Otitis Media in the Young Infant: An IgE-Mediated Disease?

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 133-137 ◽  
Author(s):  
John L. Sloyer ◽  
John H. Ploussard ◽  
Laurel J. Karr
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Skin Testing ◽  
Young Infant ◽  
Specific Ige ◽  
Serum Samples ◽  
Igg Antibody ◽  
Total Ige ◽  
Ige Antibody ◽  
The Mean

IgE antibody directed against noncapsular antigens of mechanically disrupted Streptococcus pneumoniae, serotype 3 rough, was demonstrated in middle ear effusions (MEE) and serum of infants with and without prior evidence of pneumococcal otitis media with effusion (OME). The techniques employed included radioimmunoassay (RIA), passive skin testing, Prausnitz-Küstner (P/K), and enzyme-linked immunospecific assay (ELISA). Adsorption of MEE with ultrasonically disrupted crude pneumococcal antigen (CPA-U) resulted in a reduction of total IgE counts per minute and suggested bacteria-specific IgE antibody ranging from approximately 22 to 92% of the total IgE. The biological activity of the IgE antibody was confirmed by challenging skin passively sensitized with MEE IgE and CPA-U. Areas of induration appeared 20 minutes after challenge and continued to increase in size until 90 minutes. An ELISA procedure was developed as a tool to determine the nature of the antigen(s) and to determine the class(es) of antibody other than IgE. It appeared that CPA-U possesses free amino groups and that it can withstand the rigors of autoclaving. An analysis of 45 cord bloods revealed that high levels of IgG CPA-U antibody occur in this type of sample and that no correlation exists between the IgE and IgG levels. The mean IgG: IgE ratio, optical density at 420 nm (OD 420), for cord bloods was 2.49. In contrast, serum samples from nine infants without pneumococcal otitis media and from 14 infants with pneumococcal otitis media had lower levels of IgG antibody. There was no significant relationship between IgG and IgE OD 420 in infants who never had an episode of pneumococcal otitis media and the mean IgG: IgE was 1.88, whereas the ratio for those infants with pneumococcal otitis media was 1.56. In addition, there was a significant correlation between IgG and IgE levels in this latter group. The results suggest that it may be important to monitor the levels of at least these two classes of antibody to enhance our understanding of the pathogenesis and recovery from otitis media.

The Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion

1981 ◽  
Vol 89 (5) ◽  
pp. 874-878 ◽  
Author(s):  
Joel M. Bernstein ◽  
Elliot Ellis ◽  
Philip Li
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Skin Testing ◽  
Specific Ige ◽  
Total Ige ◽  
History Of ◽  
Ige Mediated ◽  
Physical Findings

Forty-one children with recurrent otitis media with effusion (OME) were evaluated for IgE mediated allergy by critical analysis of history, physical findings, skin testing for selected antigens, and laboratory determination of total IgE and radioallergosorbent testing (RAST) for six inhalant and two food allergens. The children were divided into an allergic and nonallergic group. The allergic group clearly had higher total IgE in their serum. There was an elevation of middle ear effusion (MEE) IgE in 5 of 20 allergic cases. In three of these five patients or 15% of the allergic group, the IgE/mg protein was higher in the MEE than in the corresponding serum, suggesting the possibility of local production of IgE. Specific IgE antibody as measured by RAST was noted in 9 of 20 MEE and 5 of 20 nasal washings in the allergic group and in only 2 of 21 MEE and in 10 nasal washings of the nonallergic group. Nasal IgE was substantially increased in three patients of the allergic group; however, the corresponding MEE IgE was not increased in proportion to the nasal IgE. The MEE RAST was positive in 22% of the allergic group and in less than 1% of the nonallergic group. Nasal RAST was positive in 20% of the allergic group and in none of the nonallergic group. We conclude that IgE-mediated allergic reactions may play a role in the pathogenesis of OME in only about 15% of children defined as allergic on the basis of clinical and laboratory evidence. Allergy investigation as a diagnostic procedure in children with recurrent OME, but without a history of allergy on the basis of history, family history, or laboratory testing is likely to be nonproductive.

