SUMMARYWe have investigated a possible association beiween recurrence of otitis media and low concentrations of mannan-binding protein (MBP) in plasma and upper-airway secretions. The protein eoncentration was measured in plasma (H = 76). nasopharyngeal secretions (/j = 83) and middle ear effusions (« -73) from otitis-prone children, children wilh less recurrence of acule otitis media, children with no previous history of acute olitis media, but suffering from seeretory otitis media, and healthy children. Moreover, genetic polymorphistrts associated with low MBP plasma levels were investigated in DNA from nasopharyngeal tonsils of S9 children with recurrence of otitis media. A wide rangeof MBP plasma concentrations was found. No statistically significant differences in MBP plasma concetitralion were observed between patients and controls. Nor was there any increased frequency of the genotypes associated with low MBP plasma concentrations. Thus, our resulls do nol support the assumption thai low eoncenlration and/or MBP deficiency alone predispose to recurrence of otitis media in Caucasian children. MBP was detecicd in bolh nasopharyngeal secretions (1/175 of plasma level) and middleear effusions (1/4 of plasma level), suggesting a role for the protein in the local mucosal immune defence system at these locations. In contrast, MBP was undetectable in 53 samples of mixed-saliva.