Correlation between adenotonsillar microbiome and clinical characteristics of pediatrics with snoring: a preliminary study
Objectives: The paired microbiome of adenoids and tonsils in pediatric patients with snoring has rarely been reported, and its correlation with clinical characteristics has not been evaluated. The aim of this study was to identify the adenotonsillar microbiome and determine its correlation with the subjective symptoms of pediatric patients with snoring and regional mucosal immune molecules.Methods: Twenty-four children who underwent tonsillectomy with adenoidectomy because of snoring were enrolled in a cross-sectional study performed between August 2017 and December 2018. The adenoid and tonsil microbiomes and their alpha- and beta-diversity were determined. Clinical characteristics, including subjective discomfort during sleep [obstructive sleep apnea (OSA)-18 questionnaire], presence of allergic rhinitis, concentrations of heat shock protein (Hsp) 27, Hsp70, and interleukin-8 (IL-8) in lavage fluids, and whole blood cell (WBC) counts were measured.Results: At the phylum level, the microbiome was not significantly different between the adenoids and tonsils. Alpha and beta indices were not significantly different between the adenoid and tonsil. Alpha-diversity of the entire adenotonsillar microbiome was associated with sex, emotional stress, and IL-8 levels in the tonsil lavage fluids. Beta-diversity of the entire adenotonsillar microbiome was associated with Hsp27 levels in the tonsil lavage fluids and WBC counts. Results of the multiple allergen simultaneous tests were not significant, but total serum immunoglobulin E levels were significantly associated with the beta-diversity of the adenotonsillar microbiome.Conclusion: These data suggest for the first time that the adenotonsillar microbiome interacts with the regional mucosal immune system. Furthermore, the association of the microbiome with subjective discomfort is a unique observation and warrants further investigation