OBJECTIVE: To investigate the relationship between the immune status of adenoids and secretory otitis media (SOM). METHOD: The adenoids tissue samples of 30 cases of recurrent secretory otitis media (SOM), 17 cases of non-recurrent secretory otitis media and 20 cases of the adenoids hypertrophy without SOM were studied by immunohistochemical method. RESULT: The expression of PCNA, BCL-2, CD4+, CD8+ cells and CD4+/CD8+ in recurrent SOM tissue were 30.85 +/- 1.73, 21.27 +/- 1.25, 41.90 +/- 9.07; 20.45 +/- 7.08 and 2.10 +/- 0.17, respectively, which was remarkably higher than those of non-recurrent SOM, (25.50 +/- 1.66, 14.23 +/- 1.06, 17.40 +/- 6.85, 13.02 +/- 5.88, 1.33 +/- 0.11, respectively) and those of simple adenoid hypertrophy (25.25 +/- 1.75, 14.05 +/- 1.02, 16.30 +/- 8.21, 11.15 +/- 5.71 and 1.39 +/- 0.15, respectively) (P < 0.01); the difference of the expression of PCNA, BCL-2, CD4+, CD8+ and CD4+/CD8+ between the latter two groups was not significant. Differences of the gender or the size were not significant (P > 0.05). In group of simple adenoid hypertrophy, PCNA in the subgroup of the age 3 to 6 was significantly higher than those in the other groups (P < 0.05). CONCLUSION In adenoid tissues of recurrent SOM patients, the activities of T-lymphocyte subsets cells in hypertrophic status increase, the adenoids enlarge and local immunity enhances. The age and gender have nothing to do with the SOM, but low age is one of the influencing factors of adenoid hypertrophy. Therefore, adenoidectomy for recurrent SOM patients with adenoid hypertrophy should be carried out as early as possible.
Adenoids ; immunology ; metabolism ; pathology ; Adolescent ; CD8-Positive T-Lymphocytes ; immunology ; metabolism ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Hypertrophy ; immunology ; metabolism ; pathology ; Male ; Otitis Media with Effusion ; immunology ; metabolism ; pathology

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.
Adenoids/chemistry/*pathology ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin A/analysis ; Immunohistochemistry ; Keratins/analysis ; Male ; Metaplasia ; Mucous Membrane/chemistry/pathology ; Otitis Media with Effusion/metabolism/*pathology ; Proto-Oncogene Proteins c-bcl-6/*analysis