusitis, bronchiolitis, pneumonia, and croup had also no effect.The CD 23 expression was found significantly lower in patients who had allergic diseases:urticaria ( p= 0.041), drug allergy ( p= 0.035) ve polen allergy ( p = 0.037)Discussion:We found a significantly reduced CD 23 expression on cell surface in patients with urticaria,drug allergy, and polen allergy as similar to other studies. These results support the hypothesisthat the binding of Ig E to CD 23 regulates the production of Ig E by a negative feed backmechanism resulting in a decrease of surface CD 23 expression in atopic patients.Key words: CD23 expression, adenoid tissue, atopy13