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Plasma IgG, IgG subclasses and acute-phase proteins in children with recurrent acute otitis media
1ENT-Department, Gentofte University Hospital, Hellerup, Denmark.
Insights
Children with recurrent acute otitis media (rAOM) show altered immunoglobulin G (IgG) levels, with higher total IgG and IgG1, and lower IgG2. Secretory otitis media (SOM) is linked to increased IgG1, suggesting immune stimulation.
Area of Science:
- Immunology
- Pediatrics
- Otolaryngology
Background:
- Otitis media is a common childhood illness.
- Understanding immune responses in otitis media is crucial for effective management.
- Immunoglobulin G (IgG) and its subclasses play a role in immune defense against middle ear infections.
Purpose of the Study:
- To investigate IgG, IgG subclass, and acute-phase protein levels in children with varying degrees of otitis proneness.
- To compare immune profiles of children with recurrent acute otitis media (rAOM) and secretory otitis media (SOM) to healthy controls.
Main Methods:
- Plasma samples were collected from 156 children (aged 2-162 months) without acute otitis media or recent antibiotic use.
- Quantification of total IgG, IgG subclasses (including IgG2), and acute-phase proteins (haptoglobin, orosomucoid, alpha 1-antitrypsin) was performed.
- Statistical analysis was used to compare immune parameters between groups.
Main Results:
- Children with rAOM exhibited significantly higher total IgG and IgG1 levels, and significantly lower IgG2 levels compared to healthy children.
- Lower IgG2 levels in rAOM children may be partly attributed to their younger age.
- Children with SOM showed elevated IgG1 levels, indicating recurrent immune stimulation, less pronounced than in rAOM.
- Acute-phase protein levels were similar across all groups, indicating no acute illness at sampling.
Conclusions:
- Distinct alterations in IgG subclass profiles are associated with recurrent acute otitis media and secretory otitis media in children.
- Elevated IgG1 in SOM suggests chronic immune activation.
- Further research into the role of IgG subclasses in otitis media pathogenesis is warranted.
Abstract:
Quantitation of IgG, IgG subclasses and acute-phase proteins was performed in plasma samples from 156 children, aged 2 to 162 months, with varying degrees of otitis proneness. None of the children had acute otitis media or had received any antibiotics 3 weeks before the examination. Children with recurrent acute otitis media (rAOM) had significantly higher levels of total IgG, IgG1, and significantly lower levels of IgG2 than healthy children (p less than 0.02, p less than 0.0003, and p less than 0.03, respectively). However, the low levels of IgG2 found in the rAOM children could at least, to some extent, be explained by the observation that these children were somewhat younger than the healthy children. Except for recurrent episodes of common colds, children suffering from secretory otitis media (SOM) most often show no clinical signs of inflammatory events. Nevertheless, children with SOM had raised levels of plasma IgG1, indicating recurrent polyclonal stimulation of the immune apparatus, which seems to be less pronounced than that of rAOM children. Levels of acute-phase proteins, haptoglobin, orosomucoid and alpha 1-antitrypsin were evenly distributed in the children investigated, reflecting that they had no acute illness at the time of plasma sampling.