{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:10:13Z","timestamp":1789971013061,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,1,31]],"date-time":"2014-01-31T00:00:00Z","timestamp":1391126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize the immunologic changes of the tonsil as they correlate with increasing apnea\u2010hypopnea index (AHI) in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective immunologic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care pediatric otolaryngology practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Tonsils were collected from 24 children with obstructive sleep apnea, all of whom had undergone polysomnography at an accredited sleep center using scoring determined by the American Academy of Sleep Medicine 2007 scoring manual. Patients were excluded if they had been diagnosed with craniofacial abnormalities, neuromuscular disorders, or immunodeficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010cell suspensions were isolated from tonsils of 13\u00a0individuals and stained with fluor\u2010conjugated antibodies and analyzed using fluorescence\u2010activated cell sorting. Single\u2010cell suspensions from tonsils of 11 additional individuals were incubated 21 hours and subjected to multiplexed enzyme\u2010linked immunosorbent assay cytokine analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients with an AHI &gt;5 events\/h, there was a statistically significant increase in the fraction of CD4<jats:sup>+<\/jats:sup> CD45RO<jats:sup>+<\/jats:sup> T cells (<jats:italic>P<\/jats:italic> &lt;. 01), and the percentage of CD8<jats:sup>+<\/jats:sup> FoxP3<jats:sup>+<\/jats:sup> T cells (Tc<jats:sub>REG<\/jats:sub>) showed a statistically significant decrease (<jats:italic>P<\/jats:italic> &lt;. 005). Cytokine analysis revealed high levels of interleukin (IL)\u201317A, IL\u20101b, IL\u201010, and IL\u201012p70 production. Cytokine profiles revealed a conspicuous absence of IL\u20104 and IL\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate the tonsils of patients with obstructive sleep apnea have an ongoing inflammatory response characterized by increased effector CD4\u00a0T cells and decreased FoxP3 CD8\u00a0T cells. The T<jats:sub>H<\/jats:sub>17 skewing suggests that local immune activation may be either autoimmune or due to an extracellular pathogen.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599814521780","type":"journal-article","created":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T00:59:15Z","timestamp":1391216355000},"page":"880-886","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Patients with Pediatric Obstructive Sleep Apnea Show Altered T\u2010Cell Populations with a Dominant T<sub>H<\/sub>17\u00a0Profile"],"prefix":"10.1002","volume":"150","author":[{"suffix":"Jr","given":"Martin E.","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Saint Louis University School of Medicine St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary 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