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. 2021 Aug 19;26(2):e208-e212.
doi: 10.1055/s-0041-1730301. eCollection 2022 Apr.

Is There a Difference between the Preoperative and Postoperative Serum Levels of Interleukin-6 and Tumor Necrosis Factor-α in Children Submitted to Adenotonsillectomy?

Jose Neto Ribeiro de Souza  1 , Fernanda de Oliveira Feitosa de Castro  2 , Camila Lemes de Souza  2 , Mikhael Romanholo El Cheikh  1 , Hugo Valter Lisboa Ramos  3 , Simone Gonçalves da Fonseca  2 , Claudiney Candido Costa  3
Affiliations

Is There a Difference between the Preoperative and Postoperative Serum Levels of Interleukin-6 and Tumor Necrosis Factor-α in Children Submitted to Adenotonsillectomy?

Jose Neto Ribeiro de Souza et al. Int Arch Otorhinolaryngol. .

Abstract

Introduction Palatine and pharyngeal tonsils are the first line of defense against pathogens. Clinically, two alterations may require surgical removal of the tonsils: hypertrophy and recurrent tonsillitis. The two conditions probably result from a dysfunction of the immune system. Objective To evaluate possible differences in the plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in patients submitted to adenotonsillectomy. Methods Prospective, longitudinal study with 25 children undergoing adenotonsillectomy separated into 3 different groups: recurrent tonsillitis (RT), composed of 7 patients; recurrent hypertrophy tonsillitis (RTTH), with 8 patients; and the tonsillar hypertrophy (TH) group, with 10 patients. Ten healthy control children (SD) were also included in the study. Peripheral blood was collected, and plasma was separated to measure the levels of TNF-α, IL-6, and IL-10. The Mann-Whitney test was used for statistical analysis. Results The plasma level of IL-6 was higher in the RT ( p = 0.0394) and TH ( p = 0.0009) groups, compared with the control group. The TH group also had higher levels of IL-6 than the RT group ( p = 0.039). The IL-6/IL-10 ratio was higher in the RT ( p = 0.029) and TH ( p = 0.0005) groups compared with the control group. Between the RT and RTTH groups, the IL-6/IL-10 ratio was higher in the RT group, with a statistically significant difference ( p = 0.0091). Conclusion Patients with a history of chronic tonsillitis had higher levels of IL-6, compared with the control group.

Keywords: adenotonsillectomy; chronic tonsillitis; cytokines; tonsillar hypertrophy.

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Figures

Fig. 1
Fig. 1
Plasma levels of TNF-α (A), IL-6 (B) and IL-10 (C) to each group in the present study (preoperatively). Plasma levels of TNF-α, IL-6 and IL-10 were quantified in the recurrent tonsillitis (RT), tonsillar hypertrophy (TH), recurrent tonsillitis with hypertrophy (RTTH) and controls (DS) groups by the ELISA method. The horizontal bars indicate medians. The Mann-Whitney statistical method was used and values less than 0.05 were considered significant.
Fig. 2
Fig. 2
Ratio between plasma levels of TNF-α (A) and IL-6 (B) in relation to IL-10. Plasma levels of TNF-α, IL-6 and IL-10 were quantified in the recurrent tonsillitis (RT), tonsillar hypertrophy (TH), recurrent hypertrophy tonsillitis (RTTH) and healthy controls (DS) groups by the ELISA method. The ratios of pro-inflammatory and anti-inflammatory cytokine concentrations were calculated for each individual in each group. The horizontal bars indicate the medians. The Mann-Whitney statistical method was used and values less than 0.05 were considered significant.
Fig. 3
Fig. 3
Plasma levels of TNF-a (A), IL-6 (B) and IL-10 (C), in preoperatively (1st collection) and postoperatively (2nd collection) between 4 and 6 months after the surgery. No significant difference. The horizontal bars indicate the medians. The Mann-Whitney statistical method was used and values less than 0.05 were considered significant.
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