Abstract
Purpose: :
Orbital cellulitis with subperiosteal abscess in the pediatric patient is an aggressive infection that usually originates from an adjacent sinusitis. In addition to the underlying infection, orbital abscesses may also represent an exuberant inflammatory response that has spilled over into the subperiosteal space. Cytokines are glycoprotein molecules that modulate the immune system and play a key role in various infectious and inflammatory processes. The purpose of this study is to characterize the cytokine expression in the subperiosteal abscess of pediatric patients with orbital cellulitis.
Methods: :
Specimens were obtained from 4 patients undergoing surgical drainage of their orbital subperiosteal abscess. Approximately 1 ml of the abscess fluid was taken for analysis. A commercially available protein array membrane (RayBio Human Cytokine Array, RayBiotech) was used to identify cytokine expression within the abscesses.
Results: :
The following cytokines were positive in the subperiosteal abscesses: Interleukin (IL) 1 alpha, IL1 beta, IL1ra, IL6, IL16, Tumor Necrosis Factor (TNF) alpha, TNF beta, sTNF RI, sTNF RII. The following cytokines are negative: IL1R4/ST2, IL1R1, IL2, IL2R alpha, IL3, IL4, IL5, IL6R, IL7, IL10, IL11, IL12p40, IL12p70, IL13, IL15 and IL17.
Conclusions: :
Our study has identified nine major cytokines present in pediatric orbital subperiosteal abscesses. All of these cytokines are involved in regulating the intensity and duration of the immune response by stimulating or inhibiting the activation, proliferation and differentiation of various cells. As orbital subperiosteal abscesses may represent an example of an immune–mediated inflammatory disorder, we may be able to develop anti–cytokine agents to modulate the immune system to treat orbital subperiosteal abscesses in the future.
Keywords: orbit • cytokines/chemokines • inflammation