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[Correlation of immunoglobulins, the complement system and inflammatory mediators with reference to the pathogenesis
1Univ.-Klinikum Rudolf-Virchow. Abt. für klin. Immunologie und Asthma-Poliklinik, FU-Berlin.
Insights
This study reveals distinct immunoglobulin levels in middle ear fluid, suggesting a unique mucosal immune response in children with otitis media with effusion. These findings highlight the roles of the kallikrein-kinin and complement systems in the disease.
Area of Science:
- Immunology
- Otolaryngology
- Pediatrics
Context:
- Otitis media with effusion (OME) is a common pediatric condition with unclear causes.
- Chronic OME can result from initial OME episodes.
- Understanding OME's pathophysiology is crucial for effective treatment.
Purpose:
- To investigate correlations between immunoglobulins (IgA, IgG, IgM, IgE), complement system components, and inflammatory mediators (histamine, bradykinin, PGE2, LTC4) in middle ear secretions.
- To compare these levels with serum concentrations.
- To explore differences between serous and mucous secretions in OME.
Summary:
- Significant increases in IgA and IgG, with decreases in IgM and IgE, were observed in middle ear secretions compared to serum.
- Protein concentration was higher in mucous than serous secretions.
- Correlations between immunoglobulins, bradykinin, complement C3c, histamine, and PGE2 were identified, varying between secretion types and suggesting distinct inflammatory stages.
Impact:
- Findings support the hypothesis of an independent mucosal immune response in the middle ear.
- The study implicates the kallikrein-kinin system, complement system, and arachidonic acid cascade in OME pathogenesis.
- Bradykinin appears to link the complement and immune systems in OME.
Abstract:
Otitis media with effusion (OME) is a very common pediatric disease of unknown etiology which sometimes leads to chronic recurrent OME. The author investigated 90 secretions (39 serous/51 mucous) of 61 children whose ages ranged from 1 to 14 years (mean = 4.9 +/- 2.2) for correlations of Immunoglobulins A, E, G, M, the complement system and mediators of inflammation: histamine, Bradykinin, PGE2 and LTC4. A highly significant increase in IgA and IgG and a decrease in IgM and IgE were found in the secretions as compared to the serum concentrations. These data support the hypothesis that there is an independent mucosal immune response in the middle ear. The protein concentration was significantly higher in the mucous than in the serous secretion; for the other parameters determined only a slight tendency toward higher levels in serous secretions was found. There was a slight positive correlation between IgA and IgG in serum, and in particular in the serous secretions. A slightly negative correlation between IgM and IgE was found only in serum. The secretion showed highly significant correlations between the following: IgG:IgM, IgG:IgA, IgA:IgM, IgG:Kinin, C3c:Kinin and lg Histamine:lg PGE2. The correlations were stronger in serous than in mucous secretions. Only in mucous secretions there were any significant correlations between IgE:IgG, lg IgE:lg Kinin, and a negative correlation between IgE:C3c. Serous and mucous secretions represent different stages of inflammation. The kallikrein kinin system, complement-system, and the arachidonic acid cascade, especially the cyclo-oxygenase pathway, play a role in OME. Bradykinin showed a connection between the activated complement system and the immune system.(ABSTRACT TRUNCATED AT 250 WORDS)