Adenotonsillar Microbiome Shifts in Children With Obstructive Sleep Apnea Syndrome

Objective: To characterize the microbiomes of adenoids and tonsils in pediatric Obstructive Sleep Apnea Syndrome (OSAS) patients compared to healthy controls. We hypothesized that the microbiome composition of the tonsils and adenoids in OSAS patients differs significantly from that of healthy controls. Methods: Thirty OSAS patients and 30 healthy controls were included. Samples from adenoids and tonsils were analyzed using 16S rRNA amplicon sequencing to characterize bacterial communities. Differential abundance and alpha and beta diversity were used to compare the microbiome compositions between groups. Results: Significant differences in the microbial composition of adenoids and tonsils were observed within both OSAS and control groups. The tonsillar microbiome in OSAS patients exhibited lower alpha diversity and distinct microbial composition compared to controls, with an overrepresentation of pathogenic genera such as Haemophilus and Neisseria. Adenoid microbiomes, however, showed no significant differences in alpha diversity between OSAS and controls but displayed a trend toward variation in beta diversity. Conclusion: This study highlights distinct microbiome profiles in adenoids and tonsils, with significant microbial shifts in the tonsillar microbiome of OSAS patients. These findings underscore the importance of syndrome-specific studies and suggest the potential contribution of microbial communities to pathogenesis. Future research should focus on further characterizing the microbiomes of healthy individuals and OSAS patients, aiming to establish a clearer distinction between normal and pathological microbial populations, which could inform the development of novel, non-invasive therapies. Level of Evidence: 3.