Impaired Proinflammatory Response in Stringently Defined Otitis-prone Children During Viral Upper Respiratory
Dabin Ren1, Qingfu Xu1, Anthony L Almudevar2
1Rochester General Hospital Research Institute, University of Rochester Medical Center, New York.
Insights
Stringently-defined otitis-prone (sOP) children experience more viral upper respiratory infections (URIs) and acute otitis media (AOM) due to deficient nasopharyngeal inflammatory responses. This suggests a link between impaired antiviral immunity and recurrent ear infections in susceptible children.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Otolaryngology
Background:
- Viral upper respiratory infections (URIs) commonly precede bacterial acute otitis media (AOM) in young children.
- Acute inflammatory responses during viral URIs are crucial for preventing AOM development.
- Stringently-defined otitis-prone (sOP) children are highly susceptible to recurrent AOM.
Purpose of the Study:
- To assess nasopharyngeal proinflammatory cytokine and chemokine levels during viral URIs.
- To compare nasopharyngeal inflammatory responses between viral URI events and subsequent AOM episodes.
- To differentiate these responses between sOP and non-otitis-prone (NOP) children.
Main Methods:
- Nasopharyngeal samples were collected during viral URIs and AOM episodes in sOP and NOP children.
- Levels of various proinflammatory cytokines and chemokines were measured.
- Statistical analysis compared inflammatory profiles between groups and conditions.
Main Results:
- sOP children had significantly more AOM episodes, viral URIs, and viral URIs followed by AOM compared to NOP children.
- sOP children exhibited lower nasopharyngeal levels of IL-6, IL-10, TNF-α, and RANTES during viral URIs.
- NOP children showed distinct inflammatory profiles during URIs versus AOM, with higher levels of multiple cytokines/chemokines compared to sOP children.
Conclusions:
- sOP children experience more frequent viral URIs and AOM.
- This increased susceptibility is attributed to deficient antiviral nasopharyngeal proinflammatory cytokine and chemokine responses.
- Impaired inflammatory responses in sOP children may underlie their predisposition to recurrent AOM.
Background:
Viral upper respiratory infections (URIs) are common and often precipitate acute otitis media (AOM), caused by bacterial otopathogens, in young children. Acute inflammatory responses initiated in the early phase of viral URI contribute to preventing the development of AOM. Stringently-defined otitis-prone (sOP) children are susceptible to recurrent AOM.
Methods:
We assessed proinflammatory cytokine and chemokine levels in the nasopharynxes during viral URIs, and examined the different nasopharyngeal responses between viral URI events and the following AOM episodes in both sOP and non-otitis-prone (NOP) children.
Results:
The sOP children exhibited significantly more AOM episodes per child (8.86-fold higher), viral URIs (P < .0001), and viral URIs followed by AOMs (P < .0001) than the NOP children. The sOP children had lower nasal proinflammatory levels of interleukin (IL)-6 (P = .05), IL-10 (P = .001), tumor necrosis factor (TNF)-α (P = .004), and regulated on activation, normal T-cell-expressed and -secreted (RANTES; P = .002) than NOP children during viral URIs. NOP children had higher levels of IL-6 (P = .02), IL-10 (P = .02), interferon-γ (P = .003), TNF-α (P = .006), IL-1β (P = .022), monocyte chemoattractant protein 1 (P = .028), RANTES (P = .005), IL-2 (P = .002), and IL-17 (P = .007) during viral URIs versus AOMs following the URIs, when compared to sOP children.
Conclusions:
We conclude that sOP children have more frequent viral URIs than NOP children, due to deficient antiviral nasopharyngeal proinflammatory cytokine and chemokine responses.
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