Effect of bacterial endotoxin and middle ear effusion on ciliary activity: implications for otitis media.
OBJECTIVE
Otitis media with effusion (OME) is the most common cause of childhood deafness. The pathogenesis is not fully understood, especially the reasons for failure of mucociliary clearance of the middle ear. It is not clear whether the cilia function normally in the middle ear and eustachian tube in the chronic phase of otitis media with effusion. However, impaired ciliary function in primary ciliary dyskinesia is known to be frequently associated with the development of otitis media with effusion. We hypothesized that endotoxin or the bacterial products in middle ear fluid in otitis media with effusion would adversely affect ciliary activity, thereby contributing to the pathogenesis of the disease.


METHODS
Laboratory-based study of human ciliary activity with reference to otitis media with effusion.


METHODS
We have studied the activity of human adenoidal cilia under various conditions. Ciliary activity in the presence of Haemophilus influenzae endotoxin additions (at varying concentrations) to cultured adenoidal explants has been measured. In addition, ciliary activity of these explants was also observed after addition of middle ear effusion aspirated from patients.


RESULTS
We have shown that endotoxin in concentrations far in excess of those found in the middle ear with chronic otitis media with effusion had no effect on ciliary activity. Furthermore, ciliary activity was completely unaffected by the presence of middle ear effusion.


CONCLUSIONS
There is no evidence that ciliary activity is reduced by the constituents of middle ear fluid in chronic otitis media with effusion.
Mason
Paul S
PS
Department of Otorhinolaryngology, Southampton University Hospitals Trust, UK.
Adam
Elizabeth
E
Prior
Matthew
M
Warner
John O
JO
Randall
Christopher J
CJ
D000234:Adenoids / Q000166:cytology*; D002648:Child; D002923:Cilia / Q000502:physiology; D004432:Ear, Middle; D004731:Endotoxins / Q000494:pharmacology*; D006193:Haemophilus influenzae; D006801:Humans; D008876:Middle Ear Ventilation; D009079:Mucociliary Clearance / Q000502:physiology*; D010034:Otitis Media with Effusion / Q000209:etiology / Q000503:physiopathology*; D012486:Salmonella typhimurium
D004731:Endotoxins