Adenotonsillectomy Significantly Modifies Gut Microbial Taxonomy and Function in Children With Obstructive Sleep Apnea

Sunday, September 29, 2024

2:36 PM – 2:42 PM EDT

Location: MBCC, 238-239

Disclosure(s):

Li-Ang Lee, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Obstructive sleep apnea (OSA) is associated with gut dysbiosis. The impact of adenotonsillectomy, the primary treatment for childhood OSA, on the relationship between disease severity and the gut microbiome in affected children is yet to be fully understood.

Methods: This study employed a prospective case series approach, enrolling children diagnosed with OSA at a tertiary medical center in Taiwan between March 1, 2017 and January 31, 2019. The cohort comprised of 55 children who underwent adenotonsillectomy. Post-surgical follow-up lasted for 12 months. We analyzed the 16S rRNA-based gut microbiome, standard polysomnographic parameters, and clinical variables at three time points: baseline, three months, and 12 months post-surgery. The study focused on exploring the relationship between changes in the apnea-hypopnea index (AHI) and alterations in the gut microbiome. To achieve this, we utilized repeated measures correlation analysis and generalized estimating equations.

Results: Following adenotonsillectomy, the apnea-hypopnea index (AHI) and other polysomnographic parameters exhibited significant improvement at both three and 12 months post-surgery. Baseline α- and β-diversity metrics remained consistent across different OSA severity levels. AHI was found to negatively correlate with six bacterial taxa. Postoperative changes in the α- and β-diversities of the gut microbiota and certain predictive functional pathways were evident. Notably, AHI level changes positively correlated with the Chao 1 index, observed species, and four specific bacterial taxa, while exhibiting negative correlations with the Simpson index, four bacterial taxa, and functional pathways (purine metabolism, transcription, type II diabetes mellitus).

Conclusions: Our results shed light on the transformative influence of adenotonsillectomy on the gut microbiome of pediatric OSA patients. Acknowledging the potential detrimental effects of gut dysbiosis in OSA, along with the therapeutic efficacy of interventions such as adenotonsillectomy, emphasizes the need for sustained research in this area.

Presenting Author(s)

LL

Li-Ang Lee, MD, PhD

Professor, Departments of Otorhinolaryngology-Head and Neck Surgery, Sleep Center
Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
Taoyuan City, Taoyuan, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

HC

Hai-Hua Chuang, MD

Associate Professor, Departments of Family Medicine
Chang Gung Memorial Hospital, Taipei and Linkou Branches, and Chang Gung University, Taoyuan, Taiwan, Taipei, Taiwan (Republic of China)

Disclosure information not submitted.
HL

Hsueh-Yu Li, MD

Professor
Linkou-Chang Gung Memorial Hospital
Taoyuan City, Taoyuan, Taiwan (Republic of China)

Disclosure information not submitted.
CH

Chung-Guei Huang, PhD

Associate Professor, Department of Laboratory Medicine
Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, United States

Disclosure information not submitted.

Senior Author(s)

LL

Li-Ang Lee, MD, PhD

Professor, Departments of Otorhinolaryngology-Head and Neck Surgery, Sleep Center
Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
Taoyuan City, Taoyuan, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.