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Objectives: The study objective was to assess the levels of VEGF-A and TGF-β cytokines in the children with adenoid hypertrophy concomitant with exudative otitis media (OME) and in children with adenoid hypertrophy (HA) alone., Methods: The study material consisted of hypertrophic adenoids removed during adenoidectomy from 39 children (20 girls and 19 boys), aged 2-7 years suffering from OME. The reference group included 41 children (19 girls and 22 boys), aged from 3 to 9 years with adenoid hypertrophy. The levels of VEGF-A and TGF-β were determined in supernatants obtained from phytohemagglutinin-stimulated cell cultures of the adenoids using a commercial enzyme-linked immunosorbent assay kit., Results: The median VEGF-A and mean TGF-β concentrations in the study group were significantly higher than those in the reference group (503 pg/mL versus 201 pg/mL, P < 0.001 and 224 pg/mL versus 132 pg/mL, P < 0.001, respectively). ROC analysis revealed that the area under the curve (AUC) for VEGF-A was 0.952 with diagnostic sensitivity and specificity of 95%, whereas for TGF-β it was 0.902 with 60% sensitivity and the same specificity as for VEGF-A. There was no significant difference between the AUC for VEGF-A and TGF-β (P = 0.573)., Conclusions: The changes in the levels of VEGF-A and TGF-β may indicate bacterial pathogen as one of the causes of exudative otitis media in children. Determination of VEGF-A and TGF-β could be used as additional and objective tests to confirm the clinical diagnosis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Ltd.)

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., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The hypertrophic adenoid may promote chronic suppurative otitis media in children as it fulfills its immune function. The number of lymphocytes in the adenoid and their cooperation in the immune response depend of on their proliferation and migration to the effector sites. Interleukin 7 (IL-7) is essential for the normal development and function lymphocytes. IL-7 plays pivotal role for activation and proliferation of T and B cells. The heterodimeric interleukin-7 receptor (IL-7R) is composed of the IL-7Rα (127) and the common cytokine receptor γc (CD132). The aim of this study was to evaluate the percentage of lymphocytes T (CD4(+) and CD8(+)) with IL-7R (CD127 and CD132) expression in hypertrophic adenoid in children suffering with otitis media with effusion for a duration of 3 months. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. CD4(+) CD127(+), CD4(+)132(+), CD8(+)CD127(+) and CD8(+)CD132(+) cell subpopulations were identified using monoclonal antibodies and flow cytometry. The percentage of CD4(+) and CD8(+) T cells with CD127 receptor expression in hypertrophic adenoid of children with otitis media with effusion was statistically significantly higher than in hypertrophic adenoid group. The percentage of CD4(+) T cells with CD132 expression in the study group was statistically significantly higher than in the reference group. The percentage of CD8(+) T cells with CD132(+) expression was not statistically different in both groups. The increased percentage of T lymphocytes with IL-7R expression (CD127 and CD132) in hypertrophic adenoid seems to influence the quantity of lymphocytes and upset the immunological function of tonsils which can influence the course of otitis media with effusion.

Hypertrophic adenoids with otitis media with effusion is a common infectious disease and present a serious otological problem in children. Cytokines, potent inflammatory mediators, play important role in the initiation of immunological response in otitis media. Adenoids excised due to hypertrophy with or without chronic otitis media with effusion were used to isolate mononuclear cells. Secretion of cytokines by non-stimulated and PHA-stimulated cells was determined by specific ELISAs. We found a significant increase in the production of IL-5 and TNF-α secreted by adenoidal cells of children with otitis media with effusion compared to group with hypertrophic adenoids. No differences were found in the secretion of IL-8, IL-6, and IL-10 between these two groups of patients. Our results suggest a difference between the immunological responses in the course of hypertrophic adenoids with otitis media as compared to hypertrophic adenoids.

