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Vol. 56. Issue 4.
Pages 310-317 (01 April 2002)
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Vol. 56. Issue 4.
Pages 310-317 (01 April 2002)
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Niveles de superóxido dismutasa amigdalar y eritrocitaria en niños con y sin amigdalitis de repetición
Superoxide dismutase levels from tonsil and erythrocytes in children with recurrent tonsillitis
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F.J. García Callejoa,*, M.H. Orts Alborcha, A. Morant Venturaa, I. Costa Alcácerb, M.M. Velert Vilac, L. Blay Galauda
a Servicio de ORL y Hospital La Fe. Valencia.
b Departamento de Pediatría. Hospital Clínico Universitario. Valencia.
c Centro de Investigación. Hospital La Fe. Valencia.
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Antecedentes y objetivos

El estrés oxidativo de la infección amigdalar infantil determina la expresión de antioxidantes locales y sistémicos. Su determinación parece tener valor como marcador de padecimiento amigdalar previo a la amigdalectomia, pero permanece desconocida, y es ésa nuestra meta, la evolución de este parámetro en niños intervenidos y seguidos a largo plazo.

Métodos

Se estudiaron 136 niños amigdalectomizados, 46 por hipertrofia amigdalar sin infección, y 90 por amigdalitis recurrente. En ellos se midieron concentraciones de super-óxido dismutasa (SOD) preoperatoria, así como a los 6, 12, 24 y 36 meses postamigdalectomía.

Resultados

La infección generó concentraciones significativamente mayores que la hipertrofia amigdalar en tejido amigdalar (223,06 ± 30,46 frente a 156,39 ± 54,05 U/l; p < 0,001) y sangre (1.124,91 ± 141,73 frente a 1.007,19 ± 97,03 U/g Hb; p < 0,001), existiendo muy buena correlación entre las concentraciones amigdalares y eritrocitarias en ambos grupos. El seguimiento a 3 años permitió detectar una progresiva tendencia al descenso en los niveles de SOD en sangre en todos los casos hasta su estabilización. Este estado se alcanza antes en el grupo con hipertrofia amigda-lar a los 6 meses postamigdalectomía, y a los 2 años en el de infecciones. En cualquier caso, en su seguimiento post-amigdalectomía los niños con amigdalitis de repetición siempre mostraron concentraciones de SOD más altas.

Conclusiones

El daño oxidativo en tejido amigdalar resulta de la incidencia y gravedad de las infecciones focales, y la anulación de éstas redunda en un descenso en los niveles de SOD que no llegan a la normalización, a modo de registro inmune frente a una agresión oxidativa.

Palabras clave:
Amigdalitis
Enfermedades infecciosas
Infancia
Pediatría
Enfermedades otorrinolaringológicas
Superóxido dismutasa
Estrés oxidativo
Background and objectives

Oxidative stress secondary to infant tonsillar infection produces the expression of local and systemic antioxi-dants. Its determination seems to be useful as a marker of tonsillar suffering before tonsillectomy but is currently unknown. The aim of this study was to determine the evolution of this parameter in tonsillectomized children during a long-term follow-up.

Methods

One hundred thirty-six children underwent tonsillec-tomy, 46 for tonsillar hypertrophy without infection and 90 for recurrent tonsillitis. Superoxide dismutase (SOD) concentrations were measured before tonsillectomy and at 6, 12, 24 and 36 months post-tonsillectomy.

Results

Infection provoked significantly higher SOD concentrations than tonsillar hypertrophy in tonsillar tissue (223.06 ± 30.46 vs 156.39 ± 54.05 U/l, p < 0.001) and in blood (1124.91 ± 141.73 vs 1007.19 ± 97.03 U/gr Hb,p < 0.001). There was a strong correlation between tonsi-llar and erythrocyte concentrations. During the 3-year follow-up, SOD concentrations in blood progressively decreased until stabilizing in all patients. Stabilization was reached at 6 months post-tonsillectomy in the group with tonsillar hypertrophy and at 2 years in the group with infection. Children with recurrent tonsillitis consistently showed higher SOD concentrations in blood throughout the follow-up.

conclusions

Oxidative damage in tonsillar tissue results from the in-cidence and severity of focal infections. Tonsillectomy re-duces SOD levels but, as a consequence of oxidative stress, these do not return to normal.

Key words:
Tonsillitis
Infectious diseases
Infancy
Pediatrics
Otorhinolaryngologic diseases
Superoxide dismutase
Oxidative stress
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