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Divergent mucosal and systemic responses in children in response to acute otitis media

D Verhoeven1, M E Pichichero

  • 1Rochester General Research Institute, Rochester General Hospital, Rochester, NY, USA.

Clinical and Experimental Immunology
|June 4, 2014
PubMed

Insights

Recurrent acute otitis media (AOM) in children may stem from weakened immune responses. Local mucosal immunity in the nasopharynx (NP) and middle ear (ME) differs from systemic blood responses, impacting bacterial infection control.

Area of Science:

  • Pediatric infectious diseases
  • Immunology
  • Otolaryngology

Background:

  • Acute otitis media (AOM) is a common childhood illness, with some children experiencing recurrent infections.
  • Previous research suggested diminished systemic antibacterial immune responses in children prone to recurrent AOM.
  • Local immune responses in the nasopharynx (NP) and middle ear (ME) have not been fully characterized in relation to systemic immunity.

Purpose of the Study:

  • To compare local mucosal immune responses (NP and ME) with peripheral blood immune responses in children with AOM.
  • To investigate differences in effector cytokine profiles between mucosal and systemic compartments during AOM.
  • To identify potential immune dysregulation contributing to recurrent AOM in susceptible children.

Main Methods:

  • Analysis of effector cytokine profiles in peripheral blood, NP, and ME samples from children with AOM.
  • Comparison of immune responses between children prone to recurrent AOM and non-prone children.
  • Assessment of cytokine patterns related to CD4 T cell antigen-recall responses.

Main Results:

  • Plasma effector cytokines reflected CD4 T cell antigen-recall responses, showing lower levels in prone children.
  • Middle ear (ME) cytokine levels were more similar to nasopharyngeal (NP) levels than to blood levels.
  • Interferon (IFN)-γ and Interleukin (IL)-17 levels in the NP were comparable between prone and non-prone children, but IL-2 production was higher in prone children.

Conclusions:

  • Immune responses at mucosal sites (NP, ME) diverge from systemic responses in the blood during bacterial middle ear infections.
  • These differences in local versus systemic immunity may play a role in the susceptibility to and recurrence of AOM in young children.
  • Understanding these compartmentalized immune responses is crucial for developing targeted strategies against AOM.

Keywords:
Streptococcus pneumoniaacute otitis mediaadaptive immune responsesmucosal cytokinesotitis-prone children

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