Immune Complexes in Middle Ear Fluid in Chronic Secretory Otitis Media

Abstract

Data on 87 patients (113 ears) with chronic secretory otitis media (SOM) are reported. The bacteriological analysis of the middle ear fluid (MEF) revealed Streptococcus pneumoniae in 7% of ears, Hemophilus influenzae in 9%, opportunistic bacteria in 20%, while 64% of the samples showed no growth. Free capsular polysaccharide pneumococcal antigens were found in 5% of the MEF samples using counterimmunoelectrophoresis (CIEP) with Omniserum containing 83 different pneumococcal polysaccharide types. Heating of the samples to disrupt the immune complexes increased the frequency of positive samples to 27%. These findings, together with the frequent occurrence of S pneumoniae and H influenzae in the nasopharynx, strongly support the opinion that chronic SOM in a considerable number of cases is an immune complex disease.

Role of Superoxide Dismutase in Otitis Media with Effusion

“…It has been reported that serous and mucoid MEEs contain harmful factors such as bacterial endotoxins, 2 immune complexes, 3,16 and arachidonic acid metabolites. 17 Those factors can stimulate the production of SOD.…”

“…Many investigators have shown that middle ear effusion (MEE) in patients with otitis media with effusion (OME) contains several pathogenic factors such as microorganisms, 1 endotoxins, 2 immune complexes, 3 and arachidonic acid metabolites. 4 Microbial infection is considered to play an important role in the pathogenesis of OME.…”

Antibodies Mediate Formation of Neutrophil Extracellular Traps in the Middle Ear and Facilitate Secondary Pneumococcal Otitis Media

“…In these immunologically naive individuals, natural antibodies may represent an important defense mechanism against influenza virus-mediated pneumococcal disease, as is seen in pneumococcal sepsis (20). Conversely, the formation of immune complexes in the middle ear may facilitate, rather than clear, bacterial OM (21), suggesting that organ-specific differences may exist with regard to the role of antibodies during pneumococcal disease. Moreover, the ability of antibodies to interact with neutrophils in the middle ear (19), and the suggestion that neutrophils may facilitate bacterial OM (14,15), may indicate that the role of antibodies and neutrophils in pneumococcal-influenza virus OM is more complex than simply protecting against disease development.…”

Otitis media with effusion: disease or defense?

“…Bacteria, especially Haemophilus influenzae and Streptococcus pneumoniae (normal residents of the nasopharynx), have been cultured from up to 40% of the effusions studied [29,31,[56][57][58]. Under direct microscopy, bacteria are more often visible in mucoid than in serous effusions [59].…”