title: Association of otitis media with effusion and allergy as demonstrated by intradermal skin testing and eosinophil cationic protein levels in both middle ear effusions and mucosal biopsies.
abstract: This study was performed to ascertain the role of allergy, as defined by skin testing and histochemical markers, in the pathogenesis of otitis media with effusion (OME). A historical perspective of allergy as it relates to OME is presented. The study included 89 patients: 48 with persistent effusion but no recent acute infection, 25 with purulent OME complicated by a superimposed infection, and 16 control subjects. All 89 patients had persistent effusion for more than 2 months and subsequently required the placement of tympanostomy tubes. Allergy was defined using the radioallergosorbent test (RAST), serum immunoglobulin E (IgE) levels, and skin tests. Allergies were present in 97% of the patients with nonacute OME. The relationship between allergy and OME was corroborated clinically in 89% of patients and was also substantiated by elevated levels of effusion eosinophil cationic protein (ECP) in 87.5% of OME patients. Histologically, polyclonal antibody staining for ECP demonstrated the presence of eosinophils in middle ear mucosal biopsy specimens. This study confirms that OME is a sign of allergic inflammation in the middle ear that is associated with an increase in eosinophils and a concomitant release of ECP into the effusion in individuals with allergy demonstrated by skin testing.
authors.affiliation: Department of Clinical Chemistry, Uppsala University, Sweden.
authors.forename: D S
authors.initials: DS
authors.lastname: Hurst
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001798:Blood Proteins / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D047091:Eosinophil Granule Proteins; D006801:Humans; D006967:Hypersensitivity / Q000150:complications*; D007223:Infant; D018836:Inflammation Mediators / Q000032:analysis*; D007428:Intradermal Tests; D009092:Mucous Membrane / Q000473:pathology; D010034:Otitis Media with Effusion / Q000276:immunology* / Q000473:pathology; D011852:Radioallergosorbent Test; D012260:Ribonucleases
chemical_list: D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D012260:Ribonucleases