Cytokine mRNA Expression of Otitis Media with Effusion in Children / 대한이비인후과학회지

ABSTRACT

Otitis media with effusion(OME) is the most common cause of acquired hearing loss in children. Some children suffer from a chronic form of this disease known as chronic otitis media with effusion(COME), which is manifested by the retention of fluid and inflammatory products in the middle ear cleft and by the eustachian tube dysfunction. The etiology and pathogenesis of COME, however, have not been fully elucidated. Middle ear effusion(MEE) is a complex mixture of transudate, secretory products from glands of middle ear mucosa and products from inflammatory cells and infecting organisms. Recently, there has been a great interest in the pathogenetic roles of cytokines, a group of low molecular weight glycoproteins produced by macrophages, lymphocytes and other cells. Activities of cytokines include fever production, activation of osteoclasts, fibroblasts, phagocytes and cytotoxic cells, regulation of antibody formation and inhibition of growth of cartilage, bone and endothelial cells. In this study, we have utilized the reverse transcription polymerase chain reaction(RT-PCR) technique to determine accurately the existence of mRNAs for five cytokines in MEEs collected from 22 children with COME. Messenger RNAs for TNF-alpha, IL-1beta, IL-2 and IL-8 were detected in 68%, 86%, 59% and 95% of specimens, respectively, Interleukin-4 mRNA was absent in all the specimens. The persistent production of cytokines by the inflammatory cells in MEE of COME due to sustained presence of antigens or most-recent antigenic stimuli may play the central role in prolonged OME and responsible for the mucosal damage, bone erosion, fibrosis and resulting hearing loss seen in some cases of COME.