The Administration of Steroids and its Impact on Caspase-3 Expression in Pediatric Adenoid Hypertrophy

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4516-4522. doi: 10.1007/s12070-024-04900-8. Epub 2024 Jul 18.

Abstract

Objective: Adenoid hypertrophy is a prevalent pediatric condition, often necessitating surgical intervention. Intranasal steroid administration shows promise as a conservative treatment, particularly by inducing apoptosis in adenoidal cells, leading to a reduction in adenoid size and inflammation. This study aims to characterize the expression profile of caspase-3 as an apoptotic inducer protein in inflammatory and epithelial adenoid tissues and explore its association with steroid administration.

Methods: We performed immunohistochemical staining for caspase-3 proteins in adenoid tissues obtained from 51 pediatric patients aged between 2.5 and 12 years (mean age: 6.09 ± 2.1 years) who underwent adenoid surgery. A retrospective analysis of clinical data was conducted, categorizing participants into steroid treatment receivers (n = 25) and non-receivers (n = 26). Subsequently, the lymphoid inflammatory tissue and epithelial tissue from the adenoid were compared in terms of caspase-3 protein expression, and associated clinical variables were assessed.

Results: Immunohistochemical analysis revealed significant caspase-3 expression in inflammatory tissues. The expression levels were scored, and no significant correlation was observed between inflammation and epithelium based on caspase-3 expression (correlation coefficient = 0.143; p > 0.05). Furthermore, demographic and clinical characteristics did not show a statistically significant difference in caspase-3 expression levels.

Conclusion: Caspase-3 expression was significant in inflammatory adenoid tissue, but it showed no association with nasal steroid administration.

Keywords: Adenoid Hypertrophy; Caspase-3; Epithelium; Immunohistochemical; Inflammation; Pediatric.