Serum Intercellular Adhesion Molecule 1 Variations in Young Children with Acute Otitis Media

Abstract

Acute otitis media (AOM) is an inflammatory reaction in the middle ear, most often occurring in young children. Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis are the most common bacteria isolated. Intercellular adhesion molecule 1 (ICAM-1) is involved in the innate immune response to infection by microorganisms, in effective antigen presentation, and in subsequent T-cell activation. Here we prospectively studied levels of serum soluble ICAM-1 (sICAM-1) before, at the time of, and after antimicrobial treatment of AOM in a group of 138 children ages 6 to 30 months. Middle ear fluids were collected by tympanocentesis to identify otopathogens. We found that (i) serum levels of sICAM-1 were significantly higher in S. pneumoniae-, nontypeable H. influenzae-, and M. catarrhalis-infected children than in well children (P < 0.001), confirming that a systemic inflammatory response occurs during AOM; (ii) sICAM-1 levels varied from no elevation (110 ng/ml) to elevation to high levels (maximum, 1,470 ng/ml) among children with AOM; (iii) in paired samples, sICAM-1 levels increased 4-to 20-fold when children developed AOM compared to their sICAM-1 levels before infection; and (iv) the level of sICAM-1 returned to the pre-AOM level at the convalescent stage of AOM after successful antimicrobial therapy. We conclude that AOM often causes a systemic inflammatory reaction, as measured by elevation of the serum sICAM-1 level, and that a high variability in sICAM-1 responses occurs with the presence of otopathogens during AOM.Acute otitis media (AOM) is defined by the presence of middle ear effusion (MEE) with acute onset of symptoms of inflammation of the middle ear. Although more than half of patients who develop AOM have fever (14), the condition is considered a localized, mucosal infection. Currently, AOM is regarded as relatively benign due to spontaneous resolution of the infection in a majority of patients (42). The complications and sequelae of bacterial systemic invasion from the middle ear, including mastoiditis, brain abscess, and meningitis, are sufficiently rare that they have recently been considered less consequential in comparison to the consequences from the costs of antimicrobial treatment and overtreatment (2).The cause and pathogenesis of otitis media are multifactorial, involving viral and bacterial infections. The most frequently isolated bacteria in AOM are Streptococcus pneumoniae (20 to 55% of cases), nontypeable Haemophilus influenzae (15 to 40%), and Moraxella catarrhalis (10 to 25%) (12,25,29). When bacteria gain entry into the middle ear space, they damage the middle ear mucosa directly by releasing toxins and indirectly by provoking both specific immunological and general inflammatory responses in the host. A prominent feature of the host response is an influx of inflammatory cells into the middle ear.The migration of leukocytes into sites of inflammation is mediated by numerous factors, including intercellular adhesion molecule 1 (ICAM-1; CD54). ICAM-1 is a m...

Transcriptome signature in young children with acute otitis media due to Streptococcus pneumoniae

“…Closely timed sampling avoided the influence of changing age on responses in pediatric subjects. Our previous work identified significant changes in blood of a limited number of specific pro-inflammatory molecules during AOM caused by Spn [4,5,6]. However, with transcriptome analysis, we were able to identify a much broader range of significant changes in gene regulation.…”

Otitis media

“…Thus far, investigators have studied biomarkers in serum and nasopharyngeal secretions and have correlated them with AOM diagnosis, types of bacteria or viruses, and outcome. High serum levels of intercellular adhesion molecule 1 were found in children with AOM compared with healthy children 222 . At the time of AOM onset, the serum levels of S100-A12 were increased, which returned to normal during recovery 223 .…”

Carotid Intima-Media Thickness and Plasma Asymmetric Dimethylarginine in Mexican Children Exposed to Inorganic Arsenic

“…In contrast, we did not find significant correlations between both adhesion molecules and any arsenicals in the urine. Prospective cohort studies have reported that the plasma concentration of sICAM-1 is elevated many years before an initial myocardial infarction (Hwang et al 1997; Ridker et al 1998) but sICAM-1 has also been reported to be elevated in children with acute otitis media caused by bacterial infections (Liu et al 2010). In contrast with the adhesion molecules, ADMA was associated with cIMT and with the relative proportion of iAs in our study population.…”