title: Expression of epidermal growth factor, tumor necrosis factor-alpha, and interleukin-1alpha in chronic otitis media with or without cholesteatoma.
abstract: OBJECTIVE
  The object of this study was to compare the expression of epidermal growth factor, interleukin-1alpha, and tumor necrosis factor-alpha in chronic otitis media with or without cholesteatoma.
  
  
  BACKGROUND
  It has been reported that cytokines and epidermal growth factor are effective in the bone resorption process in chronic otitis media. Bone resorption can also occur in chronic otitis media without cholesteatoma. However, comparative analysis is lacking. This issue has been investigated in a blind, controlled and prospective analysis.
  
  
  METHODS
  The activities of interleukin-1alpha, tumor necrosis factor-alpha, and epidermal growth factor were determined by commercially available enzyme-linked immunosorbent assay kits in tissue biopsy samples from 16 patients without cholesteatoma and from 23 patients with cholesteatoma (cholesteatoma epithelium). To establish a control group, external auditory canal skin was randomly collected from two groups (21 patients). The Mann-Whitney and Kruskal-Wallis tests were used for statistical analysis.
  
  
  RESULTS
  The levels of interleukin-1alpha, tumor necrosis factor-alpha, and epidermal growth factor in tissue samples from the group with cholesteatoma were significantly greater than those in the group without cholesteatoma and the control group. No correlation was observed with other clinical factors such as age, sex, and antibiotic coverage.
  
  
  CONCLUSIONS
  Higher levels of cytokines in patients with cholesteatoma confirm that the destructive behavior of cholesteatoma is likely mediated by cytokines and epidermal growth factor and is the result of keratinocyte activity. Antibiotic treatment does not affect the level of cytokine concentration in patients with chronic otitis media and cholesteatoma, although the ear discharge subsides and inflammation-related symptoms regress in some cases.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey. syetiser@yahoo.com
authors.forename: Sertac
authors.initials: S
authors.lastname: Yetiser
authors.forename: Bulent
authors.initials: B
authors.lastname: Satar
authors.forename: Nizamettin
authors.initials: N
authors.lastname: Aydin
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001862:Bone Resorption / Q000378:metabolism; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D002908:Chronic Disease; D004431:Ear, External / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D004815:Epidermal Growth Factor / Q000378:metabolism*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D004815:Epidermal Growth Factor