The role of adenoid immune phenotype in polysensitized children with
allergic rhinitis and adenoid hypertrophy
Background: There has been increasing interest in elucidating
the relationship between adenoid hypertrophy (AH) and allergic rhinitis
(AR). However, the impact of aeroallergen sensitization patterns on
children concurrently experiencing AH and AR remains unclear.
Methods: Patients aged 2-8 years (January 2019 to
December 2022) with nasal symptoms were assessed for allergies, adenoid
size and respiratory viral infection history. The levels of serum total
immunoglobulin E (IgE) and specific IgE and flexible nasal endoscopy
were performed. We analyzed the relationship between AH and
sensitization patterns and lymphocyte subpopulations in adenoid samples
using flow cytometry. Results: 5281 children were enrolled in
our cohort. 56.5% of children was diagnosed with AR and 48.6% with AH.
AR was more prevalent in AH children compared to nAR. Compared to
non-sensitized, those with AR polysensitized to molds had a higher
prevalence of AH (adjusted OR 1.61, 95%CI 1.32-1.96) and a greater
occurrence of two or more respiratory viral infections, particularly in
cases with adenoidectomy. In AH-AR children, adenoid tissues showed
reduced frequencies and corrected absolute counts of regulatory T cells
(Tregs), activated Tregs, class-switched memory B cells (CSMB), natural
killer (NK) T cells and NK subpopulations compared to AH-nAR children.
Polysensitization in AH-AR children correlated with lower CSMB
frequencies. Conclusion: Polysensitivity to molds significantly
increased the risk of AH in children with AR. Adenoids of AR children
demonstrated less number of B cells, NK cells and Treg cells with an
effector/memory phenotype, which was closely linked to sensitization
models and respiratory viral infection, particularly concerning CSMB.