Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2016

Antibody Titres to Bacterial Protein Vaccine Candidate Antigens in Children with Obstructive Sleep Apnoea and Recurrent Tonsillitis (#334)

Tulia Mateus 1 2 , Lea-Ann Kirkham 1 2 , Harvey Coates 1 2 , Shyan Vijayasekaran 1 , Peter Richmond 1 2 , Ruth Thornton
  1. University of Western Australia, Perth, WA, Australia
  2. Telethon Kids Institute, Perth, WA, Australia

Obstructive sleep apnoea (OSA) related to adenotonsillar hypertrophy (ATH) affects 2-3% of children under 10 years of age (1). Adenotonsillectomy for OSA and recurrent tonsillitis is the most common major surgery in children (2). There is a paucity of data on the pathogenesis of adenotonsillar hypertrophy, particularly in OSA and research into this area is required. This study aimed to determine the host immune response to common respiratory pathogens in children with OSA due to ATH compared to children with recurrent tonsillitis (RT) and healthy controls.

Serum specific IgG, IgA to vaccine candidate proteins from NTHi (P4, P6 and PD), S. pneumoniae (Ply, PspA1, PspA2 and CbpA) and GAS (ScpA) were assessed in children with OSA (n=40), recurrent tonsillitis (RT, n=21), OSA+recurrent tonsillitis (OSA+RT, n=16) and healthy controls (n=55) using a multiplex bead based assay. Serum specific IgE against NTHi (P6) and S. pneumoniae (CbpA) was measured by DELFIA. Aeroallergen specific IgE was performed using diagnostic methodologies. Atopic status was assessed using total IgE and parental questionnaire.

Our results showed that IgA and IgG titers against all bacterial proteins from NTHi, S. pneumoniae and GAS were significantly higher in children with OSA and OSA+RT compared to children with RT and healthy controls (p ≤ 0.003). IgE titers against NTHi (P6) and S. pneumoniae (CbpA) and total IgE titers were comparable across the 4 groups. Healthy controls have significantly higher IgE titers against moulds and house dust mite aeroallergens compared to all 3 groups with adenotonsillar disease.

Whilst overall atopy and pathogen specific IgE responses were similar among the 4 groups, IgA and IgG titers were significantly higher in children with OSA and OSA+RT. These results may reflect differences in microbial load and the constant stimulation of the immune system by bacteria persisting in biofilms or intracellularly. We are currently identifying and quantifying the relative abundance of bacterial species in the adenoids, tonsils, nasopharyngeal and throat swabs.

  1. 1. Tauman R, Ivanenko A, O'Brien LM, Gozal D (2004) Plasma C-reactive protein levels among children with sleep-disordered breathing. Pediatrics 113: e564-569.
  2. 2. The Royal Australasian College of Physicians and the Australian Society of Otolaryngology HaNS: Indications for Tonsillectomy and Adenotonsillectomy in Children. In.; 2008.