title: Role of innate immunity in the pathogenesis of otitis media.
abstract: Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.
authors.affiliation: Department of Otolaryngology, University of Miami - Miller School of Medicine, 1601 NW 12th Avenue, Miami, FL 33136, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Mittal
authors.affiliation: Department of Otolaryngology, University of Miami - Miller School of Medicine, 1601 NW 12th Avenue, Miami, FL 33136, USA.
authors.forename: Joyson
authors.initials: J
authors.lastname: Kodiyan
authors.affiliation: Department of Otolaryngology, University of Miami - Miller School of Medicine, 1601 NW 12th Avenue, Miami, FL 33136, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gerring
authors.affiliation: Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
authors.forename: Kalai
authors.initials: K
authors.lastname: Mathee
authors.affiliation: Center for Inflammation, Immunity, and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, USA.
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Li
authors.affiliation: Department of Otolaryngology, University of Miami - Miller School of Medicine, 1601 NW 12th Avenue, Miami, FL 33136, USA.
authors.forename: M'hamed
authors.initials: M
authors.lastname: Grati
authors.affiliation: Department of Otolaryngology, University of Miami - Miller School of Medicine, 1601 NW 12th Avenue, Miami, FL 33136, USA. Electronic address: xliu@med.miami.edu.
authors.forename: Xue Zhong
authors.initials: XZ
authors.lastname: Liu
mesh_terms: D004432:Ear, Middle / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D010033:Otitis Media / Q000276:immunology* / Q000382:microbiology
keywords: Epithelial cells; Innate immunity; Mucin; Otitis media