title: Younger patients with COME are more likely to have mucoid middle ear fluid containing mucin MUC5B.
abstract: BACKGROUND
  Chronic otitis media (COM) is one of the most common childhood diseases. Its pathophysiology is complex and multifactorial. The role of specific mucin glycoprotein subtypes in OM is only recently being elucidated.
  
  
  OBJECTIVE
  To determine the relationship between middle ear fluid mucins and clinical variables of patients needing tympanostomy tubes (TT).
  
  
  METHODS
  Middle ear effusions (MEE) from children receiving TT were collected over a 2-year period. Western blot characterization of mucins MUC5B and MUC5AC along with chart review of age, gender, effusion viscosity, hearing loss >30 dB, history of allergies, and/or respiratory disease were performed.
  
  
  RESULTS
  MEE samples from 58 patients were available for analysis. Overall, MUC5B was significantly more often detected in middle ear fluid relative to MUC5AC (90% vs. 51%, p = 0.005). MUC5B presence was statistically associated with mucoid effusions relative to serous effusions (100% vs. 57%, p = 0.0064), MUC5AC presence was not significantly different in mucoid and serous fluid (55.1% vs. 37.5%, p = 0.447). Patients younger than 48 months were more likely to present with mucoid effusion, compared to those older than 48 months of age (p = 0.038). Finally, patients with effusions positive for MUC5B were younger than those with effusions negative for MUC5B (35.1 vs. 76 months, p = 0.045). No other variables correlated to either effusion viscosity or specific mucin content.
  
  
  CONCLUSIONS
  Patients younger in age needing TT placement are more likely to present with mucoid effusions, predominantly containing MUC5B mucin. As such, we postulate a distinct pathophysiology for mucoid and serous effusions across ages in children with COM.
authors.affiliation: George Washington University, Institute of Biomedical Sciences, Washington, DC, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Duah
authors.affiliation: Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Val
authors.affiliation: Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA.
authors.forename: Christie
authors.initials: C
authors.lastname: DeMason
authors.affiliation: Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA. Electronic address: marianpoley@gmail.com.
authors.forename: Marain
authors.initials: M
authors.lastname: Poley
authors.affiliation: Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA. Electronic address: dpreciad@cnmc.org.
authors.forename: Diego
authors.initials: D
authors.lastname: Preciado
mesh_terms: D000367:Age Factors; D015153:Blotting, Western; D002675:Child, Preschool; D002908:Chronic Disease; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D055271:Mucin 5AC / Q000378:metabolism*; D055257:Mucin-5B / Q000378:metabolism*; D010033:Otitis Media / Q000378:metabolism / Q000601:surgery; D010034:Otitis Media with Effusion / Q000378:metabolism* / Q000601:surgery; D014783:Viscosity
chemical_list: C524678:MUC5AC protein, human; C524578:MUC5B protein, human; D055271:Mucin 5AC; D055257:Mucin-5B
keywords: Chronic otitis media with effusion; MUC5AC; MUC5B; Mucous; Serous