title: Antigenic as well as nonantigenic stimuli induce similar middle ear responses in the rat.
abstract: OBJECTIVE
  The observation that during otitis media many different types of micro-organisms have been cultured from effusions indicate that, once present in the middle ear cavity, most types of micro-organisms are able to trigger an inflammatory reaction leading to otitis media. The present study was designed to determine the middle ear response after injection of different substances into the middle ear cavity.
  
  
  METHODS
  To determine whether and to what extent an inflammatory response of the middle ear depends on the entering agent, the response in the tympanic cavity was studied by otomicroscopy and histological examination after inoculation of various substances.
  
  
  METHODS
  Lewis rats were inoculated in transtympanic fashion either with live or heat-killed bacteria (pathogenic and nonpathogenic), Keyhole limpet hemocyanin, active charcoal, or saline. The mucosal response of the challenged middle ears was studied histologically.
  
  
  RESULTS
  Irrespective of the inoculated substance, no essential differences in the mucosal response were found. The intensity of the inflammatory response was greater when live bacteria were inoculated.
  
  
  CONCLUSIONS
  The present study demonstrates that any substance reaching the middle ear cavity is likely to induce otitis media. These observations emphasize the role of the eustachian tube as "porte d'entrée" in the pathogenesis of this disorder. Determination of specific aspects of the eustachian tube involved in protection or in facilitating bacterial translocation will be important for the understanding of the pathogenesis of otitis media and the subsequent development of new therapeutic strategies. In addition, elucidation of bacterial factors involved in the process of colonization and translocation will be of equal importance.
authors.affiliation: Department of Otorhinolaryngology, University Medical Center St. Radboud, Nijmegen, The Netherlands. E.Tonnaer@KNO.UMCN.NL
authors.forename: Edith L G M
authors.initials: EL
authors.lastname: Tonnaer
authors.forename: Koen J A O
authors.initials: KJ
authors.lastname: Ingels
authors.forename: Ger T
authors.initials: GT
authors.lastname: Rijkers
authors.forename: Jo H A J
authors.initials: JH
authors.lastname: Curfs
mesh_terms: D000818:Animals; D000941:Antigens / Q000008:administration & dosage; D002606:Charcoal / Q000008:administration & dosage; D004432:Ear, Middle / Q000473:pathology*; D004487:Edema / Q000473:pathology; D005064:Eustachian Tube / Q000503:physiopathology; D005260:Female; D006433:Hemocyanins / Q000008:administration & dosage; D007249:Inflammation; D007267:Injections; D008974:Mollusca; D009092:Mucous Membrane / Q000473:pathology; D010034:Otitis Media with Effusion / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D011008:Pneumococcal Infections / Q000473:pathology / Q000503:physiopathology; D051381:Rats; D011917:Rats, Inbred Lew; D013296:Streptococcus pneumoniae; D013298:Streptococcus sanguis
chemical_list: D000941:Antigens; D002606:Charcoal; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin