Submitted to: Otolaryngology Head and Neck Surgery
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/1/2003
Publication Date: 2/1/2004
Citation: RUSSO, E., SMITH, W.C., FRIEDMAN, E.M., SMITH, O.E., KAPLAN, S.L. CELL ADHESION MOLECULES AND CYTOKINES IN MIDDLE EAR EFFUSIONS IN CHILDREN WITH OR WITHOUT RECENT ACUTE OTITIS MEDIA. OTOLARYNGOLOGY HEAD AND NECK SURGERY. 2004. Interpretive Summary: This study was designed to determine if mediators of inflammation could be detected in the fluid surgically drained from the middle ear in children with and without acute middle ear infections. Several inflammatory mediators were detected in the middle ear fluids, but one inflammatory hormone, interleukin 6 (IL-6) was found to be a potentially important mediator since its concentration correlated with the degree of hearing loss measured in the children.
Technical Abstract: OBJECTIVES: We sought to compare the levels of cytokines and cell adhesion molecules in middle ear effusions (MEEs) of children with (group 1) or without (group 2) acute otitis media (AOM) within 3 months of obtaining MEE and to correlate these levels with hearing loss. DESIGN AND SUBJECTS: MEE were collected from children (49 and 51 children composed groups 1 and 2, respectively) with otitis media with effusion (OME) undergoing tube placement who had an audiogram performed preoperatively. MEE was assessed as serous or mucoid. Cytokines and cell adhesion molecules were measured by enzymelinked immunosorbent assay. Data were analyzed with the Student t test, x2 test, and the Pearson correlation test. RESULTS: Concentrations of interleukin (IL)-1, IL-6, and vascular cell adhesion molecules (VCAM) were greater in the MEE of the children in group 1 compared with those of group 2 children. (P < 0.001 for IL-1 and IL-6; P < 0.05 for VCAM). The concentrations of IL-1, IL-6, VCAM, and E-selectin were greater in serous than in mucoid MEE. (P < 0.05). Concentrations of IL-6 correlated with the concentrations of the other 2 cytokines and the 3 cell adhesion molecules. Only concentrations of IL-6 in MEE correlated with the degree of hearing loss (P < 0.002). CONCLUSIONS: The inflammatory response leading to OME involves multiple cytokines regardless of an AOM episode in the 3 months before obtaining MEE. IL-6 is an important cytokine in the pathogenesis of OME.