Viral RNA in middle ear mucosa and exudates in patients with chronic otitis media with effusion.
OBJECTIVE
To evaluate viral and cytokine signaling correlates of the persistent inflammation associated with chronic otitis media with effusion (OME).


METHODS
Prospective study.


METHODS
Reverse transcriptase-polymerase chain reaction targeting RNA viruses frequently associated with OME (respiratory syncytial virus and parainfluenza virus type 3, the proinflammatory cytokines interleukin 8 and interleukin 1beta, and RANTES [regulated upon activation, normal T cell expressed and secreted]) was performed on mucosal biopsy samples and on samples of the liquid and cellular compartments of inflammatory exudates obtained from 26 children (49 ears) with infected middle ears. Ribonucleic acid extracted from rapidly frozen samples was reverse transcribed by Moloney murine leukemia virus reverse transcriptase and amplified for 35 cycles using previously validated primers. Amplicons were evaluated by molecular size after agarose gel electrophoresis with ethidium bromide.


RESULTS
Most children had evidence of the presence of an RNA virus in at least one specimen. Respiratory syncytial virus was present in 40% and parainfluenza virus type 3 in 8% of effusions. Interleukin 8 messenger RNA was present in 21% of inflammatory exudates but never in cells from the mucosal biopsy samples.


CONCLUSIONS
Our data support a viral contribution to the cause of OME and suggest that the inflammatory cytokines observed derive more from cells in the inflammatory exudate than from those in the middle ear mucosa.
Moyse
E
E
Département d'ORL et de Chirurgie Cervico-Faciale, Hôpital E. Herriot, 69003 Lyon, France.
Lyon
M
M
Cordier
G
G
Mornex
J F
JF
Collet
L
L
Froehlich
P
P
D001706:Biopsy; D018946:Chemokine CCL5 / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004432:Ear, Middle / Q000737:chemistry* / Q000821:virology; D005122:Exudates and Transudates / Q000737:chemistry* / Q000821:virology; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D009092:Mucous Membrane / Q000737:chemistry / Q000821:virology; D010034:Otitis Media with Effusion / Q000821:virology*; D010224:Parainfluenza Virus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis*; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification*
D018946:Chemokine CCL5; D007375:Interleukin-1; D016209:Interleukin-8; D012333:RNA, Messenger; D012367:RNA, Viral