Evaluation of lymphocyte homeostasis within the chronically inflamed adenoid, closely related to the functioning of the immune system, may have a role in qualifying children for adenoidectomy. Apoptosis is a major process maintaining balance between tonsillar lymphocytes. The Fas receptor and Bcl-2 protein family which show pro-apoptotic and anti-apoptotic actions are of particular significance in apoptosis induction. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. Flow cytometry was used to assess the percentages of apoptotic lymphocytes and CD4(+), CD8(+), CD19(+) cells with CD95(+) antigen and Bcl-2 protein in the group of children who underwent adenoidectomy due to adenoid hypertrophy and accompanying otitis media with effusion. The percentages of CD4(+)Bcl-2(+), CD8(+)Bcl-2(+) and CD19(+)Bcl-2(+) lymphocytes in the group of children with adenoid hypertrophy and acute otitis media were lower as compared to the reference group. However, the percentages of CD4(+), CD8(+) and CD19(+) cells with CD95(+) antigen were higher in the study group comparing to the reference group. The tendency of reduced percentages of T and B lymphocytes with Bcl-2 expression and elevated percentages of these cells with CD95(+) expression within the adenoid may reflect local immunity disorders., (Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.)

Aim: The aim of this study was evaluation of the percentage and mean fluorescence intensity of lymphocytes B with expression CD80 and CD86 in hypertrophied adenoids in children with otitis media with effusion., Material and Methods: Expression coreceptors CD80 and CD86 on lymphocytes B in adenoid tissue were estimated by flow cytometry method. 15 children with otitis media with effusion and 15 children with hypertrophied adenoid were tested., Results: This study showed significantly higher percentage of lymphocytes CD19+ CD80+ in children with otitis media with effusion (OME 1.42% +/- 0.91) than in comparative group with hypertrophied adenoids (AH 0.63% +/- 0.21). The receptor CD86 didn't show differences in expression on lymphocytes B between both examinated groups., Conclusion: Low expression of CD80 and CD86 indicates that local immunity response in hypertrophied adenoids in children with otitis media with effusion is weakened. It can contribute to the otitis media with effusion.

Introduction: In hypertrophied adenoid lymphocytes B make up about 60% all lymphocytes. When the lymphocytes B come in interaction with antigens this membranes signal be passed through their receptor (BCR) to interior of cell. This signal affect modulation on gene expression, activation from which depends activation, anergy or apoptosis of lymphocyte B. Accompany BCR co-receptors regulate his functions influence stimulate or inhibitive. To the most important co-receptors stepping out on lymphocyte B belong: CD40, CD22, CD72., Aim of Study: The aim of study was evaluation of lymphocytes B (CD19) with co-expression with CD72 and CD40 receptors in hypertrophied adenoid with at children with otitis media with effusion., Material: An investigation was executed in hypertrophied adenoids with or without otitis media with effusion., Methods: By flow cytometry percentage of lymphocytes B with co-receptors CD 40, CD22 and CD72 in was analyzed., Results: The percentages of CD19+CD72+ lymphocytes in the group of children with adenoid hypertrophy and exudative otitis media were lower as compared to the reference group. However, the percentages of CD19+CD22+, CD19+CD40+ in the study group was approximate to the reference group., Conclusions: The lower percentage of lymphocytes B CD72 + near approximate percentages of lymphocytes B CD40+ and BCD22+ at children with otitis media with effusion can be the cause of incorrect humoral response in hypertrophied adenoid at children. Maybe it is cause reduced spontaneous production IgA and IgG through lymphocyte at children with otitis media with effusion.

