Secretory Immunoglobulin a Antibodies to Respiratory Viruses in Middle Ear Effusionl of Chronic Otitis Media with Effusion

In order to obtain evidence that viral infection may be involved in chronic otitis media with effusion, an attempt was made to detect secretory IgA antibodies to respiratory viruses in the effusions. The enzyme-linked immunosorbent assay used with purified viral antigens was employed for detecting antibodies in this study. Secretory IgA antibodies against adenoviruses, respiratory syncytial, and parainfluenza type 2 viruses were demonstrated in 31 of 128 effusions (27 of 114 ears with chronic otitis media with effusions and 4 of 14 ears with blue eardrum conditions). The specificity of antibody activity to each virus was confirmed by an absorption test.

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Antibody Activity in Otitis Media with Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947908800317 ◽

1979 ◽

Vol 88 (3) ◽

pp. 392-396 ◽

Cited By ~ 11

Author(s):

Daniel M. Lewis ◽

Herbert G. Birck ◽

James L. Schram ◽

David J. Lim

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Bacterial Species ◽

Disease Process ◽

Antibody Activity ◽

Igg Antibodies ◽

Iga Antibodies ◽

Antibody Method ◽

Serous Otitis Media ◽

Immunofluorescence Antibody

Bacteria were isolated from a high percentage of the effusions from patients with otitis media with effusion (OME, serous otitis media). In an attempt to determine if the isolated bacteria were involved in the disease process, we analyzed the serum and effusion of 25 OME patients for the presence of antibacterial antibodies by the indirect immunofluorescence antibody method. Specific antibody activity was detected in 20 of 25 effusions (80%) and 19 of 22 sera (86%). IgG antibodies were the most frequently found class of antibodies in both sera and effusions, but IgA antibodies were detected more frequently in the effusions than in the sera. Hemophilus influenzae, Streptococcus pneumoniae, and diphtheroids were the most frequently isolated organisms, and antibody activity to all bacterial species isolated was detected. The results support the concept that the isolated bacteria are not contaminants but are actively involved in the disease process.

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Immunologic Characteristics of Cytokines in Otitis Media with Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489492101s1006 ◽

1992 ◽

Vol 101 (10_suppl) ◽

pp. 21-25 ◽

Cited By ~ 40

Author(s):

Tetsuo Himi ◽

Toshio Suzuki ◽

Hiroyuki Takezawa ◽

Hiroyuki Kodama ◽

Akikatsu Kataura

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

Chronic Otitis Media ◽

Inflammatory Cells ◽

Enzyme Linked Immunosorbent Assay ◽

Gm Csf ◽

Cytologic Analysis ◽

Macrophage Colony

Levels of cytokines, interleukin (IL)–1α, IL-1β, tumor necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were investigated in samples of the middle ear effusions (MEEs) from 144 ears with otitis media with effusion (OME) by enzyme-linked immunosorbent assay, followed by cytologic analysis. Middle ear effusions of the acute purulent type contained a significantly higher concentration of cytokines compared with normal control sera (p < .001). Cytokines were observed at lower levels in MEE in adults than in children. Tests of children at the chronic stage of MEE showed higher levels of TNF than IL-1 and GM-CSF. Meanwhile, IL-1β showed significantly higher concentrations in acute purulent types than in serous and mucoid types (p < .01). In cytologic analysis, the mean level of IL-1β was significantly higher in the neutrophil-rich group than in other groups (p < .05). Cytokines possess several biologic properties, some of which are associated not only with acute otitis media but also with chronic otitis media. This study showed that cytokines, especially IL-1β, contribute to infiltration into the middle ear by inflammatory cells. This implies that the persistent presence of cytokines in MEE could be a factor in prolonged OME.

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Antibody in Middle Ear Fluid of Children Originates Predominantly from Sera and Nasopharyngeal Secretions

Clinical and Vaccine Immunology ◽

10.1128/cvi.05443-11 ◽

2012 ◽

Vol 19 (10) ◽

pp. 1593-1596 ◽

Cited By ~ 15

Author(s):

Ravinder Kaur ◽

Thomas Kim ◽

Janet R. Casey ◽

Michael E. Pichichero

Keyword(s):

Middle Ear ◽

Acute Otitis Media ◽

Secretory Iga ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Two Dimensional Gel Electrophoresis ◽

Middle Ear Fluid ◽

Iga Antibodies ◽

Iga Antibody ◽

Entire Array

ABSTRACTThe human middle ear is devoid of any immunocompetent cells in normal mucosa. We sought to determine the source of antibody present in the middle ear of children. Total IgG, IgA, and secretory IgA antibodies were determined by enzyme-linked immunosorbent assay from the nasopharyngeal, middle ear, and serum samples of children with acute otitis media. The two-dimensional gel electrophoresis pattern of the entire array of IgA antibodies in the nasal wash (NW) and middle ear fluid (MEF) was compared from the MEF and NW samples using isoelectric focusing and Western blotting. The total IgG and IgA antibodies in the MEF and NW samples of 137 children were compared. The ratio of IgG to IgA in the MEF was significantly different (P< 0.008) compared to NW because IgA levels were higher and IgG levels lower in NW. The IgG/IgA ratio of MEF resembled serum consistent with transudation to the MEF. Small amounts of secretory IgA were detected in MEF but the electrophoresis patterns of the entire array of IgA antibodies in the MEF and NW were virtually identical in each child evaluated; thus, IgA in MEF derived predominantly from serum and the nasopharynx by reflux via the Eustachian tube. The IgG/IgA antibody levels in the MEF and the same composition of IgA antibody in the MEF and NW identifies the predominant source of antibody in the MEF as a transudate of serum combined with nasal secretions refluxed from the nasopharynx in children.

