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Published on: August 7, 2017
Comparative analysis of middle ear immune response and micronutrient level between mucoid and purulent otitis media
1Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria. akeemlasisi@gmail.com
Insights
Purulent otitis media (POM) showed a stronger middle ear immune response and higher serum zinc than mucoid otitis media (MOM). However, MOM had a greater chronicity, indicating different disease pathways for these middle ear infections.
Area of Science:
- Otolaryngology
- Immunology
- Pediatrics
Background:
- Otitis media is a common childhood illness with purulent (POM) and mucoid (MOM) forms.
- Understanding differences in immune response and micronutrient status is crucial for effective treatment.
Purpose of the Study:
- To compare treatment outcomes, middle ear immune responses, and zinc levels in children with POM versus MOM.
- To identify distinct characteristics of purulent and mucoid otitis media.
Main Methods:
- Children with acute otitis media were recruited and followed for 6-10 months.
- Sera and middle ear secretions (MES) were analyzed for immunoglobulins (IgA, IgG, IgE) and zinc.
- Immune parameters and zinc levels were compared between POM, MOM, and healthy controls.
Main Results:
- Chronicity was significantly higher in MOM (56/102) than POM (31/126).
- Purulent otitis media (POM) exhibited a higher middle ear immune response (MES to serum IgA/IgG ratio) and serum zinc levels compared to MOM.
- Mucoid otitis media (MOM) showed a higher middle ear IgE response.
Conclusions:
- Purulent otitis media (POM) is associated with a more robust local immune response and better zinc status.
- Mucoid otitis media (MOM) demonstrates a higher propensity for chronicity.
- Distinct immunological and nutritional profiles suggest different pathophysiological mechanisms for POM and MOM.
Objective:
To determine the differences in the outcome of treatment, the middle ear immune response, and micronutrient status between patients with purulent (POM) and mucoid (MOM) otitis media.
Design:
Children with acute otitis media were recruited, treated, and followed up for between 6 and 10 months. The sera and middle ear secretion (MES) were analyzed for immunoglobulins and zinc using enzyme-linked immunoassay and flame atomic absorption spectrophotometry, respectively. The parameters were compared with selected healthy controls.
Subjects:
There were 399 participants: 228 children with acute otitis media selected using the American Academy of Otolaryngology-Head and Neck Surgery criteria and 171 healthy controls, with ages ranging between 6 months and 9 years (mean 7 years; SD 2.32 years).
Result:
POM accounted for 126 of 228 patients, and MOM accounted for 102. The chronicity of otitis media (using the 3-month duration cutoff) was seen in 87 subjects (46%): 31 of 126 POM subjects and 56 of 102 MOM subjects (p = .002). The serum IgA to IgG ratios were 0.03 and 0.07 among POM and MOM, respectively; however, the MES IgA to IgG ratios were higher, 0.3 and 0.2, for POM and MOM, respectively. This gives a MES to serum ratio of IgA to IgG value of 0.3 to 0.03 (10) for POM and 0.2 to 0.07 (2.67) for MOM, which showed a significant statistical difference (p = .001). The MES to serum ratios of IgE were 0.89 and 1.3 among POM and MOM, respectively (p = .03). There was a significant difference in the serum IgG (p = .019), serum zinc (p = .009), and MES IgA (p = .028) and IgG (p = .01).
Conclusion:
Chronicity was greater in MOM than in POM; POM had a higher middle ear immune response (measured by the MES to serum ratio of IgA to IgG) and serum zinc than MOM but a lower MES IgE.