Further Observations on the Role of IgE-Mediated Hypersensitivity in Recurrent Otitis Media with Effusion

1985 ◽  
Vol 93 (5) ◽  
pp. 611-615 ◽  
Author(s):  
Joel M. Bernstein ◽  
Josephine Lee ◽  
Kathleen Conboy ◽  
Elliott Ellis ◽  
Phillip Li
Keyword(s):  
Allergic Rhinitis ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Skin Testing ◽  
Young Patients ◽  
Local Production ◽  
Total Ige ◽  
Ige Mediated ◽  
Recurrent Otitis Media

One hundred young patients with recurrent otitis media with effusion (OME) were evaluated for IgE-mediated hypersensitivity by critical analysis of history, physical findings, skin testing for selected antigen, laboratory determination of total IgE, and radioallergosorbent testing (RAST) for six inhalant and two food allergens. The patients could be divided into allergic rhinitis and nonallergic groups. Allergic rhinitis patients had higher total IgE in their serum, and middle ear effusion (MEE). IgE was elevated in 16 of 35 allergic patients. in 8 of these 16 (23% of the allergic group), the IgE/mg protein was higher in the MEE than in the corresponding serum, suggesting local production of IgE. Nasal IgE was substantially increased in the allergic patients; however, in many patients there was no correlation between the corresponding MEE IgE and elevated nasal IgE, suggesting that local production of nasal and middle ear IgE is Independent. We conclude that IgE-mediated allergic reactions may play a role in the pathogenesis of OME in about 23% of young allergic patients.

Specific IgE and IgG4 antibodies to Japanese cedar pollen and total IgE antibody in lumbermen

Aerobiologia ◽  
1998 ◽  
Vol 14 (4) ◽  
pp. 321-324 ◽  
Author(s):  
Kensei Naito ◽  
G. Ishii ◽  
T. Ogawa ◽  
N. Yokoyama ◽  
S. Iwata
Keyword(s):  
Japanese Cedar ◽  
Specific Ige ◽  
Total Ige ◽  
Ige Antibody ◽  
Japanese Cedar Pollen ◽  
Cedar Pollen

scholarly journals Detection of antibodies to recombinant truncated flagellin and sonicated whole cell antigen of Burkholderia pseudomallei in acute melioidosis and in healthy Bangladeshi individuals

2020 ◽  
Vol 14 (1) ◽  
pp. 47-52
Author(s):  
Md Shariful Alam Jilani ◽  
Tang Thean Hock ◽  
Sraboni Mazumder ◽  
Fahmida Rahman ◽  
Md Mohiuddin ◽  
...  
Keyword(s):  
Rural Areas ◽  
Burkholderia Pseudomallei ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
Healthy Individuals ◽  
Serum Samples ◽  
Igg Antibody ◽  
Whole Cell ◽  
Cell Antigen ◽  
The Mean

Background and objectives: Several types of Burkholderia pseudomallei antigens have been used to determine the antibody response in acute and asymptomatic cases. In the present study, we have detected immunoglobulin G (IgG) antibody to recombinant truncated flagellin antigen (RTFA) of B. pseudomallei in the sera of acute melioidosis cases and healthy individuals from melioidosis endemic areas of Bangladesh by indirect enzyme-linked immunosorbent assay (ELISA). In parallel, IgG antibody to sonicated whole cell antigen (SWCA) of B. pseudomallei was determined to compare with anti-RTFA antibody. Methodology: Serum samples from culture confirmed melioidosis cases and from healthy individuals aged 21 years and above residing in melioidosis endemic rural areas were included in the study. Serum IgG antibody to RTFA and SWCA of B. pseudomallei was determined by indirect ELISA. Results: Out of 8 culture confirmed acute melioidosis cases, 7 (87.5%) and 8 (100%) were positive for anti-B. pseudomallei IgG antibodies by RTFA and SWCA methods respectively. Among 361 healthy individuals, the rate of seropositivity by RTFA-ELISA was significantly less than that of SWCA-ELISA (16.1% versus 26.8%; p = 0.001). The mean optical density (OD) of RTFA-ELISA of positive cases was significantly less than that of SWCA-ELISA in both melioidosis and healthy individuals (0.79±0.11 versus 2.4±0.08, p = 0.0001; 0.67±0.01 versus 1.27±0.02, p = 0.0001). The sensitivity and specificity of RTFA-ELISA were 88.9% and 100% respectively. Conclusion: Findings of the study suggest that multiple or combination of antigens should be used to study the seroprevalence of B. pseudomallei infection in a community. Also, prospective study is necessary to find out the duration of persistence of antibodies to different antigenic components of B. pseudomallei after exposure. Ibrahim Med. Coll. J. 2020; 14(1): 47-52

Vitamin D levels in children with otitis media with effusion

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adly Mohamed ◽  
Marwa Mohamed EL-Begermy ◽  
Ahmed Abdelmoneim Teaima ◽  
Mohamed Ali Abdelghafar
Keyword(s):  
Vitamin D ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Serum Vitamin ◽  
Control Group ◽  
University Hospitals ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
The Mean

