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August 1995

Cytokines, Immunoglobulins, and Bacterial Pathogens in Middle Ear Effusions

Arch Otolaryngol Head Neck Surg. 1995;121(8):865-869. doi:10.1001/archotol.1995.01890080033006

Objective:  To elucidate the role of cytokines, immunoglobulins, and bacterial pathogens in the middle ear effusions (MEEs) of children with otitis media (OM).

Design:  Paired MEEs and serum samples collected from consecutive patients were assayed for immunoglobulins. Middle ear effusions were cultured for bacterial pathogens and assayed for interleukin-1β, interleukin-6, tumor necrosis factor a, and interferon y. The medical charts of the patients were retrospectively reviewed to define the history of OM.

Subjects:  Seventy-five patients with a history of recurrent acute OM, persistent OM with effusion, or both. Exclusion criteria included the presence of a major coexisting condition, or an unclear or atypical history of OM.

Setting:  A private practice at a tertiary care children's hospital.

Interventions:  At the time of tympanostomy tube place-ment, with the patient under general anesthesia, one MEE and a serum sample were collected.

Results:  Interleukin-1β was detected in 58% (44/75) MEEs; interleukin-6, 83% (60/72); tumor necrosis factor a, 38% (38/75); and interferon y, 61% (45/74). Concentrations of interleukin-1β, interleukin-6 and tumor necrosis factor α in MEEs were highly correlated with each other (P<.01 for each association) suggesting increased local production and the expected effects of cytokines stimulating their own production during OM. High concentrations of tumor necrosis factor a in MEEs were also associated with a history of multiple placements of tympanostomy tubes (r=.63).

Conclusions:  These data suggest a regulatory role for cytokines in inflammation during OM, and suggest that high concentrations of tumor necrosis factor a in MEEs may be a marker for OM chronicity.(Arch Otolaryngol Head Neck Surg. 1995;121:865-869)