T(H)2 cytokine expression in atopic children with otitis media with effusion.
BACKGROUND
Otitis media with effusion (OME) is more common in atopic children. Few studies have looked for the presence of inflammatory mediators in the middle-ear effusions of this population.


OBJECTIVE
We hypothesize that atopic children with OME have a different inflammatory cell and cytokine profile than nonatopic patients with the disease.


METHODS
Twenty-six patients with OME undergoing myringotomy and ventilation tube placement were recruited at the McGill University Hospital Center. The atopic status was determined for each patient by using standard skin testing. By means of immunocytochemistry, fluid specimens were assessed for T lymphocytes (CD3), eosinophils (major basic protein), neutrophils (elastase), mast cells (tryptase), and basophils (BB1). By using in situ hybridization, the expression of IL-4, IL-5, and IFN-gamma was assessed.


RESULTS
There is a higher percentage of eosinophils and T lymphocytes in atopic patients with OME (n = 8) compared with that seen in nonatopic patients (n = 18, P <.01). There is a higher percentage of neutrophils in nonatopic patients with OME compared with that seen in atopic patients (P <.01). In examining cytokine profiles, there is a higher percentage of cells expressing IL-4 and IL-5 in atopic patients with OME compared with that seen in nonatopic patients (P <.01).


CONCLUSIONS
The predominance of eosinophils, T lymphocytes, and T(H)2 mediators in the middle-ear effusions of atopic children provides evidence that allergy might play a role in the pathogenesis of OME.
Sobol
Steven E
SE
Department of Otolaryngology, McGill University, Montreal, Quebec, Canada.
Taha
Rame
R
Schloss
Melvin D
MD
Mazer
Bruce D
BD
Manoukian
John J
JJ
Tewfik
Ted L
TL
Hamid
Qutayba
Q
D001491:Basophils / Q000276:immunology; D017252:CD3 Complex / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000096:biosynthesis*; D004804:Eosinophils / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology*; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D007223:Infant; D008407:Mast Cells / Q000276:immunology; D009504:Neutrophils / Q000276:immunology; D010034:Otitis Media with Effusion / Q000276:immunology / Q000503:physiopathology*; D018418:Th2 Cells / Q000276:immunology* / Q000378:metabolism
D017252:CD3 Complex; D016207:Cytokines