Abstract
The tonsil microbiome is associated with chronic tonsillitis and obstructive sleep apnea (OSA) in children, and the gut microbiome is associated with host weight status. In this study, we hypothesized that weight status may be associated with clinical profiles and the tonsil microbiome in children with OSA. We prospectively enrolled 33 non-healthy-weight (cases) and 33 healthy-weight (controls) pediatric OSA patients matched by the proportion of chronic tonsillitis. Differences in the tonsil microbiome between the non-healthy-weight and healthy-weight subgroups and relationships between the tonsil microbiome and clinical variables were investigated. Non-healthy weight was associated with significant intermittent hypoxemia (oxygen desaturation index, mean blood saturation (SpO2), and minimal SpO2) and higher systolic blood pressure percentile, but was not related to the tonsil microbiome. However, chronic tonsillitis was related to Acidobacteria in the non-healthy-weight subgroup, and oxygen desaturation index was associated with Bacteroidetes in the healthy-weight subgroup. In post hoc analysis, the children with mean SpO2 ≤ 97% had reduced α and β diversities and a higher abundance of Bacteroidetes than those with mean SpO2 > 97%. These preliminary findings are novel and provide insights into future research to understand the pathogenesis of the disease and develop personalized treatments for pediatric OSA.
Highlights
Obstructive sleep apnea (OSA) is a chronic disorder characterized by intermittent partial or complete upper airway obstruction during sleep
Seventy-six Taiwanese children of Han ancestry with obstructive sleep apnea (OSA) were assessed for eligibility, 10 of whom were excluded from this study
We address several novel and interesting findings of this study regarding the relationships of the tonsil microbiome with weight status, OSA
Summary
Obstructive sleep apnea (OSA) is a chronic disorder characterized by intermittent partial or complete upper airway obstruction during sleep. The prevalence of pediatric OSA is estimated to be 1–4%, with adenotonsillar hypertrophy and overweight/obesity being the two most important risk factors [1,2,3]. Previous studies have reported that the gut microbiota is involved in the pathogenesis of OSA [7,8], obesity [9,10], and hypertension [11,12]. More recent studies have suggested that, in addition to the gut microbiota, OSA is linked to alterations in various other microbiomes in the human body such as the nasal cavity [17], adenoids [18], tonsils [19], oropharynx [20], oral cavity [21], lungs [22], and urine [21]. The adenotonsillar microbiome has been shown to interact with the regional mucosal immune system such as interleukin-8 and heat shock protein 27 [23]
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