Introduction: Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The mining of antigen CD27 on lymphocytes T and B in creation of memory cells is still unclear., Aim: CD27 on lymphocytes T and B has a crucial role in development of immune response against inflammatory state. Aim of this study was evaluation functions of lymhocytes with expression CD27 in hypertrophied adenoid in children with otitis media with effusion., Material and Methods: [corrected] We tested 24 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 29 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19, anty-CD3, anty-CD5 and anty-CD27 monoclonal antibodies to examinations., Results: We showed the lowest percentage lymphocytes B CD5+ with expression of CD27 in subgroup older children with otitis media with effusion (O.M.E. 22.43 +/- 2.66%) in compartative to younger children in the same group (15.96 +/- 5.31%; p < 0.005) and to older comparative subgroup (H.A. 15.50 +/- 8.03; p < 0.001). Percentages of B CD5 cells with expression of CD27 was statistical lower in examinated group (7.25 +/- 3.81) than in comparative group (H.A. 16.26 +/- 5.82; p < 0.04). In group with hypertrophied adenoid showed higher percentages of CD5-CD27+CD19+ cells both in younger and older supgroup than in equivalent supgroups with O.M.E., Conclusions: Iteraction of CD27-CD70 regulates many functions of T and B lymphocytes. It seems that disorders humoral immunologucal answer in hypertrophied adenoids are supported to develop of otitis media with effusion.

Introduction: Chemokine receptors play a crucial role in the recruitment of leucocytes into inflamed tissue from secondary lymphoid organs., Aim of This Study: was evaluation of the percentage Th (CD4+) lymphocytes with expression of chemokine receptors: CCR3, CCR4, and CCR5 in hypertrophied adenois tissue in children with otitis media with effusion., Material and Methods: 36 children with otitis media with effusion and 25 children with hypertrophied adenoids were tested. Expression of chemokine receptors CCR3, CCR4 and CCR5 on T CD4 lymphocytes of hypertrophied adenoid's tissue was estimated by flow cytometry method., Results: Average percentage of T CD4+ lymphocytes with expression CCR4 in hypertrophied adenoid in children group with otitis media with effusion (OME = 64.11%) was significantly higher than in comparative group with hypertrophied adenoid (HA = 75.05%, p < 0.04). We showed statistically lower percentage of CD3+CD4+ cells with expression CCR3 in examinated group (OME = 47.19%) than HA group (62.66%; p < 0.003)., Conclusion: Results suggests that intensify of humoral immunological answer in hypertrophied adenoid depends on Th2 lymphocytes with expression CCR3 and CCR4 chemokine receptors in course of inflammatory state in middle ear.

Introduction: Adenoid hypertrophy is a problem of more than 1/3 of children and is the predominant reason of otolaryngology consultations in this population. Diagnosis and surgical qualification are based on physical examination and other methods introduced more than 100 years ago. Development of endoscopic techniques has been found this method to be a gold standard in adenoid assessment up to date. However, the method is difficult to performed in some young patient because of their invasiveness. Acoustic assessment of nosopharyngs seems to be a new promising method., The Aim of the Study: Were an assessment of nasal obstruction due to adenoid hypertrophy in group of patients referring to adenoidectomy and an objective evaluation of changes in the volume of the nasopharynx after adenoidectomy., Material and Methods: The examination was carried on the group of 30 patients aged 5-10 y.o. with adenoid hypertrophy admitted for adenoidectomy. The control group consisted of 10 children free of otolaryngological problems. All studied individuals had acoustic rhinometry performed and additionally, endoscopic method such as rhynofiberoscopy and endoscopy of nasopharyngs were introduced in the patient's group., Results: The study showed that children with adenoid hypertrophy have statistically significant reduction of nasopharyngeal volume (NPV) vs control group. Adenoidectomy increases the NPV parameter and makes it equal to control group., Conclusions: The acoustic rhynometry seems to be a promising method in assessment of nasopharyngeal volume. This and further studies may help to reduce the number of "unnecessary" adenoidectomies, by making standards for NPV in different group of age.

Introduction: Otitis media with effusion and hypertrophied adenoid are still common diseases in childhood. Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The origin CD19+CD5+ B cells remains controversial. The differentiation response to ligation of CD5 resulting in apoptosis or proliferation lymphocytes. The aim of this study was compare the percentage of CD19+CD5+ lymphocytes in hypertrophied adenoid tissue at children with otitis media with effusion to comparative group without inflammatory state in middle ear., Material and Methods: We tested 37 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 32 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19 and anty-CD5 monoclonal antibodies to examinations., Results: In this study we showed significantly higher percentage of the CD19+CD5+ lymphocytes at children with examined group (OME 22.12 +/- 4.31%) than in comparative group (HA 19.16 +/- 4.32%), p < 0,04. Percentage of the subpopulation CD5+ B cells was significantly higher (p < 0,02) at younger subgroup (21.55 +/- 5.34%) than in older subgroup (18.24 +/- 2.35%) of children with both groups (OME + HA)., Conclusions: The significant higher percentage of B lymphocytes with expressions of CD5+ receptor in hypertrophied adenoid tissue at children with otitis media with effusion are important to develop of early immunological response to inflammatory state in middle ear.

