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【科普】糖皮质激素减少儿童OSA扁桃体细胞增殖
糖皮质激素减少儿童OSA扁桃体细胞增殖
Published date : 15 Dec 2008
MedWire News: Corticosteroid therapy suppresses in vitro proliferation of tonsil cells and reduces the production and release of pro-inflammatory cytokines in children with obstructive sleep apnea (OSA), US research shows.
The findings provide new insights into therapeutic approaches aiming to resolve frequent pediatric diseases associated with adenotonsillar hypertrophy, comment David Gozal (University of Louisville, Kentucky) and colleagues in the European Respiratory Journal.
Adenotonsillar hypertrophy is the biggest contributor to the pathophysiology of OSA in children. The severity of OSA loosely correlates with adenoid and tonsillar size, making surgical removal of these tissues the usual first line of treatment. But this approach is accompanied by an increased risk for potential postoperative complications and increased health-related costs, as well as emotional stress for the patient and family.
In this laboratory investigation, the group studied the effects of corticosteroids in cell cultures of tonsils and adenoids in children with OSA undergoing surgery. They first showed that stimulation with lipopolysaccharide (LPS) and concanavalin A increased tonsillar and adenoidal proliferation in cells from OSA children compared with controls.
Dexamethasone, fluticasone, and budesonide all reduced cellular proliferation rates in a dose-dependent manner. Fluticasone was the most potent corticosteroid, and dexamethasone the least potent.
Steroid therapy also increased cellular apoptosis and significantly decreased concentrations of various proinflammatory cytokines, including tissue necrosis factor-α, interleukin (IL)-8, and IL-6.
The findings, say the researchers, suggest the beneficial effects of intranasal and topical corticosteroids to reduce the severity of sleep-disordered breathing in children are due to the steroid-induced involution of the tonsils and adenoids.
Children with OSA have nasal and oropharyngeal mucosal inflammation and this is believed to contribute to increased adenotonsillar proliferation. Studies of nasal corticosteroids in the management pediatric OSA have previously been conducted with encouraging results, write the researchers.
Further studies are needed to identify the optimal dosage and duration of therapy, as well as pediatric subgroups, most likely to respond favorably to corticosteroids, the group adds. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Corticosteroid therapy suppresses in vitro proliferation of tonsil cells and reduces the production and release of pro-inflammatory cytokines in children with obstructive sleep apnea (OSA), US research shows.美国的研究表明，在儿童阻塞性睡眠呼吸暂停（OSA）的治疗中，应用类皮质甾酮疗法会抑制扁桃体细胞在体外的增殖，并且减少了抗炎因子的产生与释放。
The findings provide new insights into therapeutic approaches aiming to resolve frequent pediatric diseases associated with adenotonsillar hypertrophy, comment David Gozal (University of Louisville, Kentucky) and colleagues in the European Respiratory Journal.肯塔基州，路易斯维尔大学的David Gozal 和欧洲呼吸学杂志的同僚们评论说，这个发现提供了新的治疗学方法旨在解决常见儿童疾病引起的腺扁桃体肥大。
Adenotonsillar hypertrophy is the biggest contributor to the pathophysiology of OSA in children.腺扁桃体肥大在儿童阻塞性睡眠呼吸暂停（OSA）中是最大的病理症状。The severity of OSA loosely correlates with adenoid and tonsillar size, making surgical removal of these tissues the usual first line of treatment. 阻塞性睡眠呼吸暂停（OSA）的严重程度与腺瘤和扁桃体的大小没有紧密的联系，通常会首先用外科手术切除这些组织。But this approach is accompanied by an increased risk for potential postoperative complications and increased health-related costs, as well as emotional stress for the patient and family.但是这种方法伴随着术后并发症增多，健康相关花费增多的风险，并且病人及其家属还要承受情感上的压力。
In this laboratory investigation, the group studied the effects of corticosteroids in cell cultures of tonsils and adenoids in children with OSA undergoing surgery.在实验室调查中，小组研究糖皮质激素对正处于外科治疗的儿童阻塞性睡眠呼吸暂停患者的扁桃体和腺样细胞的影响。
They first showed that stimulation with lipopolysaccharide (LPS) and concanavalin A increased tonsillar and adenoidal proliferation in cells from OSA children compared with controls.
他们首先显示出在脂多糖和刀豆蛋白A的刺激下，OSA儿童较糖皮质激素控制组的扁桃体和腺样体的细胞增殖增多。
Dexamethasone, fluticasone, and budesonide all reduced cellular proliferation rates in a dose-dependent manner. Fluticasone was the most potent corticosteroid, and dexamethasone the least potent.
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作者:admin@医学,生命科学 2011-04-18 10:18
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