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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Substance P and vasoactive intestinal peptide levels in middle ear effusions of children
Hulya Eyigor1, Ustun Osma, Mustafa Deniz Yilmaz
1Department of ENT Head and Neck Surgery, Antalya Education and Research Hospital, Turkey. hulinar@yahoo.com
Insights
This study found higher substance P (SP) and lower vasoactive intestinal peptide (VIP) levels in middle ear effusions of children with otitis media with effusion (OME), suggesting a role in chronic OME pathogenesis.
Area of Science:
- Otolaryngology
- Neuroimmunology
- Pediatric Medicine
Background:
- Neurogenic inflammation is implicated in the multifactorial etiology of otitis media with effusion (OME).
- Substance P (SP) and vasoactive intestinal peptide (VIP) levels in middle ear effusions (MEEs) of children with OME have not been previously investigated.
Purpose of the Study:
- To evaluate the levels of SP and VIP in MEEs of children diagnosed with OME.
- To determine the correlation between SP and VIP levels and their potential role in OME pathogenesis.
Main Methods:
- Fifty children aged 2-12 years with OME were enrolled.
- Middle ear effusions were classified as mucoid or serous.
- SP and VIP concentrations in MEEs were quantified using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Elevated SP levels were detected in MEEs, with significantly higher concentrations in serous effusions compared to mucoid ones.
- SP levels exhibited age-dependent variations, being highest in the youngest children (2-3 years).
- VIP levels were undetectable in 30% of samples, and mean VIP levels were similar in both serous and mucoid MEEs.
Conclusions:
- This study is the first to report an inverse correlation between SP and VIP levels in MEEs from patients with OME.
- Increased SP and decreased VIP levels may contribute to the pathogenesis of chronic OME.
Conclusion:
This is the first report demonstrating high levels of substance P (SP) that inversely correlate with vasoactive intestinal peptide (VIP) levels in middle ear effusions (MEEs) of patients with otitis media with effusion (OME). Increased SP and decreased VIP levels might play a role in the pathogenesis of chronic OME.
Objective:
The etiology of OME is multifactorial, and neurogenic inflammation may play a significant role. SP and VIP levels were not evaluated previously in MEEs of children with OME.
Methods:
Fifty patients aged 2-12 years (mean age 5.24 ± 2.64) were included in the study. MEEs were classified as mucoid or serous based on the gross appearance. SP and VIP levels were determined using ELISA.
Results:
High levels of SP were detected in MEEs. In addition SP levels were significantly higher in serous samples (2910.55 ± 307.96 vs 2218.55 ± 262.30 pg/ml). There were also age-dependent changes, such that SP levels were significantly higher in children aged 2-3 years compared with those who were 4-5 and 6-12 years old. VIP levels were undetectable in 30% of patients and the mean level of VIP was 50.91 ± 16.01 pg/ml in serous middle ear effusions and 54.86 ± 15.91 pg/ml in mucoid MEEs.