Ciliary activity in the tubotympanum during type I allergic reaction

The immune system is active in the tubotympanum and some middle ear diseases might be partially or exclusively immunologically mediated. However, the effect of an allergic reaction on the tubotympanic cilia remains to be elucidated. The response of normal tubotympanic cilia from the guinea pig was investigated in an in vitro experimental system to evaluate ciliary responsiveness without the influence of secretions. Mucosal samples were obtained from three different tubotympanic locations (Eustachian tube, and middle ear close to the tube (proximal site) and more distal to the tube (distal site)). Each mucosal sample was cultured in 2 ml of RPMI 1640 and 1 ml of heparinized venous blood from a nonallergic human subject, a patient with ragweed-sensitive nasal allergy, or 3 patients with Dermatophagoides farinae-sensitive nasal allergy. One microgram of D. farinae extracts was added in each chamber to evoke an in vitro allergic reaction, and the ciliary activity of the most active cell in each culture was monitored for up to 120 min. When D. farinae extracts were added into the chamber containing blood from subjects without sensitivity to D. farinae, no changes were induced in ciliary activity throughout the examination. When the same dose of allergens was added into the chamber containing blood from D. farinae-sensitive subjects, ciliary excitation was induced in the culture from the Eustachian tube and the proximal site. The peak and plateau of this phenomenon were observed at 30-40 min after the addition of the allergen, and a gradual slowdown to the baseline level was observed after the plateau. No ciliary depression was induced by an allergic reaction in the culture from the Eustachian tube or the proximal site. Such ciliostimulatory effects were correlated with D. farinae induced-percent histamine release from whole blood. In the cultures from the distal site, however, a gradual ciliodepression followed the peak of ciliary excitation. In conclusion, an in vitro allergic reaction affected the ciliary activity in the distal site, but such ciliary dysfunction was not observed in the Eustachian tube or the proximal site during such a reaction.