Search

Recent studies have shown that allergic diseases may be associated with the pathogenesis of recurrent otitis media with effusion (OME). We aimed to assess the relationship between OME and allergic diseases and other types of disease in children with OME. We also evaluated the between group differences in the characteristics of middle ear effusion.We evaluated 370 patients diagnosed with OME between January 2007 and December 2012 and, as a control group, 100 children with no medical history of OME but who had undergone blood tests and MAST-CLA (multiple allergosorbent test - chemiluminescent assay) were selected.Among the allergic diseases, the incidence of allergic rhinitis alone was significantly higher in children with OME (33.8%) than without OME (16.0%) (p0.05). The rate of adenoid, but not tonsil, hypertrophy was significantly greater in patients with than without OME also (p0.05). When we evaluated the characteristics of middle ear effusion (MEE) in patients with OME, we found that 186 had serous, 129 had mucous and 55 had purulent MEE. Of these patients, 75 (40.3%), 36 (27.9%) and 14 (25.5%), respectively, had allergic rhinitis and the rates of allergic rhinitis and asthma were significantly higher in the serous group than in the mucous group (p0.05).Allergic rhinitis was significantly more frequent among pediatric patients with than without OME, although the rates of other allergic diseases did not differ in these two groups. The likelihoods of allergic rhinitis and asthma were higher in patients with serous than with mucous MEE.

Pattern recognition receptors (PRRs) induce appropriate immune responses after recognizing certain molecular characteristics of pathogens. It is not known, however, whether PRRs are expressed in middle ear infections and whether the expression of PRRs and immunoglobulins is correlated in recurrent otitis media with effusion (OME). We therefore investigated the expression of PRRs and immunoglobulins in children with OME.The study population consisted of 66 children with OME, of whom 27 had more than 4 episodes in 12 months or more than 3 episodes in 6 months (otitis-prone group), and 39 had fewer than 4 episodes in 12 months or 3 episodes in 6 months (non-otitis-prone group). The expression in middle ear effusion of Toll-like receptor (TLR)-9, nucleotide-binding oligomerization domain (NOD)-1, NOD-2, and retinoic acid-inducible gene (RIG)-I mRNA, as determined by real-time PCR, and the concentrations of IgG, IgA, and IgM, as determined by ELISA, were compared between the two groups.The levels of TLR-9, NOD-1 and RIG I mRNAs were significantly lower in the otitis-prone than in the non-otitis-prone group (p0.05 each). The concentrations of IgG, IgA and IgM in effusion fluid did not differ significantly between the two groups (p0.05), and there were no correlations between immunoglobulin concentration and the expression of PRPs (p0.05).Decreased expression of PRRs may be associated with increased susceptibility to OME.

Objective To evaluate the level of immunogloblins and expression of the transcription factors in the adenoids. Methods The study population consisted of 30 children with otitis media with effusion (OME), 22 children with chronic rhinosinusitis (CRS) and 27 children with adenoid hyperplasia. IgA, IgG, IgD and IgM concentrations in these three groups were compared immunohistochemically. We also compared the levels of expression of B lymphocyte inducer of maturation program 1 (BLIMP-1), a promoter of plasmacytosis, and B cell leukemia/lymphoma-6 (BCL-6), a repressor of plasmacytosis, in the adenoids of these children. Results The expression of antibody to Ig A in the OME and CRS groups each was significantly lower than the score in the adenoid hyperplasia group. The staining scores of antibodies to IgG, IgD and Ig M did not differ significantly among the three groups. The expression of antibody to BLIMP-1 in the CRS and adenoid hyperplasia groups showed a significant difference. Staining scores of Antibody to BCL-6 did not differ significantly among the three groups. Conclusions We found that the reduction of IgA in the adenoids was associated with pediatric OME and CRS, and that reduction of expression of the transcription factor BLIMP-1 rather than BCL-6 was associated with CRS.