To the Editor.—In the August 1985 issue of the Archives, Doyle et al1 conclusively demonstrate that a propensity toward otitis media with effusion (OME) in the presence of an allergic diathesis need not be the product of a type 1 immediate hypersensitivity reaction. The young child with allergies whose history of onset of OME frequently follows the cessation of breast feeding invariably fails to demonstrate a type 1, IgE-mediated allergic response through skin whealing or the radioallergosorbent test.
The infantile eczemas, which in this group generally follow the withdrawal of breast milk with its high levels of secretory IgA, strongly suggest the development of hypersensitivities to specific foods during this period. The loss of the gut's food-retention factor furnished by secretory IgA permits undigested, highly antigenic foreign protein to penetrate the mucosa. This allows contact with plasma cells in the lamina propria and the production of antibodies specific
WILSON WH. The Role of Allergy in Otitis Media With Effusion. Arch Otolaryngol Head Neck Surg. 1986;112(4):454–455. doi:10.1001/archotol.1986.03780040094022
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