Evaluation of cytokines produced by β-hemolytic streptococcus in acute pharyngotonsillitis

INTRODUCTION: The most common pathogen in bacterial pharyngotonsillitis is group A β-hemolytic streptococcus, although groups B, C, F,and G have also been associated with pharyngotonsillitis.OBJECTIVE: To assess the levels of the cytokines TNF-α, IL-6,IL-4, and IL-10 in bacterial pharyngotonsillitis caused by group A and non-A (groups B, C, F and G) β-hemolytic streptococcus.METHODS: The study was conducted at a pediatric emergency care unit. The sample comprised children (5-9 years old) with acute bacterial pharyngotonsillitis diagnosed between December of 2011 and May of 2012. The research involved collection of blood samples from the patients, enzyme-linked immunosorbent assay detection of TNF-α, IL-6,IL-4, and IL-10, and collection of two oropharyngeal swabs for bacterial isolation. Additionally, the medical history of the study participants was also collected.RESULTS: In the studied group (mean age: 5.93 years), higher pharyngotonsillitis incidence was observed in the female gender (64.76%). Higher incidence of tonsillar exudates was observed with groups A and C. No statistically significant differences in cytokine levels were observed among groups. However, the group A and the control group showed a difference in the IL-6 level (p = 0.0016).CONCLUSIONS: The Groups A and C showed higher cytokine levels than the Groups B and control, suggesting similar immunological patterns.

研究背景：细菌性扁桃体咽炎最常见的致病菌为A群β溶血性链球菌，尽管B、C、F、G群链球菌也与该病存在关联。研究目的：评估A群及非A群（B、C、F、G群）β溶血性链球菌引发的细菌性扁桃体咽炎患者体内肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-4（IL-4）及白细胞介素-10（IL-10）的水平。研究方法：本研究于儿科急诊科室开展，研究样本为2011年12月至2012年5月期间确诊的急性细菌性扁桃体咽炎患儿，年龄介于5至9岁之间。研究流程包括采集患者血液样本，采用酶联免疫吸附试验（enzyme-linked immunosorbent assay, ELISA）检测上述四种细胞因子水平，同时采集两份口咽拭子用于细菌分离培养，此外还收集了研究对象的病史资料。研究结果：本研究纳入的患者群体平均年龄为5.93岁，女性群体的细菌性扁桃体咽炎发病率更高，占比达64.76%。A群与C群链球菌感染者的扁桃体渗出物发生率更高。各组间细胞因子水平未观测到统计学显著差异，但A群感染组与对照组的IL-6水平存在显著差异（p=0.0016）。研究结论：A群与C群链球菌感染者的细胞因子水平高于B群感染者及对照组，提示二者具有相似的免疫应答模式。