Characterization of otitis media with effusion based on the ratio of albumin and immunoglobulin G concentrations in the effusion.
OBJECTIVE
To characterize the groups of middle ear effusions (MEE) defined on the basis of the ratio of albumin and immunoglobulin G concentrations (A/G) in the effusion and to identify the correlation between these groups of MEE and the clinical features of otitis media with effusion (OME).


METHODS
A laboratory analysis of 88 samples of MEE and a retrospective analysis of the medical history of all patients was performed.


METHODS
Tertiary referral center.


METHODS
Thirty-three girls and 23 boys with OME were included in the study.


METHODS
The concentrations of albumin, immunoglobulins (IgG, IgA, and IgM), complement factors (C3, C4), and C-reactive protein were determined by means of nephelometry. Enzyme-linked immunosorbent assay was used to measure cytokines interferon-gamma, tumor necrosis factor alpha, interleukin (IL)-4, and IL-10 concentrations. Groups were defined according to A/G ratio in the effusions. Thirty-five children underwent allergy testing.


METHODS
Two groups of MEE could be recognized on the basis of A/G ratio; the ratio was lower than 0.7 in group A and was higher than 0.7 in group B.


RESULTS
Increased levels of interferon-gamma and tumor necrosis factor alpha were observed in group A, whereas IL-4 and IL-10 were dominating in group B. No association was found between the MEE groups and the clinical features of the disease or the atopic status of the patient.


CONCLUSIONS
These results suggest that various groups of OME can be categorized according to the differences in A/G ratio in the effusions. These differences can reflect the variances in the pathomechanism of the development of the effusion, the stage of the disease, or the clinical background of the patients.
Rezes
Szilárd
S
Department of Otorhinolaryngology/Head and Neck Surgery, and Autoimmune Research Group of the Hungarian Academy of Sciences, Health Science Center, University of Debrecen, Debrecen, Hungary. szrezes@freemail.hu
Késmárki
Katalin
K
Sipka
Sándor
S
Sziklai
István
I
D000233:Adenoidectomy / Q000706:statistics & numerical data; D000293:Adolescent; D000418:Albumins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005122:Exudates and Transudates / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007074:Immunoglobulin G / Q000276:immunology*; D007075:Immunoglobulin M / Q000276:immunology*; D007371:Interferon-gamma / Q000276:immunology*; D016753:Interleukin-10 / Q000276:immunology*; D015847:Interleukin-4 / Q000276:immunology*; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000276:immunology* / Q000378:metabolism* / Q000473:pathology; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000418:Albumins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma; D002097:C-Reactive Protein