“…Inflammatory cytokines, including COX-2, TNF-α, NF-κB, IL-1, IL-6, and IL-8, play a critical role in immune regulation, the initiation of mucosal changes, the inflammatory response in the middle ear, and stimulating mucin secretion [22,23] . Increased inflammatory cytokine and mucin gene expression have been demonstrated in cigarette smoke-and diesel-induced OM [9,10] . Inhalation of cadmium resulted in increased TNF-α, IL-6, and macrophage inflammatory protein (MIP-2) in rat lungs [24] .…”