[The influence of interleukin gene polymorphism on the serum cytokine level in the patients presenting with chonic suppurative otitis media]. / Vliianie polimorfizma genov interleikinov i faktora nekroza opukholei na uroven' tsitokinov v syvorotke krovi u bol'nykh khronicheskim gnoinym srednim otitom.

The objective of the present work was to study the influence of allelic variant associations of 1-beta interleukin (C3953T, &511C, T31C), interleukin-6 (C174G), and tumour necrosis factor-alpha (G308A) gene polymorphisms on the serum cytokine level in the patients presenting with chronic suppurative otitis media. A total of 299 patients at the age varying from 16 to 55 years with this condition divided into three groups were examined. Group 1 was comprised of 146 patients suffering from the tubotympanic form of chronic suppurative otitis media (CSOM). Group 2 was composed of 153 patients with epitympanic antral form of this condition. The control group included 183 subjects who have never suffered pathological changes in the middle ear. Human genomic DNA was analyzed with the use of the polymerase chain reaction (PCR). The serum cytokine levels were measured by the solid-state enzyme immunoassay in the beginning and at the end of the treatment period. The study has demonstrated that 56.2% of the healthy residents of the trans-Baikal region had the C/T Il-1b (C3953T) genotype. 79.1% of the patients presenting with the carious carious-destructive form of chronic suppurative otitis media were the heterozygous carriers of the T511C gene of 1-beta interleukin and had the maximally high concentrations of this interleukin in the blood serum. A rise in the production of the pro-inflammatory mediator (IL-6) was found to be related to the severity of the inflammatory process in the middle ear. The TNF-alpha content in the patients with CSOM during the active period of the disease proved to increase by a factor of 6 in comparison with that in the subjects of the control group irrespective of the type of mutation.

Comparative analysis of middle ear immune response and micronutrient level between mucoid and purulent otitis media.

OBJECTIVE: To determine the differences in the outcome of treatment, the middle ear immune response, and micronutrient status between patients with purulent (POM) and mucoid (MOM) otitis media. DESIGN: Children with acute otitis media were recruited, treated, and followed up for between 6 and 10 months. The sera and middle ear secretion (MES) were analyzed for immunoglobulins and zinc using enzyme-linked immunoassay and flame atomic absorption spectrophotometry, respectively. The parameters were compared with selected healthy controls. SUBJECTS: There were 399 participants: 228 children with acute otitis media selected using the American Academy of Otolaryngology-Head and Neck Surgery criteria and 171 healthy controls, with ages ranging between 6 months and 9 years (mean 7 years; SD 2.32 years). RESULT: POM accounted for 126 of 228 patients, and MOM accounted for 102. The chronicity of otitis media (using the 3-month duration cutoff) was seen in 87 subjects (46%): 31 of 126 POM subjects and 56 of 102 MOM subjects (p = .002). The serum IgA to IgG ratios were 0.03 and 0.07 among POM and MOM, respectively; however, the MES IgA to IgG ratios were higher, 0.3 and 0.2, for POM and MOM, respectively. This gives a MES to serum ratio of IgA to IgG value of 0.3 to 0.03 (10) for POM and 0.2 to 0.07 (2.67) for MOM, which showed a significant statistical difference (p = .001). The MES to serum ratios of IgE were 0.89 and 1.3 among POM and MOM, respectively (p = .03). There was a significant difference in the serum IgG (p = .019), serum zinc (p = .009), and MES IgA (p = .028) and IgG (p = .01). CONCLUSION: Chronicity was greater in MOM than in POM; POM had a higher middle ear immune response (measured by the MES to serum ratio of IgA to IgG) and serum zinc than MOM but a lower MES IgE.

[Interpretation of leukocyte count in acute purulent otitis media in infants]. / Interpretatsiia leikogrammy pri ostrom gnoinom srednem otite u detei grudnogo vozrasta.

Interpretation of leukograms of 181 infants with acute otitis media purulenta (OMP) has shown that these patients had leukopenia in 15.5%, normal leukocyte count in 66.3%, leukocytosis in 6.6%, neither neutrophylesis with a left shift nor toxic granularity of leukocytes, neutropenia in 13.8%, neutrophylesis in 5%, monocytopenia in 87.8%, normal lymphocyte count in 78.6%, lymphocytopenia in 21.2%. The leukograms of the infants with acute OMP evidence for low tension of normal adaptation reactions. This may help in assessment of the efficacy of on-going treatment.

[Blood group-dependent efficiency of immunological correction in patients with chronic purulent otitis media]. / Zavisimost' éffektivnosti immunokorrektsii ot grupp krovi u bol'nykh khronicheskim gnoinym srednim otitom.

