Update on otitis media &amp;ndash; prevention and treatment

Qureishi, Ali; Lu, Yan; Belfield, Katherine; Birchall, John P.; Daniel, Matija

doi:10.2147/idr.s39637

Cited by 106 publications

(82 citation statements)

References 117 publications

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“…Chronic suppurative OM (CSOM) is a chronic inflammation of the middle ear characterized by persistent middle ear drainage through the perforated tympanic membrane for more than 6 weeks (Bluestone, 1998; Qureishi et al, 2014; Mittal et al, 2015). The most common cause of CSOM is the bacterial infection (Meyerhoff, 1988; Mittal et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

et al. 2016

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Otitis media (OM) is a broad term describing a group of infectious and inflammatory disorders of the middle ear. Despite antibiotic therapy, acute OM can progress to chronic suppurative otitis media (CSOM) characterized by ear drum perforation and purulent discharge. Pseudomonas aeruginosa is the most common pathogen associated with CSOM. Although, macrophages play an important role in innate immune responses but their role in the pathogenesis of P. aeruginosa-induced CSOM is not known. The objective of this study is to examine the interaction of P. aeruginosa with primary macrophages. We observed that P. aeruginosa enters and multiplies inside human and mouse primary macrophages. This bacterial entry in macrophages requires both microtubule and actin dependent processes. Transmission electron microscopy demonstrated that P. aeruginosa was present in membrane bound vesicles inside macrophages. Interestingly, deletion of oprF expression in P. aeruginosa abrogates its ability to survive inside macrophages. Our results suggest that otopathogenic P. aeruginosa entry and survival inside macrophages is OprF-dependent. The survival of bacteria inside macrophages will lead to evasion of killing and this lack of pathogen clearance by phagocytes contributes to the persistence of infection in CSOM. Understanding host–pathogen interaction will provide novel avenues to design effective treatment modalities against OM.

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Section: Introductionmentioning

confidence: 99%

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

et al. 2016

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“…This makes it easier for nasopharyngeal pathogens to enter the middle ear, and, together with poorly developed immune defence, predisposes small children to middle ear inflammation. By the age of 7 years, the tube takes a more adult structure and location, which results in lower prevalence of OM (Casselbrant and Mandel, 2010;Mansour et al, 2013;Qureishi et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Krenz‐Niedbała

Łukasik

2016

Intl J of Osteoarchaeology

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In palaeopathological research, otitis media (OM) is a rarely reported disease, although it is one of the most common diseases of childhood, with potentially severe consequences resulting in physical and social impairment, or even death. The episodes of OM are often preceded by upper respiratory tract infections, though the aetiology of OM is multifactorial, with significant role of environmental factors. In archaeological skeletons, middle ear inflammation is identified as erosive lesions and new bone formation of auditory ossicles. The aim of this study was to examine the skeletal signs of OM in children from a mediaeval early urban site (Cedynia) and a post‐mediaeval rural site (Słaboszewo) located on the territory of Poland. Among the entire sample (N = 435), ear bones were present in 99 skeletons. The total of 168 ossicles were examined. The general frequency of individuals with eroded ossicles was 47.5% (53.4% in Cedynia and 39.0% in Słaboszewo). In the total sample, 33.9% of ear bones showed pathological changes, with the incudes being most frequently affected. The frequency of altered ossicles was significantly higher in the early urban site than in the rural settlement (42.2% vs 25.9%, respectively; Fisher exact test, p = 0.0339). The children aged 0–3 years old tend to have a higher frequency of altered ear bones than the children aged 4–11 years old. The majority of the mastoid processes of the subadults with ear bone erosion show abnormal pneumatisation pattern. The results indicate that the environmental and socio‐cultural conditions in the stronghold likely made their inhabitants more prone to upper respiratory tract infections than the inhabitants of the village. A variety of factors may be responsible for this pattern, such as exposure to dust, environmental pollution, indoor pollution, wood smoke, occupation, population density, sanitation and quality of housing. Copyright © 2016 John Wiley & Sons, Ltd.

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“…With its diverse clinical syndromes and affected host groups, OM remains one of the challenging diseases encountered in clinical practice. 3 It is the leading cause of hearing loss and is associated with significant morbidity. 4–7 Children are at greater risk and suffer most frequently from OM.…”

Section: Introductionmentioning

confidence: 99%

Role of innate immunity in the pathogenesis of otitis media

Mittal

Kodiyan

Gerring

et al. 2014

International Journal of Infectious Diseases

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Summary Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.

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Update on otitis media – prevention and treatment

Cited by 106 publications

References 117 publications

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Role of innate immunity in the pathogenesis of otitis media

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