Author(s)
Li-Ang Lee, MD, FICS
Hai-Hua Chuang, MD
Yen-Lin Huang, MD
Li-Jen Hsin, MD
Wan-Ni Lin, MD
Tuan-Jen Fang, MD, FICS
Hsueh-Yu Li, MD, FACS
Li-Pang Chuang, MD, PhD
Yu-Shu Huang, MD, PhD
Jen-Fu Hsu, MD
Jau-Yuan Chen, MD
Hsin-Chih Lai, PhD
Chung-Guei Huang, PhD
Chung-Jan Kang, MD
Affiliation(s)
Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; Obesity Institute & Genomic Medicine Institute, Geisinger, Danville, Pennsylvania, USA
Abstract:
Objective: To elucidate the associations among the tonsil microbiome, serum level of interleukin 10 (IL-10), and clinical characteristics in healthy weight children with obstructive sleep apnea (OSA).
Method: This prospective cohort study recruited healthy weight children with OSA who underwent adenotonsillectomy between March 1, 2017 and January 31, 2019. The tonsil microbiome was examined using bacterial 16S rRNA gene-targeted high throughput amplicon sequencing and the morning serum level of IL-10 was measured by immunoassay.
Results: A total of 33 consecutive patients (11 girls and 22 boys) with a median age of 6.0 years, body mass index z-score of -0.360 and apnea-hypopnea index (AHI) of 5.4 events/hour completed this study. At phylum level, the relative abundances of Actinobacteria (r=0.40, P=.02), Gemmatimonadetes (r=0.44, P=.01), BRC1 (r=0.38, P=.03), WS4 (r=0.43, P=.01), Halanaerobiaeota (r=0.43, P=.01), Kiritimatiellaeota (r=-0.36, P = .04) and Modulibacteria (r=0.43, P=.01) were significantly related to the serum level of IL-10 (Spearman correlation test). The relative abundance of Gemmatimonadetes (r=-0.37, P=.04) significantly correlated with platelet-to-lymphocyte ratio (PLR) whereas the relative abundances of Bacteroidetes (r=0.44, P=.01) and Deferribacteres (r=0.41, P=.02) were significantly associated with AHI. The serum level of IL-10 was significantly associated with PLR (r=-0.40, P=.02), but IL-10 and PLR were not related to AHI.
Conclusion: These results suggest that the tonsil microbiome involves systemic inflammation (PLR), anti-inflammation (IL-10) and OSA (AHI) in healthy weight children with OSA. These findings offer the possibility of the tonsil microbiome as a promising pharmaceutical target in childhood OSA, which warrants further investigations.