Similar allergic inflammation in the middle ear and the upper airway: Evidence linking otitis media with effusion to the united airways concept

Nguyen, Lily H. P.; Manoukian, John J.; Sobol, Steven E.; Tewfik, Ted L.; Mazer, Bruce; Schloss, Melvin D.; Taha, Rame; Hamid, Qutayba

doi:10.1016/j.jaci.2004.07.061

Cited by 137 publications

(132 citation statements)

References 21 publications

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“…We do not have any local data with which to compare our rate, but identifying a greater than 20% prevalence of asthma in our overall population is pertinent for two reasons. First, it correlates with many studies that have identified the Unified Airway Concept, such that the inflammatory substrate found in the effusions of otitis media can be similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in allergic rhinitis and asthma [17,18]. Second, there has also been evidence of abnormal exercise-induced bronchoconstriction and elevated exhaled nitric oxide concentration, markers of bronchial hyper-reactivity and airway inflammation respectively, in children with ROM [19].…”

Section: Discussionsupporting

confidence: 64%

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Risk Factors for Refractory and Delayed De Novo Otitis Media Requiring Pressure Equalization Tube Insertion

Bowe¹,

Vargo²,

Abramoff³

et al. 2014

Otolaryngol.--head neck surg.

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Objective-Limited data exists regarding risk factors for otitis media in older children and specifically those for which surgical intervention is performed. This study investigated potential risk factors in this older age group who required pressure equalization tube (PET) insertion. Study design-Retrospective cohort study Setting-Tertiary care pediatric academic medical centerSubjects and methods-Children 6-12 years old undergoing PET insertion between October 1, 2010 and September 30, 2011. Data was stratified into two separate age cohorts (6-7 versus 8-12-year-olds) and compared using chi-square analysis.Results-A total of 263 patients met study criteria. PET insertion was most common in 6 yearolds (36%, 95/263). Presence of siblings (p=0.03) and history of recurrent upper respiratory tract infection (p<0.01), otalgia (p<0.05), otorrhea (p<0.001), and nasal discharge (p<0.001) were common in the older cohort. No statistical difference was found for history of recurrent acute otitis media, allergy, asthma, or atopy between the two groups (p=0.23-0.92), although the overall prevalence of these conditions was high in both cohorts. Conclusion-The 8-12-year-olds had a history of recurrent upper respiratory tract infection and more infectious symptoms than the 6-7-year-olds. Atopy can lead to a heightened susceptibility to upper respiratory tract infections and potential increase in the relative risk of otitis media. In our patient population, while there was no statistically significant difference in history of asthma, allergy, or atopy, the overall prevalence within both cohorts was relatively high. Therefore, this This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 64%

“…As noted above, allergy or atopy appears to have a substantial association with COM/ROM [17,18]. Numerous studies continue to elucidate the strong link between allergy and otitis media with effusion [5,[20][21][22].…”

Section: Discussionmentioning

confidence: 90%

Risk Factors for Refractory and Delayed De Novo Otitis Media Requiring Pressure Equalization Tube Insertion

Bowe¹,

Vargo²,

Abramoff³

et al. 2014

Otolaryngol.--head neck surg.

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“…Overall, these results support the hypothesis that the immunopathologic mechanism underlying the development of MEE can be largely a result of the effects of T-helper type 2 (Th2) mediators; thus, the inflammation within the middle ear of many patients is allergic in nature. In contrast to atopic patients, nonatopic patients revealed different cellular and cytokine profiles in the MEE and nasopharynx, with a predominantly Th1-mediated inflammatory response [29].…”

Section: Role Of Atopymentioning

confidence: 83%

Audiological Investigation of Otitis Media in Children with Atopy

Martines

Bentivegna

2011

Curr Allergy Asthma Rep

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Otitis media (OM) describes an inflammatory process within the middle ear space that is generally associated with accumulation of fluid and that may lead to hearing loss, learning difficulties, and delays in language development. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, eustachian tube dysfunction, viral and bacterial load, and genetic and environmental factors. The involvement of IgEmediated allergic reactions in the pathogenesis of OM has been suggested by clinical observations of a high prevalence of OM among patients with allergies. Evidence from studies involving tympanometric measurements, audiometric measurements, and otoscopic examination confirms the role of atopy in the development and persistence of OM.

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“…The presence of sensitization to inhalant allergens has been reported to alter the immunology of adenoid tissue. CD1a + Langerhans cells and eosinophils are increased in the adenoids of allergic children (2121,2122). Similarly, eosinophils, IL-4 and IL-5 mRNA-positive cells are increased in the adenoids of atopic children (2122).…”

Section: Adenoid Hypertrophymentioning

confidence: 92%