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(Chest. 2004;126:13-18.)
© 2004 American College of Chest Physicians

Differential Expression of Cysteinyl Leukotriene Receptors 1 and 2 in Tonsils of Children With Obstructive Sleep Apnea Syndrome or Recurrent Infection*

Aviv D. Goldbart, MD, MSc; Julie L. Goldman, MD; Richard C. Li, MD, PhD; Kenneth R. Brittian; Riva Tauman, MD and David Gozal, MD, FCCP

* From the Departments of Pediatrics (Drs. Goldbart, Li, Tauman, and Gozal, and Mr. Brittian) and Surgery (Dr. Goldman), Division of Ear Nose and Throat, Kosair Children’s Hospital Research Institute, University of Louisville, Louisville, KY.

Correspondence to: David Gozal, MD, FCCP, Kosair Children’s Hospital Research Institute, University of Louisville, 570 South Preston St, Suite 321, Louisville, KY 40202; e-mail: david.gozal{at}louisville.edu

Background: Recurrent tonsillitis and sleep apnea are the major indications for tonsillectomy in children. We hypothesized that the recurrent vibration in the upper airway of snoring children would promote inflammatory changes in the tonsillar tissue and would lead to the up-regulation of cysteinyl leukotriene (LT) receptors (Rs).

Objective: To assess the expression patterns of the human LT-Rs in children undergoing tonsillectomy, and compare those patterns in children having recurrent throat infections (RIs) and children with obstructive sleep apnea syndrome (SA).

Methods: Tonsillar tissue from 17 children with SA and 13 with RIs was subjected to quantitative polymerase chain reaction using specific primers for LT1-R and LT2-R, and to immunohistochemistry and Western blotting for protein expression of LT1-R and LT2-R.

Results: Messenger RNA encoding for the expression of LT1-R and LT2-R was detected in the tonsils of all children. Immunoblots revealed significantly higher expressions of LT1-R and LT2-R in the tonsils of children with SA. The topographic pattern of both receptors differed among the tonsils of children with SA and RI.

Conclusion: LT1-R and LT2-R are expressed in pediatric tonsillar tissue, are more abundant in SA patients, and demonstrate a specific topographic pattern of expression. These findings suggest that an inflammatory process involving LT expression and regulation occurs in children with SA.

Key Words: leukotriene receptor • obstructive sleep apnea syndrome • recurrent tonsillitis




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