| ObjectiveTo observe the therapeutic effect of OM85-BV(Boncho-Vaxom,bacterial lysate)on adenoid hypertrophy and to explore the related mechanism.MethodsThe first part(Experiment One)1.A total of 448 children with recurrent upper respiratory tract infection with adenoid hypertrophy in our hospital from May 2018 to August 2019 were studied.According to the choice of whether or not to receive OM85-BV treatment,the patients were divided into control group and observation group.326 patients in the control group were treated with the conventional treatment only,and 122 patients in the observation group combination of conventional treatment with OM85-BV complementary treatment.2.The patients of the two groups received OSA-18 modified Chinese version questionnaire at the time point of enrollment,6weeks,12 weeks in the administration period of treatment respectively.The total symptom scores of OSA-18 and the therapeutic effects of the two groups were compared.3.The patients in the two groups were examined with X-ray before and after 12 weeks of drug treatment,and the ratio of adenoid A / N in the two groups before and after treatment was compared.The second part(Experiment Two)1.Among 448 children,there were 131 children treated with adenoidectomy according to the clinical assessment,98 children in the control group and 33 children study group.2.The levels of serum IL-2,IL-4,IL-6,IL-10,TNF,INF-?and Ig E,the ratio of serum CD3,CD4,CD8 lymphocytes and the ratio of CD4 / CD8 from clinical laboratory date in the two groups were compared before operation.3.The levels of HBD-2,IFN –?,IL-4,IL-6 in the adenoid were measured by ELISA and compared in the two groups.4.The expression and distribution of adenoid HBD-2,IFN –?,IL-4,IL-6,IL-17,TLR2,TLR4,CD4 and Foxp3 were analyzed by immunohistochemistry and compared in the two groups.Results1.Results of experiment One1.1 After 12 weeks of treatment,the improvement of OSA-18 score in the observation group(12.65 ±9.58)was better than that in the control group(9.87 ±13.309)(P<0.05),and the total effective rate in the observation group(83.6%)was higher than that in the control group(58%).(P<0.05)1.2 After treatment,the A / N ratio of adenoid in the two groups(0.55 ±0.12;0.58 ±0.10)was significantly lower than that before treatment(0.67±0.23;0.65±0.11);after treatment in the observation group(0.55 ±0.12)was significantly lower than that in the control group(0.58 ±0.10).(P<0.05).2.Results of experiment One2.1 The levels of serum INF-? and adenoid HBD-2 and IL-17 in the observation group were significantly higher than those in the control group,while the levels of IL-4 and INF-? in the adenoid were lower than those in the control group.2.2 In both groups,HBD-2 was mainly expressed in lymphoid epithelium and germinal center,IL-4,INF-? and IL-6 were mainly expressed in paracortical and interfollicular regions,TLR2 and IL-17 were expressed in cytoplasm,TLR4 and CD4 were expressed in cell membrane,and FOXP3 was expressed in nucleus.2.3 The IL-17 of adenoid in the observation group was significantly higher than that in the control group,but there was no significant difference in the expression of TLR2,TLR4,CD4 and Foxp3 between the two groups.Conclusion1.OM85-BV can significantly reduce the volume of adenoid and improve the symptoms of sleep apnea obstruction in patients with adenoid hypertrophy.2.The mechanism of OM85-BV in treating adenoid hypertrophy may be related to the enhancement of Th1 immune response and the increase of HBD-2 and IL-17 expression and the decrease of IL-4 and IFN-? expression in adenoid. |
PDF Full Text Request