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Histamine-induced mucociliary dysfunction and otitis media with effusion

Y Esaki1, Y Ohashi, H Furuya

  • 1Department of Otolaryngology, Osaka City University Medical School, Japan.

Insights

Histamine stimulates middle ear cilia via H2-receptors, but high concentrations impair function, leading to middle ear effusions (MEEs). Cilia in the Eustachian tube and tympanic orifice are crucial for clearing MEEs.

Area of Science:

  • Otolaryngology
  • Allergy and Immunology
  • Cell Biology

Background:

  • Histamine, a mediator in allergic and inflammatory responses, increases vascular permeability.
  • Histamine presence in middle ear effusions (MEEs) suggests a role in their development and persistence.
  • The impact of histamine on middle ear mucociliary function remains incompletely understood.

Purpose of the Study:

  • To investigate the effect of histamine on mucociliary function in the middle ear.
  • To determine the specific histamine receptors involved in modulating ciliary activity.
  • To assess histamine's role in inducing and resolving middle ear effusions.

Main Methods:

  • Examined the effect of various histamine concentrations (10(-8) M to 10(-2) M) on ciliary activity.
  • Utilized H1 (diphenhydramine) and H2 (cimetidine) blockers to identify histamine receptor involvement.
  • Administered intratympanic injections of histamine (10(-4) M and 10(-6) M) to induce MEEs in animal models.
  • Monitored MEE volume, mucociliary clearance time, and ciliary activity post-injection.

Main Results:

  • Histamine exhibited a biphasic effect: ciliostimulatory at 10(-8) M to 10(-4) M and inhibitory at 10(-2) M.
  • Ciliostimulatory effects were mediated by H2-receptors, as evidenced by reduction with cimetidine but not diphenhydramine.
  • Intratympanic histamine induced MEEs, with impaired mucociliary clearance and prolonged clearance times.
  • Cilia in the Eustachian tube and tympanic orifice demonstrated a critical role in MEE resolution.

Conclusions:

  • Histamine can induce mucociliary dysfunction in the tubotympanum, contributing to middle ear effusions.
  • H2-receptor activation by histamine stimulates ciliary activity, while higher concentrations are detrimental.
  • Efficient clearance of middle ear effusions relies significantly on the mucociliary function of the Eustachian tube and tympanic orifice.

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