Abstract Objective To investigate the relationship between otitis media with effusion (OME) and serum vitamin D level in children. Methods This prospective case control study was conducted at Ain Shams University Hospitals between February 2018 and May 2019. The study population included 50 children with OME confirmed by tympanometry type (B) who will undergo adenotonsillectomy and grommet tube insertion compared to 50 children without OME confirmed by tympanometry type (A) who will undergo adenotonsillectomy. Measurement of serum 25-hydroxy vitamin D using electrochemiluminescence technique from a blood sample (3cm) taken from them on the day of surgery. Results In this study, the mean age of the cases was 4.24 ± 0.80 and 5.34 ± 1.19 years for the controls besides 23 (46%) of the OME group were boys and 27 (54%) were girls, compared with 29 (58%) boys and 21 (42%) were girls in the control group. The mean levels of vitamin D in children with OME was 16.24 ± 7.14 ng/mL and in children in the control group was 15.89 ± 5.84 ng/mL (P = 0.815) and it was statistically non significant. Conclusion There was no significant relation between vitamin D serum level and the incidence of OME in children.

scholarly journals Allergen-Specific IgE Measured by a Continuous Random-Access Immunoanalyzer: Interassay Comparison and Agreement with Skin Testing

2005 ◽  
Vol 51 (7) ◽  
pp. 1241-1249 ◽  
Author(s):  
Markus Ollert ◽  
Stephanie Weissenbacher ◽  
Jürgen Rakoski ◽  
Johannes Ring
Keyword(s):  
Diagnostic Accuracy ◽  
Skin Testing ◽  
Random Access ◽  
Specific Ige ◽  
Comparison Method ◽  
Automated System ◽  
Serum Samples ◽  
Vitro Assay ◽  
Clinical Criteria

Abstract Background: Our aims were to evaluate the performance of a fully automated system for measuring circulating allergen-specific IgE (sIgE) against an established in vitro assay and to assess the system’s diagnostic accuracy against objective clinical criteria for identifying sensitization to specific allergens. Methods: Using both the IMMULITE® 2000 Allergy system (IML) and an assay based on the widely used ImmunoCAP® technology (CAP), we measured sIgE in serum samples from 169 persons with suspected allergies to airborne or insect venom allergens. Skin testing outcome served as the clinical comparison method. Results: Interassay classification agreement between the IML and CAP, relative to the usual allergen-specific IgE cutoff of 0.35 kIU/L, ranged from 76% (yellow jacket venom) to 95% (orchard grass); agreement was 88.3% for all 9 allergens combined (766 results). The 90 discordant results, when resolved by skin testing, showed better agreement with the IML (72%) than with the CAP (28%). Compared with skin testing, for each of the 9 allergens studied, the area under the ROC curve was at least as large for the IML as for the CAP, reflecting in part the more extensive working range of the IML (0.10–100 kIU/L vs 0.35–100 kIU/L for CAP). Conclusion: Laboratory testing for sIgE can be performed on a fully automated, random-access system with an extended working range and with diagnostic accuracy for representative allergens equivalent to or better than that of the semiautomated CAP technology.

Immunoglobulin E in Chronic Middle Ear Effusions

1978 ◽  
Vol 87 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Daniel M. Lewis ◽  
James L. Schram ◽  
Herbert G. Birck ◽  
David J. Lim ◽  
Gerald Gleich
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Immunoglobulin E ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Causative Factor ◽  
Serum Samples ◽  
Double Antibody ◽  
Paired Serum

To investigate the possible role of allergy in otitis media with effusion (OME), the immunoglobulin E (IgE) content of 138 middle ear effusions (MEE) and paired serum samples from patients with chronic otitis media with effusion was determined. The initial 62 paired specimens were assayed for IgE by the radioimmunosorbent test (RIST), while the later 76 paired specimens were assayed for IgE by the paper radioimmunosorbent test (PRIST). When the results obtained by these two techniques were compared, it was noted that the PRIST procedure gave significantly lower IgE values for effusions than the RIST method. When the effusion-to-serum ratios (E/S ratios) were computed from the PRIST data, the E/S ratio was less than one, while RIST data gave an E/S ratio greater than one. The results obtained with the PRIST procedure were confirmed by double antibody radioimmunoassay for IgE. Thus, the PRIST procedure appears to measure the IgE content of MEE more accurately, and the results obtained by this procedure fail to support the concept of allergy as a major causative factor in OME.