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Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211015741 ◽

2021 ◽

pp. 000348942110157

Author(s):

Jennifer L. McCoy ◽

Ronak Dixit ◽

R. Jun Lin ◽

Michael A. Belsky ◽

Amber D. Shaffer ◽

...

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Private Insurance ◽

Chronic Otitis Media ◽

The United States ◽

Socioeconomic Disparities ◽

Tube Placement ◽

Median Income ◽

Public Insurance ◽

Tympanostomy Tubes

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4

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Determinants of chronic otitis media with effusion in preschool children: a case–control study

BMC Pediatrics ◽

10.1186/s12887-016-0767-7 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 7

Author(s):

Rebecca E. Walker ◽

Jim Bartley ◽

David Flint ◽

John M. D. Thompson ◽

Edwin A. Mitchell

Keyword(s):

Preschool Children ◽

Otitis Media ◽

Case Control Study ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Case Control ◽

Control Study

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The Cephalic Index is not different among groups of children aged 36–48 months with chronic otitis media with effusion, recurrent acute otitis media and controls

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2012.11.002 ◽

2013 ◽

Vol 77 (3) ◽

pp. 334-337 ◽

Cited By ~ 5

Author(s):

Margaretha L. Casselbrant ◽

J. Douglas Swarts ◽

Ellen M. Mandel ◽

William J. Doyle

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

Chronic Otitis Media ◽

Cephalic Index ◽

Recurrent Acute Otitis Media

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Correlations between Antibody Immune Responses at Different Mucosal Effector Sites Are Controlled by Antigen Type and Dosage

Infection and Immunity ◽

10.1128/iai.68.7.3830-3839.2000 ◽

2000 ◽

Vol 68 (7) ◽

pp. 3830-3839 ◽

Cited By ~ 34

Author(s):

Dörthe Externest ◽

Barbara Meckelein ◽

M. Alexander Schmidt ◽

Andreas Frey

Keyword(s):

Cholera Toxin ◽

Plasma Cells ◽

Immunoglobulin A ◽

Secretory Iga ◽

Enzyme Linked Immunosorbent Assay ◽

Routine Diagnostics ◽

Significant Relationships ◽

Serum Igg ◽

Mucosal Surfaces ◽

Secretory Immunoglobulin

ABSTRACT Monitoring specific secretory immunoglobulin A (IgA) responses in the intestines after mucosal immunization or infection is impeded by the fact that sampling of small intestinal secretions requires invasive methods not feasible for routine diagnostics. Since IgA plasma cells generated after intragastric immunization are known to populate remote mucosal sites as well, secretory IgA responses at other mucosal surfaces may correlate to those in the intestines and could serve as proxy measures for IgA secretion in the gut. To evaluate the practicability of this approach, mice were immunized intragastrically with 0.2, 2, and 20 mg of ovalbumin plus 10 μg of cholera toxin, and the antigen-specific local secretory IgA responses in duodenal, ileal, jejunal, rectal, and vaginal secretions, saliva, urine, and feces, as well as serum IgG and IgA responses were analyzed by enzyme-linked immunosorbent assay. Correlation analysis revealed significant relationships between serum IgG and IgA, urinary IgA, salivary IgA, and secretory IgA in duodenal, jejunal, ileal, and rectal secretions for the 0.2-mg but not for the 20-mg ovalbumin dose. Fecal samples were poor predictors for intestinal antiovalbumin IgA responses, and no correlations could be established for cholera toxin, neither between local anti-cholera toxin levels nor to the antiovalbumin responses. Thus, specific IgA in serum, saliva, or urine can serve as a predictor of the release of specific IgA at intestinal surfaces after intragastric immunization, but the lack of correlations for high ovalbumin doses and for cholera toxin indicates a strong dependency on antigen type and dosage for these relationships.

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Determining Otitis Media Severity from Middle Ear Fluid Analysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894941030s512 ◽

1994 ◽

Vol 103 (5_suppl) ◽

pp. 43-45 ◽

Cited By ~ 30

Author(s):

Steven K. Juhn ◽

William J. Garvis ◽

Chap T. Le ◽

Chris J. Lees ◽

C. S. Kim

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Complex Nature ◽

Fluid Analysis ◽

Factor Α ◽

Necrosis Factor ◽

Ear Effusion ◽

Chemical Mediators

Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukrn-1β and tumor necrosis factor α) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation.

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