The Protein Expression Of Glucocorticoid Receptor(GR) In Adenoid And Tonsil And Its Clinical Significance

Objective:To investigate the theoretical foundation of treatment of children with moderate and severe OSAHS (obstructive sleep apnea hypopnea syndrome), through detecting of the protein expression of glucocorticoid receptors (GR) a and β in tonsil and adenoid tissues of the children and combining with analyzing of their clinical data.Method:Tissues were collected from patients (103cases of adenoid tissue of children with moderate and severe OSAHS and69cases tonsil tissue of children with moderate and severe OSAHS, as well as13cases of tonsil tissue of adult with chronic tonsillitis and20cases of nasopharyngeal mucous membrane with chronic pharyngitis), which were analyzed with immunohistochemcal SP method to detect the protein expression of glucocorticoid receptors (GR) α and β. All the children patients with OSAHS were divided into groups (with or without chronic rhinosinusitis, with or without allergic rhinitis, with or without chronic rhinosinusitis and allergic rhinitis, and with or without secretory otitis media). The protein expression difference of GRa,GR β and GRa/GR β were observed.Result:The protein expression in different degrees of GRaand GR βin the tissues of adenoid, tonsil and nasopharyngeal mucous membrane were observed. GRa showed a high expression in adenoid tissue, and GRβ showed a high expression in tonsil and nasopharyngeal tissues. It was very significant difference (P<0.01) between protein expression of GRa, GRa/GR β in adenoid tissue of children with OSAHS and that of nasopharyngeal tissue of adults with chronic pharyngitis. GRa, GRa/GR βin adenoid tissue of children with OSAHS were very significant higher than that in nasopharyngeal tissue of adults with chronic pharyngitis (P<0.01). But it was showed that no significant difference (P>0.05) in GRβexpression between adenoid tissue of children with OSAHS and that in nasopharyngeal tissue of adults with chronic pharyngitis. Very significant difference (P＜0.01) was showed between expression of GRa, GRa/GR βtonsil tissue of children with OSAHS and that in tonsil tissue of adult with snoring. Expression of GRa, GRa/GR βin tonsil tissue of children with OSAHS were very significant higher than that of the other groups (P＜0.01). No significant difference (P>0.05) of GR βexpression was found in tissues among groups.No significant difference (P>0.05) was showed between expression of GRa, GR β and GRa/GR βin tissues of adenoid and tonsil of children with OSAHS and that in tissues of adenoid and tonsil of children with OSAHS (with or without allergic rhinitis, with or without chronic rhinosinositis and allergic rhinitis, as well as with or without secretory otitis media). Also no significant difference (P>0.05) was found in expression of GRa, GR β and GRa/GR βbetween tissues of adenoid of children with moderate OSAHS and that of adenoid of children with severe OSAHS, and no significant difference (P>0.05) was found in expression of GRa, GR β and GRa/GR βbetween tissues of tonsil of children with moderate OSAHS and that of tonsil of children with severe OSAHS.Conclusion:High expression of GRaand GRβin tissues of adenoid and tonsil of children with OSAHS may be connected to more sensitive to glucocorticoid treatment of adenoid-hypertrophy of the children with OSAHS. So the effect of glucocorticoid treatment of adenoid-hypertrophy of children be worthy of being further studied.