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 till date. 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 with regional mucosal immune molecules.
Twenty-four children, who underwent tonsillectomy with adenoidectomy owing to snoring, were enrolled in a cross-sectional study conducted between August 2017 and December 2018. The microbiome of adenoids and tonsils, 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.
At phylum level, the microbiome was not significantly different between the adenoids and tonsils; alpha and beta indices were not significantly different across them. 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 same was associated with Hsp27 levels in the tonsil lavage fluids and WBC counts. Results of the multiple allergen simultaneous tests were not significant, although total serum immunoglobulin E levels were significantly associated with the beta-diversity of the adenotonsillar microbiome.
The data suggested, for the first time, that the adenotonsillar microbiome interacts with the regional mucosal immune system. Association of the microbiome with subjective discomfort is a unique observation and warrants further investigation.