Compositional difference in middle ear effusion: mucous versus serous.
OBJECTIVE
Serous otitis media is usually responsive to medical treatment, whereas mucoid otitis media is not. The present study was undertaken to elucidate the compositional difference between serous and mucoid effusion and to investigate whether MUC5AC acts as a major mucin in the middle ear mucosa with mucoid otitis media.


METHODS
This study involved a chemical analysis of middle ear effusion and immunostaining of the middle ear mucosa.


METHODS
Middle ear effusion samples were collected from 27 patients with mucoid otitis media and 18 patients with serous otitis media. The levels of mucin, lysozyme, secretory immunoglobulin A, and interleukin-8 were measured by dot blotting or enzyme-linked immunosorbent assay. Periodic acid-Schiff and immunohistochemical staining with monoclonal anti-MUC5AC antibody were performed on the serial sections of middle ear mucosa with mucoid otitis media.


RESULTS
Mucoid effusions contained higher levels of mucin, lysozyme, secretory immunoglobulin A, and interleukin-8 than did serous effusions. Immunohistological study revealed that MUC5AC mucin was expressed in only a small portion of the goblet cells of middle ear mucosa with mucoid otitis media.


CONCLUSIONS
The study suggests that both serous secretions and mucin might make the middle ear effusion more viscous and that mucins other than MUC5AC might have a major role in the viscosity of middle ear effusion. Further study is necessary to identify the major mucins in the middle ear effusion of otitis media with effusion.
Chung
Myung-Hyun
MH
Department of Otorhinolaryngology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea.
Choi
Jae Young
JY
Lee
Won-Sang
WS
Kim
Hee-Nam
HN
Yoon
Joo-Heon
JH
D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000473:pathology; D005260:Female; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D055271:Mucin 5AC; D009077:Mucins / Q000032:analysis; D009092:Mucous Membrane / Q000473:pathology; D009093:Mucus / Q000737:chemistry*; D009113:Muramidase / Q000032:analysis; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000473:pathology; D014783:Viscosity
D007071:Immunoglobulin A, Secretory; D016209:Interleukin-8; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D009077:Mucins; D009113:Muramidase