Acute otitis media (AOM) is one of the most common bacterial infectious diseases in children aged 2 to 7 years worldwide. We previously demonstrated that interleukin-17A (IL-17A) promotes an acute inflammatory response characterized by the influx of neutrophils into the middle ear cavity during Streptococcus pneumoniae-induced AOM. In general, the inflammatory response is viewed as an effector that frequently causes local tissue damage. However, little is known about the pathogenic effects of IL-17A in AOM. Here, we investigated the pathogenic effects of IL-17A by using wild-type (WT) and IL-17A knockout (KO) mouse models. The results showed that the pathogenic effects of AOM, including weight loss, histopathological changes, and proinflammatory cytokine production, were more severe in WT mice than in IL-17A KO mice, suggesting that IL-17A aggravates tissue damage in AOM. Furthermore, these pathogenic effects were found to be dependent on p38 mitogen-activated protein kinase (MAPK) and could be reversed in the presence of a p38 MAPK-specific inhibitor. It was also demonstrated that IL-17A promoted the production of neutrophil myeloperoxidase (MPO) through the p38 MAPK signaling pathway, which was responsible for the middle ear tissue injury. These data support the conclusion that IL-17A contributes to middle ear injury through the p38 MAPK signaling pathway.
KEYWORDS acute otitis media, IL-17A, injury, MPO, neutrophilsA cute otitis media (AOM) is one of the most common infectious diseases in the pediatric population (1). According to data from the United States, about 50% to 85% of children have suffered from at least one episode of AOM by the age of 3 years (2). The annual cost for the diagnosis and treatment of AOM approaches $3 billion in the United States alone (3). A lack of timely and effective treatment for AOM often leads to some serious complications, such as permanent hearing loss and meningitis (3, 4). Pathogenic bacteria exist in up to 70% of middle ear fluid specimens from patients with AOM, and 50% of the bacterial cases are induced by Streptococcus pneumoniae. Other common pathogens include nontypeable Haemophilus influenzae and Moraxella catarrhalis (5-7). As a result, the clinical management of AOM relies heavily on antibiotic therapies (4), which may promote the emergence of antibiotic-resistant strains of