Role of cell mediated immune response in pathogenesis of cholesteatoma

ABSTRACT

The role of cell mediated immune [CMI] response in the initiation of aural cholesteatoma was studied. Migration inhibition test [MI1] was done for 20 patients with cholesteatoma, 10 with tubotympanic chronic otitis media and 10 normal subjects, using cholesteatoma matrix as an antigen. All cholesteatoma patients had significant positive leucocyte migration inhibition response compared to the other 2 groups [P<0.05], indicating a specific antigenicity and confirming the presence of CMI response in such patients. The level of leucocyte migration inhibition factor [LMIF] was significantly correlated with extension of the disease. In the mastoid disease, LMIF was higher than that in the localized attic one [P<0.05], indicating a relationship between the degree of immunological status and extent of cholesteatoma. Other parameters such as age, sex duration of the disease, recurrence or complications did not correlate with LMIF values. The bone resorption in cholesteatoma has been explained by the occurrence of CMI response, against cholesteatoma antigen, resulting in the release of many chemical mediators that might have a lytic activity. Further studies are recommended