title: Activated osteoclasts with CD51/61 expression in otosclerosis.
abstract: OBJECTIVE
  Stapes ankylosis is supposed to be a disease with variable histopathology caused by otosclerosis or pseudo-otosclerosis. Persistent measles virus infection of the otic capsule could induce reactivation of quiescent embryonic osteoclasts in otosclerosis.
  
  
  BACKGROUND
  Presence of measles virus RNA was demonstrated in the footplates of otosclerotic patients by reverse-transcription polymerase chain reaction (RT-PCR). Histology of active otosclerosis is featured by the presence of numerous osteoclasts with unknown phenotype.
  
  
  METHODS
  Nucleic acid was extracted from stapes footplates of clinically otosclerotic patients (n = 261). Genomic RNA of measles virus was amplified by RT-PCR. Amplification results were correlated to postoperative histologic and CD51/61 specific immunohistologic findings. A parallel alcalic phosphatase activity assessment was performed to evaluate the metabolic activity of osteoclasts in each section.
  
  
  RESULTS
  Among 261 stapes fixation cases, 175 otosclerotic stapes contained measles virus RNA. Histology for virus negative stapes (n = 86) represented nonotosclerotic, degenerative disorders. Histologically confirmed otosclerosis was featured by the presence of osteoclasts with renewed, embryonic phenotype. In otosclerosis, alcalic phosphatase activity was significantly higher compared with nonotosclerotic stapes ankylosis (P < .001).
  
  
  CONCLUSIONS
  The presence of CD51/61 positive osteoclasts in otosclerotic bone containing viral sequences provides the basis for an inflammatory bone remodeling disorder. Otosclerosis is a disease caused by persistent measles virus infection and reactivation of resting embryonic osteoclasts in the otic capsule.
authors.affiliation: Departments of Otolaryngology-Head and Neck Surgery, University Medical School of Debrecen, Nagyerdei Krt. 98, H-4012 Debrecen, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Karosi
authors.forename: István
authors.initials: I
authors.lastname: Jókay
authors.forename: József
authors.initials: J
authors.lastname: Kónya
authors.forename: Mihály
authors.initials: M
authors.lastname: Petkó
authors.forename: László Z
authors.initials: LZ
authors.lastname: Szabó
authors.forename: József
authors.initials: J
authors.lastname: Pytel
authors.forename: József
authors.initials: J
authors.lastname: Jóri
authors.forename: István
authors.initials: I
authors.lastname: Sziklai
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D000951:Antigens, Neoplasm / Q000032:analysis*; D000074301:CD52 Antigen; D006023:Glycoproteins / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D039661:Integrin beta3 / Q000032:analysis*; D008457:Measles / Q000150:complications; D008459:Measles virus / Q000235:genetics / Q000302:isolation & purification; D008875:Middle Aged; D010010:Osteoclasts / Q000473:pathology / Q000502:physiology*; D010040:Otosclerosis / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013199:Stapes / Q000737:chemistry
chemical_list: D015703:Antigens, CD; D000951:Antigens, Neoplasm; D000074301:CD52 Antigen; C000613862:CD52 protein, human; D006023:Glycoproteins; D039661:Integrin beta3; D012367:RNA, Viral