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Dynamics of interleukin-1 production in middle ear fluid during acute otitis media treated with antibiotics
A Barzilai1, E Leibovitz, J H Laver
1Pediatric Infectious Disease Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Insights
Interleukin-1 (IL-1) is common in acute otitis media (AOM) and higher in bacterial infections. IL-1 levels decrease with antibiotic treatment, regardless of pathogen eradication, indicating its role in AOM inflammation.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Immunology
Background:
- Acute otitis media (AOM) is a common childhood infection, often involving bacterial pathogens.
- Interleukin-1 (IL-1) is a key inflammatory cytokine implicated in various infectious processes.
- Understanding IL-1 dynamics in AOM may provide insights into disease pathogenesis and treatment response.
Purpose of the Study:
- To investigate the presence and concentration of IL-1 in middle ear fluid (MEF) of children with AOM.
- To correlate IL-1 levels with bacterial culture results and antibiotic treatment outcomes.
- To assess changes in IL-1 concentrations during antibiotic therapy.
Main Methods:
- Prospective study of 78 children (3-36 months) with AOM receiving antibiotics.
- MEF samples collected via tympanocentesis at enrollment (Day 1) and Days 4-5.
- IL-1 concentrations measured using ELISA; bacterial pathogens identified by culture.
Main Results:
- IL-1 detected in 79% of culture-positive vs. 43% of culture-negative MEF samples on Day 1 (P=0.003).
- Mean IL-1 concentration was significantly higher in culture-positive (316 pg/ml) than culture-negative (111 pg/ml) samples on Day 1 (P=0.01).
- IL-1 concentrations decreased by Days 4-5, irrespective of bacterial eradication (65% decrease in eradicated cases, 58% in persistent/new infections).
Conclusions:
- IL-1 is frequently present in MEF during AOM, particularly in bacterial infections.
- Elevated IL-1 levels correlate with bacterial presence in AOM.
- IL-1 concentrations decline during antibiotic therapy, suggesting a role in mediating inflammation responsive to treatment.
Abstract:
In an ongoing prospective study, IL-1 concentrations were measured in 78 children (aged 3-36 months) with acute otitis media receiving antibiotics. Middle ear fluid IL-1 concentrations were determined using ELISA kits. Ninety-eight middle ear fluid samples were obtained by tympanocentesis at enrollment (day 1) and 43 samples were collected on days 4-5. Ninety-two pathogens were isolated in 77/98 samples obtained on day 1: 55 Haemophilus influenzae, 34 Streptococcus pneumoniae, 2 Moraxella catarrhalis and 1 Streptococcus pyogenes. Among 37 paired samples initially culture-positive, eradication of the pathogen was achieved on day 4-5 in 20 while pathogens were still present in 17. On day 1, IL-1 was detected in 61/77 (79%) culture-positive samples vs 9/21 (43%) culture-negative ones (P = 0.003). The mean +/- SD middle ear fluid concentration of IL-1 on day 1 was significantly higher in culture-positive (316 +/- 508 pg/ml) than in culture-negative samples (111 +/- 245 pg/ml) (P = 0.01). When paired samples were evaluated, IL-1 decreased on days 4-5 in 13/20 (65%) ears where bacterial eradication was achieved, but also in 11/19 (58%) with persistent or new infection. The mean IL-1 concentrations decreased on days 4-5 in the 20 samples from ears where bacterial eradication was achieved (330 +/- 460 vs 118 +/- 294 pg/ml, P = 0.1) but also in the 17 samples where it was not (465 +/- 660 vs 232 +/- 289 pg/ml, P = 0.02). No significant differences were found between day 1 and days 4-5 in the mean IL-1 concentrations measured in patients with H. influenzae vs S. pneumoniae or concomitant H. influenzae and S. pneumoniae. It was concluded that: 1) IL-1 was detected in the middle ear fluid of most patients with acute otitis media; 2) significantly higher IL-1 concentrations were found in patients with culture-positive than in those with culture-negative acute otits media; 3) IL-1 concentrations decreased on days 4-5 of antibiotic therapy, whether the pathogen was eradicated or not.