Increased Levels of S100A8/A9 in Patients with Peritonsillar Abscess: A New Promising Diagnostic Marker to Differentiate between Peritonsillar Abscess and Peritonsillitis.

Christoph Spiekermann,Claudia Rudack,Thomas Vogl,Markus Stenner,Antonella Russo,Johannes Roth

doi:10.1155/2017/9126560

Christoph Spiekermann, Claudia Rudack + Show 4 more

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https://doi.org/10.1155/2017/9126560

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Journal: Disease markers	Publication Date: Jan 1, 2017
Citations: 12	License type: CC BY 4.0

Affiliation: University Hospital Münster

Abstract

Peritonsillar abscess (PTA) is a very frequent reason for urgent outpatient consultation and otolaryngological hospital admission. Early, correct diagnosis and therapy of peritonsillar abscess are important to prevent possible life-threatening complications. Based on physical examinations, a reliable differentiation between peritonsillar cellulitis and peritonsillar abscess is restricted. A heterodimeric complex called calprotectin consists of the S100 proteins A8 and A9 (S100A8/A9) and is predominantly expressed not only in monocytes and neutrophils but also in epithelial cells. Due to its release by activated phagocytes at local sites of inflammation, we assumed S100A8/A9 to be a potential biomarker for peritonsillar abscess. We examined serum and saliva of patients with peritonsillitis, acute tonsillitis, peritonsillar abscess, and healthy controls and found significantly increased levels of S100A8/A9 in patients with PTA. Furthermore, we could identify halitosis, trismus, uvula edema, and unilateral swelling of the arched palate to be characteristic symptoms for PTA. Using a combination of these characteristic symptoms and S100A8/A9 levels, we developed a PTA score as an objective and appropriate tool to differentiate between peritonsillitis and peritonsillar abscess with a sensitivity of 92% and specificity of 93%.

Highlights

The palatine tonsils are related to the mucosa-associated lymphatic tissue (MALT) of the upper respiratory tract
We examined S100A8/A9 levels in the serum and saliva and its potential role as a promising and helpful biomarker to differentiate between acute tonsillitis (AT), peritonsillar cellulitis (PC), and peritonsillar abscess (PTA)
Systemic S100A8/A9 levels were increased in the serum of patients with acute tonsillitis compared to healthy controls (3450 ± 650 ng/ml versus 550 ± 90 ng/ml, p < 0 001)

Summary

Introduction

The palatine tonsils are related to the mucosa-associated lymphatic tissue (MALT) of the upper respiratory tract. They trigger severe head and neck infections causing life-threatening complications [2, 3]. The most common severe head and neck infection is the peritonsillar abscess (PTA) which is a very frequent reason for nonelective otolaryngological hospital admission [4]. Extension of an acute tonsillitis or an infection of Weber’s salivary glands in the supratonsillar fossa was discussed to be the associated pathomechanisms of PTA which is characterized by an accumulation of pus between the fibrous capsule of the palatine tonsil and the pharyngeal constrictor muscle [5, 6]. With a percentage of 75%, the superior type is described to be the more common sort of peritonsillar abscesses [3]

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