title: Antigen-specific IgE in middle ear effusion of patients with eosinophilic otitis media.
abstract: BACKGROUND
  Eosinophilic otitis media (EOM) is an intractable otitis media characterized by a highly viscous effusion that contains eosinophils. We previously reported that high levels of IgE were detected in middle ear effusion (MEE) of patients with EOM.
  
  
  OBJECTIVE
  To examine antigen-specific IgE in MEE of patients with EOM to clarify the pathogenesis of EOM.
  
  
  METHODS
  Twenty-six patients with EOM associated with bronchial asthma were included in this study. Antigen-specific IgE against inhalant and bacterial antigens were measured in the serum and MEE of these patients.
  
  
  RESULTS
  In patients with EOM, 1 or more antigen-specific IgEs were detected from the MEE of 16 of 26 patients (62%), whereas 1 of 9 control patients (11%) had antigen-specific IgE (P < .01). Total serum IgE concentrations were not different between the groups who tested positive (16 patients) and negative (10 patients) for antigen-specific IgE. None of the fungi-specific IgEs were detected in serum even though 11 patients tested positive for 1 or more fungal antigens detected in MEE. The severity score of EOM in the antigen-specific IgE-positive group was significantly higher than that in the antigen-specific IgE-negative group (P < .05).
  
  
  CONCLUSIONS
  Antigen-specific IgE against inhalant and bacterial antigens may be locally produced in the middle ear mucosa in patients with EOM. In particular, local sensitization against fungi together with Staphylococcus aureus could result in local IgE production in the middle ear and may be responsible for the severity of EOM.
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan. Electronic address: yiino@jichi.ac.jp.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology*; D000946:Antigens, Fungal / Q000276:immunology*; D001249:Asthma / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000473:pathology; D004432:Ear, Middle / Q000276:immunology / Q000473:pathology; D004804:Eosinophils / Q000276:immunology* / Q000473:pathology; D005260:Female; D005658:Fungi / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000276:immunology
chemical_list: D000942:Antigens, Bacterial; D000946:Antigens, Fungal; D007073:Immunoglobulin E