Comparative analysis of middle ear immune response and micronutrient level between mucoid and purulent otitis media.
OBJECTIVE
To determine the differences in the outcome of treatment, the middle ear immune response, and micronutrient status between patients with purulent (POM) and mucoid (MOM) otitis media.


METHODS
Children with acute otitis media were recruited, treated, and followed up for between 6 and 10 months. The sera and middle ear secretion (MES) were analyzed for immunoglobulins and zinc using enzyme-linked immunoassay and flame atomic absorption spectrophotometry, respectively. The parameters were compared with selected healthy controls.


METHODS
There were 399 participants: 228 children with acute otitis media selected using the American Academy of Otolaryngology-Head and Neck Surgery criteria and 171 healthy controls, with ages ranging between 6 months and 9 years (mean 7 years; SD 2.32 years).


RESULTS
POM accounted for 126 of 228 patients, and MOM accounted for 102. The chronicity of otitis media (using the 3-month duration cutoff) was seen in 87 subjects (46%): 31 of 126 POM subjects and 56 of 102 MOM subjects (p = .002). The serum IgA to IgG ratios were 0.03 and 0.07 among POM and MOM, respectively; however, the MES IgA to IgG ratios were higher, 0.3 and 0.2, for POM and MOM, respectively. This gives a MES to serum ratio of IgA to IgG value of 0.3 to 0.03 (10) for POM and 0.2 to 0.07 (2.67) for MOM, which showed a significant statistical difference (p = .001). The MES to serum ratios of IgE were 0.89 and 1.3 among POM and MOM, respectively (p = .03). There was a significant difference in the serum IgG (p = .019), serum zinc (p = .009), and MES IgA (p = .028) and IgG (p = .01).


CONCLUSIONS
Chronicity was greater in MOM than in POM; POM had a higher middle ear immune response (measured by the MES to serum ratio of IgA to IgG) and serum zinc than MOM but a lower MES IgE.
Lasisi
Akeem O
AO
Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria. akeemlasisi@gmail.com
D012634:Bodily Secretions / Q000737:chemistry; D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood; D007074:Immunoglobulin G / Q000032:analysis / Q000097:blood; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000032:analysis* / Q000276:immunology; D009093:Mucus; D010033:Otitis Media / Q000097:blood / Q000276:immunology* / Q000628:therapy; D010035:Otitis Media, Suppurative / Q000097:blood / Q000276:immunology / Q000628:therapy; D044967:Serum / Q000737:chemistry; D016896:Treatment Outcome; D015032:Zinc / Q000032:analysis
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D018977:Micronutrients; D015032:Zinc