The immunoregulatory and allergy‐associated cytokines in the aetiology of the otitis media with effusion

Abstract

Inflammation in the middle ear mucosa, which can be provoked by different primary factors such as bacterial and viral infection, local allergic reactions and reflux, is the crucial event in the pathogenesis of otitis media with effusion (OME). Unresolved acute inflammatory responses or defective immunoregulation of middle inflammation can promote chronic inflammatory processes and stimulate the chronic condition of OME. Cytokines are the central molecular regulators of middle ear inflammation and can switch the acute phase of inflammation in the chronic stage and induce molecular-pathological processes leading to the histopathological changes accompanying OME. In this review we present cytokines identified in otitis media, immunoregulatory [interleukin (IL)-2, IL-10, transforming growth factor-beta]) and allergy associated (IL-4, IL-5, granulocyte-macrophage colony-stimulating factor), as crucial molecular regulators, responsible for chronic inflammation in the middle ear and the chronic condition of OME.

Proinflammatory and immunoregulatory cytokines in the middle ear effusions

“…IL-10, has the inhibiting influence on the production of pro-inflammatory cytokines TNF-a, IL-1b, IL-6, and down-regulates the immune reactions, which may have an impact on the chronic course of disease [6,14]. Actually, together with IL-2, can be considered as the key cytokine mediator regulating switching of the acute phase of inflammation in the chronic stage [6].…”

“…Prolonged presence of IL-10 may increase secretion of immunoglobulins and contribute to chronic state of the disease [6].…”

“…IL-10, down-regulates the production of proinflammatory cytokines playing a very important role in controlling the inflammatory response [6,14,15]. Prolonged presence of IL-10 may increase secretion of immunoglobulins and contribute to chronic state of the disease [6].…”

“…The pro-inflammatory cytokines--tumor necrosis factor (TNF) a, interleukin (IL) 1b, IL-6, as well as IL-10, which reveals antiinflammatory activity have been observed in significant percentage of exudates in patients with OME, as well as in experimental studies [1][2][3][4][5][6]. They can be produced in the early stages of inflammation by cells in middle ear mucosa and later by accumulated leucocytes, stimulated by a series of factors, such as bacteria, viruses, bacterial endotoxins, and other elements released during infection or injury [5][6][7][8].…”

False Type An in Secretory Otitis Media (SOM): Some Case Reports

“…Audiometric and tympanometric tests were normal and even acoustic reflex (IPSI and Contra) was present in left ear, which was inconsistent with Probe Effect. After prescription of antibiotics for one period, nasal spray and nasal saline solution for improvement of Eustachian tube, left tympanic membrane became completely white in color, there was no redness in otoscopy [5][6][7], diapasonic Weber test returned to midline, tinnitus was discontinued, and vertigo was improved as said by the patient.…”