Clinical and immunological investigations were performed in 300 patients with otitis media chronica purulenta. The patients, aged 16-65 years, received immunocorrectors in addition to basic postoperative therapy consisting of antibiotics and antihistamine drugs. The highest immunocorrective effect was registered in patients with blood group AI, the weakest in those with blood group AB(IV). Blood group B(III) and A(II) were the second and the third.

Systemic absorption of gentamicin ear drops.

Aminoglycoside-containing topical preparations are commonly used in the treatment of chronic suppurative otitis media and otitis externa. We report a case where systemic absorption of topical Gentisone HC occurred producing a serum gentamicin level of 6.2 micrograms/ml.

Levels of eosinophil cationic protein and myeloperoxidase from chronic middle ear effusion in patients with allergy and/or acute infection.

BACKGROUND AND OBJECTIVE: Allergy may play a role in the middle ear inflammation that leads to otitis media with effusion. The purpose of this study was to determine whether an elevated mediator correlated with the patient's disease and thus could be used to differentiate allergy vs. infection as the cause of the middle ear inflammation. METHODS: WE evaluated 57 individuals with otitis media with effusion, 32 with persistent effusion but no recent acute infection, 14 with recent infection and purulent otitis media with effusion, and II healthy subjects. The mediator activity of eosinophils and neutrophils in effusion was studied in patients characterized as having allergy by positive intradermal skin test results and positive radioallergosorbent test results. Eosinophils were characterized by measurement of eosinophil cationic protein in the effusion. Neutrophils were characterized by measurement of myeloperoxidase in the effusion. The levels of eosinophil cationic protein and myeloperoxidase in patients with and without allergy were correlated to patient history. RESULTS: Significantly elevated levels of both eosinophil cationic protein and myeloperoxidase indicated that inflammation in the ear of patients with otitis media with effusion was characterized by a pronounced involvement of both eosinophils and neutrophils. Eighty-nine percent of all patients with disease had allergy. A higher ratio of myeloperoxidase to eosinophil cationic protein in patients with purulent otitis media with effusion indicated that in patients with a superimposed acute infection, neutrophil activity was increased even further. The level of eosinophil cationic protein was elevated only during the effusion of patients with allergies as compared with controls (p < 0.01). Among 29 cases of nonpurulent otitis media with effusion, 96.5% had allergic immune-mediated disease proved by skin testing, which was related clinically to their ear disease. Eighty-nine percent (89.6%) of these patients had eosinophil cationic protein levels greater than 10 microgram/L. CONCLUSION: Middle ear eosinophil cationic protein may be used as a marker of related allergy.

[Correction of immunologic disorders in patients with chronic suppurative otitis media]. / Korrektsiia immunologicheskikh narushenii u bolnykh khronicheskim gnoinym srednim otitom.

The absolute and relative content of T- and B-lymphocytes, T-helpers (CD4), T-suppressors (CD8), phagocytosis, complement and immunoglobulins A, M, G in the blood serum was examined in patients with chronic purulent otitis media. The investigation also involved tests on immunological activity of tymoptin (T), sodium nucleinate (SN), prodigiosan (PR), the combination of SN with PR. 148 patients aged 15-56 years were subdivided into 5 groups. In pretreatment immunological status of all the patients the count of T- and B-lymphocytes, T-helpers, phagocytosis were reduced against increased counts of IgM and T-suppressora. All the patients received similar conventional treatment with adjuvant SN (group 2), PR (group III), SN + PR (group 4), T (group 5). The conventional conservative and especially surgical treatment aggravated immunodeficiency. The adjuvant immunocorrectors potentiated the treatment effects which appeared to be most beneficial in group V followed by by groups IV, II and III in diminishing order.

Combined IgG2, IgG4 and IgA deficiency: low C1q concentrations and the presence of excess C1r and C1s in an adult patient with recurrent pneumococcal infections.

The complement (C) profile was investigated in an adult patient with combined IgG2, IgG4 and IgA deficiency and recurrent pneumococcal infections. The analysis revealed no gross impairment of the classic and alternative pathways of C activation. However, the concentrations of circulating C1q were persistently decreased, and the sera contained an excess of C1r-C1s complexes, resembling the C1 aberrations previously found in children with recurrent acute otitis media. The concentrations of C4 in the patient were persistently low. This could be ascribed to partial C4 deficiency with lack of C4A variants. The patient's IgG and IgM antibody responses to pneumococcal capsular polysaccharides and to other bacterial carbohydrate antigens were very poor. Interestingly, pneumococcal C-polysaccharide (CPS) could be detected in serum obtained during infection-free periods. Since CPS has been shown to bind C1q without causing C1 activation, the possibility was considered that the C1 aberrations in serum were due to circulating CPS. After administration of intramuscular gammaglobulin to the patient, the serum C1q levels were observed to return to normal.