Introduction: The CD44 on lymphocytes binding to its ligand hyaluronan can mediate primary adhesion (rolling interactions) of lymphocytes on high endothelial venules (HEV). This adhesion molecule plays an important role to maturation and proliferation of lymphocytes in the secondary lymphoid organs. CD44 has a crucial role in migrate of lymphocytes to inflammatory sites. The AIM of this study was evaluation of the percentage and MFI (mean fluorescence intensity) of lymphocytes CD4+, CD8+, CD19+ with expression of surface adhesive molecule CD44 in hypertrophied adenoids in children with otitis media with effusion., Material and Methods: 42 children with otitis media with effusion and 30 children with hypertrophied adenoids were tested. Children were also divided into two subgroups: young (below 5 years) and older children (above 5 years old). Expression of adhesion molecule CD28 on lymphocytes of adenoids tissue was estimated by flow cytometry method., Results: This study showed significantly higher percentage of lymphocytes CD19+CD44+ in children with otitis media with effusion (OME 87,83%) than in comparative group with hypertrophied adenoids (AH 85,61%). We did not find difference between OME and AH in mean fluorescence intensity of subpopulations lymphocytes T and B with expression CD44., Conclusions: Adhesion molecule CD44 is important for developing of effectors lymphocytes in hypertrophy adenoid. Increase percentage of lymphocytes CD19 with expression CD28, especially in older children confirms their participation in developing and forming of immunological response in otitis media with effusion.

Introduction: Otitis media with effusion (WZU) is highly prevalent among young children. The hypertrophied adenoid favorables to development (WZU). The pharyngeal tonsil delivers the essential lymphocytes for developed immunological answer. The migrations of lymphocytes to pharyngeal tonsil and to places inflammatory proceed with part of adhesive molecules (CD11a, CD54) presented on lymphocytes. The aim of this study was examination the percentage of the lymphocytes CD4+, CD8+ and lymphocytes B with expression of adhesion molecules ICAM-1 (CD54) and LFA-1 (CD11a). We examined their expression in hypertrophied adenoid by children with otitis media with effusion., Results: In investigations was showed statistically significant decrease of percentage of lymphocytes CD4+CD11a+ and CD8+CD11a+ and increase of percentage of lymphocytes CD19+CD54+ in otitis media with effusion in comparison to group with hypertrophied adenoid., Conclusions: Molecule adhesive ICAM-1 and LFA-1 fulfills important part in many immunological processes proceed to pharyngeal tonsil. The considerably lower percentage of lymphocytes T CD4+ and CD8+ with expression LFA-1 in hypertrophied adenoids is possibly of causes of incorrect their immunological answer, and the same factor favourables to prolonging the otitis media with effusion at children.

