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.引言：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（group A β-hemolytic streptococcus），尽管B、C、F及G群链球菌也与该病存在关联。 研究目的：评估A群与非A群（B、C、F及G群）β溶血性链球菌引发的急性细菌性扁桃体咽炎患者体内细胞因子TNF-α、IL-6、IL-4及IL-10的水平。 研究方法：本研究于儿科急诊单元开展。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。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）检测TNF-α、IL-6、IL-4及IL-10的含量，同时采集两份口咽拭子用于细菌分离。此外，还收集了研究参与者的病史资料。 研究结果：本研究纳入的患儿平均年龄为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发生率更高。各组间细胞因子水平未观察到统计学显著差异，但A群组与对照组的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群组及对照组，提示二者具有相似的免疫学模式。