Role of nitric oxide, superoxide dismutase and cytokines as markers in childhood secretory otitis media

ABSTRACT

The aim of this study was to investigate the role of nitric oxide [NO], antioxidant enzyme activity [superoxide dismutase [SOD]] and cytokines [interleukin- 1 beta [IL- 1 beta], interleukin-6 [IL-6], interleukin-8 [IL-8], and tumor necrosis factor- alpha [TNF-alpha]] in pathogenesis of otitis media with effusion [OME] in children. Subjects and NO metabolites, SOD activity and cytokines concentration were measured in blood plasma and middle ear effusion [MEE] of 27 patients [46 ears] with secretary otitis media [SOM] [aged 1 -4 years] and in blood plasma of 10 healthy children of the same age, as a control group. MEE was classified macroscopically to, serous in 10 samples [21.73%], mucoid in 29 samples [63.04%] and purulent in 7 samples [15.21%]. The hearing loss with air-bone gap of 20-40 dB present in 66.6% of the patients. NO, SOD, IL-1 beta, IL-6, IL-8 and TNF-alpha were found in 89.1%, 82.6%, 86.9%, 84.7%, 80.4% and 52.2% of MEE, respectively. NO, SOD and cytokines were significantly higher in blood plasma and MEE samples of patients than in control group. This study showed that in serous fluid group, the concentration of IL-6 and IL-8 was remarkably higher than in both mucoid and purulent groups, but the concentration of NO, SOD and TNF-alpha was significantly lower than in both mucoid and purulent groups. IL-1 beta showed no significant difference between the previous three groups. The shorter the course of MEE, the higher the concentration of IL-6 and IL-8, and the longer the course of MEE, the higher the concentration of NO, SOD and TNF-alpha. Highly elevated levels of NO, SOD, IL-1 beta, IL-6, IL-8 and TNF-alpha in MEE indicate ongoing cytokines activation. IL-6 and IL-8 might participate in the defensive reaction of organism during the early stage of SOM, and play a role in serous effusion secretion. Finally, NO, SOD and some proinflammatory cytokines in the MEE could be important mediators in MEE of SOM in children and used to monitor the inflammatory process of otitis media