scholarly journals Prevalence of specific immunoglobulin E and G against Aspergillus fumigatus in patients with asthma

2019 ◽  
Author(s):  
Newsha Hedayati ◽  
Vida Mortezaee ◽  
Seyed Alireza Mahdaviani ◽  
Maryam Sadat Mirenayat ◽  
Maryam Hassanzad ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Severe Asthma ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Specific Ige ◽  
Total Ige ◽  
Asthmatic Patients ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
The Mean

Background and Purpose: Aspergillus fumigatus as a ubiquitous fungus can be found in the respiratory tract of the asthmatic and healthy people. The inhalation of Aspergillus spores leads to an immune response in individuals with asthma and results in the aggravation of the clinical symptoms. The present study aimed to investigate the prevalence of specific immunoglobulin E and G (IgE and IgG) against A.fumigatus in asthmatic patients.Materials and Methods: This study was conducted on 200 consecutive patients with moderate to severe asthma referring to Masih Daneshvari hospital Tehran, Iran, from January 2016 to February 2018. Skin prick test (SPT) was performed in all subjects with Aspergillus allergens. Moreover, all patients underwent specific IgE testing for Aspergillus using Hycor method. Enzyme immune assay was applied to measure total IgE and Aspergillus-specific IgG.Results: According to the results, the mean age of the patients was 45.8 years (age range: 18-78 years). The mean levels of total IgE and Aspergillus specific IgE in asthmatic patients were obtained as 316.3 (range: 6-1300 IU/ml) and 1.5 (range: 0.1-61.3 IU/ml), respectively. Out of 200 patients, 27 (13.5%), 65 (32.5%), 22 (11.0%), and 86 (43.0%) cases had positive Aspergillus SPT, total IgE of > 417 IU/ml, Aspergillus-specific IgE, and IgG, respectively. The level of these variables in patients with severe asthma were 16 (16.5%), 36 (37.1%), 15 (15.5%), and 46 (47.4%), respectively.Conclusion: As the findings indicated, reactivity to Aspergillus is a remarkable phenomenon in asthmatic patients. It is also emphasised that the climatic condition may affect the positive rate of hypersensitivity to Aspergillus.

Chronic Secretory Otitis Media: Effects of Surgical Management

1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Surgical Management ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Tympanostomy Tubes ◽  
The Mean ◽  
First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

Immunologic Response to Pneumococcal Polysaccharide Vaccine in Infants

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 351-356 ◽  
Author(s):  
John L. Sloyer ◽  
Laurel J. Karr ◽  
John H. Ploussard ◽  
Gerald D. Schiffman
Keyword(s):  
Antibody Response ◽  
Otitis Media ◽  
Natural Infection ◽  
Young Infant ◽  
Serum Antibody ◽  
Capsular Polysaccharides ◽  
Igg Antibody ◽  
Nasopharyngeal Colonization ◽  
Antibody Levels ◽  
Group 1

The serum antibody response to purified pneumococcal capsular polysaccharides (PCP) was determined in four groups of infants ranging in age from 3 to 24 months. Group 1 consisted of eight infants immunized with an octavalent vaccine containing serotypes 1, 3, 6, 7, 14, 18, 19 and 23 (PCP-8). Group 1 received 25 μg of each serotype at 3–6 months of age and again at 18–24 months. The antibody response after the second immunization was compared to a group of nine patients receiving a primary immunization at 18–24 months and to a group of ten age-matched controls receiving saline placebo. There were no significant differences in mean serum antibody levels between the two groups receiving the PCP-8. A fourth group of 44 infants between 6 and 21 months of age received either PCP-7 or PCP-8 and were followed for two years, at which time simultaneous injections of both vaccines were administered. Types 2, 3, 7, and 8 were most immunogenic but levels six months after immunization were approximately the same as for unimmunized controls with the exception of serotypes 3 and 7 which persisted for about two years. The class of antibody induced either by natural infection or by immunization was preferentially IgG and it was more often induced by the former. There were no significant differences between the serotypes of pneumococci isolated from nasopharyngeal cultures regardless of which vaccine was administered. Finally, the least immunogenic serotypes include 4, 6, 14, 19, and 23 and these are the only serotypes thus far associated with otitis media after immunization. The results suggest that PCP do not induce a lasting immune tolerance at the dose administered in this study; PCP are not very immunogenic in the young infant; PCP antibody tends to rise naturally; IgG antibody is preferentially induced; nasopharyngeal colonization is not altered by PCP immunization; and an association may exist between PCP immunogenicity and subsequent onset of otitis media.

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