Vascular endothelial growth factor and transforming growth factor β in hypertrophic adenoids in children suffering from otitis media with effusion

Objectives: The study objective was to assess the levels of VEGF-A and TGF-beta cytokines in the children with adenoid hypertrophy concomitant with exudative otitis media (OME) and in children with adenoid hypertrophy (HA) alone. Methods: The study material consisted of hypertrophic adenoids removed during adenoidectomy from 39 children (20 girls and 19 boys), aged 2-7 years suffering from OME. The reference group included 41 children (19 girls and 22 boys), aged from 3 to 9 years with adenoid hypertrophy. The levels of VEGF-A and TGF-beta were determined in supernatants obtained from phytohemagglutinin-stimulated cell cultures of the adenoids using a commercial enzyme-linked immunosorbent assay kit. Results: The median VEGF-A and mean TGF-beta concentrations in the study group were significantly higher than those in the reference group (503 pg/mL versus 201 pg/mL, P < 0.001 and 224 pg/mL versus 132 pg/mL, P < 0.001, respectively). ROC analysis revealed that the area under the curve (AUC) for VEGF-A was 0.952 with diagnostic sensitivity and specificity of 95%, whereas for TGF-beta it was 0.902 with 60% sensitivity and the same specificity as for VEGF-A. There was no significant difference between the AUC for VEGF-A and TGF-beta (P = 0.573). Conclusions: The changes in the levels of VEGF-A and TGF-beta may indicate bacterial pathogen as one of the causes of exudative otitis media in children. Determination of VEGF-A and TGF-beta could be used as additional and objective tests to confirm the clinical diagnosis.