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  • Paediatric obstructive sleep apnoea syndrome (OSAS) is associated with tonsil colonisation by Streptococcus pyogenes.

Paediatric obstructive sleep apnoea syndrome (OSAS) is associated with tonsil colonisation by Streptococcus pyogenes.

Scientific reports (2016-02-11)
Elisa Viciani, Francesca Montagnani, Simona Tavarini, Giacinta Tordini, Silvia Maccari, Matteo Morandi, Elisa Faenzi, Cesare Biagini, Antonio Romano, Lorenzo Salerni, Oretta Finco, Stefano Lazzi, Paolo Ruggiero, Andrea De Luca, Michèle A Barocchi, Andrea G O Manetti
ABSTRACT

The involvement of pathogenic bacteria in obstructive sleep apnoea syndrome (OSAS) has yet to be elucidated. We investigated the possible role of group A streptococcus (GAS) in OSAS pathogenesis. In 40 tonsillectomized patients affected by OSAS and 80 healthy controls, significant (p < 0.0001) association of GAS with paediatric OSAS was found. Supernatant from streptolysin O (SLO)-producing GAS induced production of cysteinyl leukotrienes (CysLTs) in tonsil mononuclear cells (TMCs). CysLTs-treated TMCs showed significant (p < 0.05) proliferation of CD4+ T, CD19+ and CD19+CD27+CD38+ B lymphocytes. We discovered a SLO-dependent activation of CysLTs production through a pathway involving TOLL-like receptor 4 (TLR4), TIR-domain-containing adapter-inducing interferon-β (TRIF), Myeloid differentiation primary response gene 88 (MyD88), and p38 MAP Kinase. In conclusion, we hypothesise that GAS may contribute to paediatric tonsillar hyperplasia through CysLTs production induced by SLO, and this might explain its association with OSAS.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Montelukast sodium hydrate, ≥98% (HPLC)
Sigma-Aldrich
Leukotriene D4, ~50 μg/mL (in methanol/ammonium acetate buffer, 70:30, pH 5.6), ≥97%