title: Higher serum levels of interleukin 10 occur at onset of acute otitis media caused by Streptococcus pneumoniae compared to Haemophilus influenzae and Moraxella catarrhalis.
abstract: OBJECTIVE
  Acute otitis media (AOM) involves an inflammatory response to microbes in the middle ear that facilitates clearance of otopathogens. Clinically, Streptococcus pneumoniae (Spn) infections of the respiratory tract are characterized by greater inflammatory responses than nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat). Interleukin 10 (IL-10) plays an important role in down-regulating the inflammatory response. We compared serum IL-10 levels in children before onset, at onset, and after recovery from AOM caused by Spn, NTHi, and Mcat. We sought to determine if IL-10 could serve as a biomarker to distinguish AOM caused by Spn versus NTHi and Mcat.
  
  
  METHODS
  Prospective, longitudinal study in a primary care pediatric practice in Rochester, NY.
  
  
  METHODS
  Participants were 54 children, 6 to 30 months of age. Outcomes measured were serum IL-10 levels when healthy, at onset of AOM, and after recovery from AOM.
  
  
  RESULTS
  Serum IL-10 was elevated when children developed AOM (P=0.013) due to infections caused by Spn (P=0.011) but not AOM caused by NTHi or Mcat. Middle ear fluid levels of IL-10 mirrored those seen in serum but were 10-fold higher (P=0.02). Other effector cytokines in serum: IL-4, IFN-γ, and TNF-alpha, did not show the same increases as IL-10 at onset of AOM.
  
  
  CONCLUSIONS
  Our study indicates that AOM caused by Spn elicits a significantly higher IL-10 response compared to NTHi and Mcat and may prove to be a biomarker of AOM infections by Spn.
authors: Rochester General Hospital Research Institute, Rochester, New York 14621, USA.
authors: Keyi
authors: K
authors: Liu
authors: Ravinder
authors: R
authors: Kaur
authors: Anthony
authors: A
authors: Almudevar
authors: Michael E
authors: ME
authors: Pichichero
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D004432:Ear, Middle / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006192:Haemophilus Infections / Q000097:blood / Q000382:microbiology; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000097:blood*; D008297:Male; D001936:Moraxella catarrhalis / Q000302:isolation & purification*; D045828:Moraxellaceae Infections / Q000097:blood / Q000382:microbiology; D010033:Otitis Media / Q000097:blood* / Q000382:microbiology; D011008:Pneumococcal Infections; D011446:Prospective Studies; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D015415:Biomarkers; D016753:Interleukin-10
references: J Infect Dis. 1996 Nov;174(5):994-1000
references: 8896500
references: Clin Infect Dis. 2004 Jan 15;38(2):234-42
references: 14699456
references: Microbes Infect. 2012 Jul;14(7-8):600-9
references: 22306269
references: Pediatr Infect Dis J. 2008 Oct;27(10):929-33
references: 18724267
references: Clin Exp Immunol. 1997 Aug;109(2):233-41
references: 9276517
references: Pediatr Infect Dis J. 2012 Mar;31(3):e56-8
references: 22198825
references: Clin Vaccine Immunol. 2010 Dec;17(12):1909-16
references: 20926702
references: Eur J Pediatr. 2007 Mar;166(3):223-8
references: 16967296
references: Pediatr Infect Dis J. 1999 Oct;18(10):942-4
references: 10530598
references: Ann Otol Rhinol Laryngol. 1998 Jan;107(1):28-33
references: 9439385
references: Pediatrics. 2004 May;113(5):1451-65
references: 15121972
references: Eur J Immunol. 2006 Feb;36(2):380-8
references: 16365913
references: Pediatr Infect Dis J. 2013 Jan;32(1):27-31
references: 23241988
references: Pediatr Infect Dis J. 2011 Aug;30(8):645-50
references: 21487325
references: Pediatr Infect Dis J. 2010 Apr;29(4):304-9
references: 19935445
references: Eur Arch Otorhinolaryngol. 2000;257(6):323-6
references: 10993552
references: J Infect Dis. 2012 Apr 15;205(8):1225-9
references: 22383675
references: Chin Med J (Engl). 2009 Sep 20;122(18):2149-54
references: 19781301
references: Int J Pediatr Otorhinolaryngol. 2008 Jan;72(1):13-7
references: 17976828
references: Clin Exp Immunol. 2002 Sep;129(3):438-45
references: 12197884
references: Pediatrics. 2007 Oct;120(4):814-23
references: 17908769
references: Kulak Burun Bogaz Ihtis Derg. 2004;13(3-4):51-6
references: 16055981
references: J Infect Dis. 2011 Aug 15;204(4):645-53
references: 21791667
references: J Interferon Cytokine Res. 2010 Jan;30(1):23-32
references: 20028205
references: Cytokine Growth Factor Rev. 2010 Oct;21(5):331-44
references: 21115385
references: Am J Dis Child. 1992 Apr;146(4):433-5
references: 1558077
references: Pediatrics. 1998 Aug;102(2 Pt 1):296-9
references: 9685429
references: Int J Pediatr Otorhinolaryngol. 2008 Feb;72(2):209-14
references: 18055023
references: FEMS Immunol Med Microbiol. 2012 Aug;65(3):439-47
references: 22463053
references: Pediatr Infect Dis J. 2011 Feb;30(2):95-9
references: 20711085
references: Am J Epidemiol. 2003 Feb 15;157(4):364-75
references: 12578807