Introduction: The expansion of an optimal immune response requires fully activated T lymphocytes. For complete activation several signals are needed. The first signal is an antigen dependent via the TCR receptor, and the second signal is a costimulatory that can be delivered by the CD28 molecule after binding to their ligands. Fully activated T lymphocytes are competent to deliver activation to B cells. We suppose that this way can be important for development of immune response in hypertrophied adenoid (AH) in children with otitis media with effusion (OME). The aim of this study was evaluation of the percentage and MFI (mean fluorescence intensity) of lymphocytes CD4+, CD8+, CD19+ with expression of superficial adhesive molecule CD28 in hypertrophied adenoids in children with otitis media with effusion., Material and Methods: 37 children with otitis media with effusion and 35 children with hypertrophied adenoids were tested. Children were also divided into two subgroups: young (below 5 years) and older children (above 5 years old). Expression of adhesion molecule CD28 on lymphocytes of adenoids tissue was estimated by flow cytometry method., Results: This study showed significantly higher percentage of lymphocytes CD4+CD28+ in children with otitis media with effusion (OME 93,87%) than in comparative group with hypertrophied adenoids (AH 91,01%). Mean fluorescence intensity CD28 was higher on subpopulation lymphocytes CD4+ to children with OME (3,94) than AH (3,32). We did not find difference between OME and AH in percentages and MFI of subpopulations CD8+CD28+ and CD19+CD28+ lymphocytes., Conclusions: Adhesion molecule CD28 is very important for adenoidal lymphocytes activation and protection against apoptosa. Higher percentage of lymphocytes CD4 with expression CD28 confirms their participation in developing and forming of immunological response in otitis media with effusion.

Introduction: Otitis media with effusion (OME) and hypertrophy adenoid (AH) are still common diseases during childhood. Adenoid has particular meaning in develop of immunological answer to inflammation in upper respiratory inclusive middle ear. The CD62L lymphocyte adhesion molecule plays an important role in controlling lymphocyte extravasations into adenoid and at sites of tissue infection. The aim of this study was evaluation of the percentage lymphocytes CD4+, CD8+, CD19+ with expression of superficial adhesive molecule CD62L and its expression in hypertrophied adenoids at sick's children with otitis media with effusion., Material and Methods: In investigations has tested 37 children with otitis with effusion and 35 children from hypertrophied adenoids. Expression of adhesion molecule CD62L on lymphocytes of tissue adenoids estimated by flow cytometry method., Results: In this study showed higher significant percentage of lymphocytes CD19+CD62L+ in children in otitis media with effusion (OME. 59.33 +/- 9.65%) with reference to comparative group with hypertrophied adenoids (AH 53.47 +/- 9.67%). Mean fluorescence intensity CD62L was higher on subpopulation lymphocytes CD8+ and CD19+ at children with OME than AH., Conclusions: The increase of percentage's lymphocytes CD62L+ in tissue of adenoids can to testify to enlarged migration lymphocytes from whole blood to adenoid. The increase of density of CD62L receptor on lymphocytes can be effect local inflammatory process.

Background: The pharyngeal tonsil is the place of immunological system first contact with pathogenic factors in the nasopharyngeal region, which is responsible for local defence from infection. Chronic antigenic stimulation can lead to adenoid dysfunction and hypertrophy (PMG). Significant role in PMG and in the otitis media with effusion (WZU) play lymphocytes T (CD3(+)) and T-TCR gammadelta. THE AIM of the study was a quantitative analysis of lymphocytes T (CD3(+)) and T-TCR gammadelta in adenoid hypertrophy and otitis media with effusion lasting more than 3 months., Material and Methods: An investigation was executed by flow cytometry in hypertrophied adenoids from children after tonsillectomy. The study and control groups were divided in to 2 subgroups: children younger than 5 years and those aged from 5 to 17 years., Results: The study showed a statistically significant reduction from 35.6+/-3.1% to 32.0+/-2.8% (p < 0.04) of lymphocytes T gammadelta CD3(+) in the examined group (WZU) compared to the control group (PMG). There was a higher percentage of lymphocytes with TCR gammadelta receptor expression in children with WZU (2.04+/-1.13%) than in PMG group (0.99+/-0.44%) (p < 0.002). The lowest percentage of lymphocytes T-TCR gammadelta was found in younger children with PMG (0.67+/-0.17%) and the highest in WZU in younger children (2.13+/-1.04%) (p < 0.0001). We observed a statistically significant difference in expression of TCR receptors (p < 0.02) between younger children with PMG (0.67+/-0.17%) and older children with PMG (1.24+/-0.43%). We did not find significant differences in lymphocytes T CD3(+) related to age., Conclusions: The enlarged percentage of lymphocytes T gammadelta in adenoid hypertrophy in children with WZU create a possibility of a more rapid response to inflammatory factors.