We found a positive correlation between endotoxin and the primary cytokines TNFalpha and IL1beta in culture-positive OME effusions as well as in culture-negative ones, suggesting endotoxin-induced local production of TNFalpha and IL1beta in the middle ear. ICAM-1 and VCAM-1 were also present in the middle ear, but their concentrations were not directly correlated to endotoxin or the primary cytokines.
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