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Published on: August 7, 2017
Three Innate Cytokine Biomarkers Predict Presence of Acute Otitis Media and Relevant Otopathogens
Michael E Pichichero1, Matthew C Morris1, Anthony Almudevar2
1Rochester General Hospital Research Institute, Center for Infectious Diseases and Immunology, USA.
Insights
A new biomarker score using serum cytokines accurately identifies Acute Otitis Media (AOM) in children, distinguishing it from viral infections and predicting the causative pathogen. This advances pediatric care by enabling targeted antibiotic use.
Area of Science:
- Pediatric Infectious Diseases
- Biomarker Discovery
- Immunology
Background:
- Accurate diagnosis of Acute Otitis Media (AOM) is challenging, leading to overdiagnosis and antibiotic misuse.
- A reliable serum biomarker for AOM is needed to improve pediatric care for this common illness.
Purpose of the Study:
- To develop and validate a serum biomarker score for diagnosing AOM in children.
- To differentiate AOM from viral upper respiratory infections (URIs).
- To predict the causative bacterial pathogen in AOM cases.
Main Methods:
- Serum samples were collected from 197 children aged 6-36 months in health, URI, and AOM states.
- Serum concentrations of S100A12, IL-10, and ICAM-1 were measured using ELISA.
- A predictive model was developed using cytokine levels and subject age to identify AOM and otopathogens.
Main Results:
- A biomarker score incorporating age and serum cytokines (S100A12, IL-10, ICAM-1) effectively distinguished AOM from URI.
- The score accurately predicted the specific bacterial pathogen causing AOM.
- The biomarker also identified children prone to recurrent otitis media.
Conclusions:
- A novel biomarker risk score derived from serum cytokine levels can predict bacterial AOM and identify the causative pathogen.
- This biomarker aids in reducing AOM overdiagnosis and enables targeted antibiotic prescriptions.
- The findings support improved management of AOM in pediatric populations.
Background:
1.1Diagnosis of Acute Otitis Media (AOM) is challenging, resulting in frequent over diagnosis and improper prescription of antibiotics. A serum biomarker of AOM would significantly improve pediatric care for this common illness.
Methods:
1.2Serum samples were studied from 197 children 6-36 months old during health, during viral Upper Respiratory Infection (URI) without middle ear involvement, and at the onset of AOM (confirmed by tympanocentesis). Serum concentrations of S100A12, IL-10, and ICAM-1 were measured by ELISA. Otopathogens were identified by culture of middle ear fluid. A predictive model for infection and causative otopathogen was developed based on density distributions of the measured cytokines.
Results:
1.3A biomarker score derived from subject age and serum concentrations of S100A12, IL-10, and ICAM-1 was significantly able to distinguish both between health and disease and between upper respiratory infections with and without middle ear involvement (AOM vs URI), and further predicted the specific causative bacterial pathogen. This biomarker could also identify recurrent OM-prone children.
Conclusions:
1.4For the first time we show that a biomarker risk score derived from serum cytokine levels can predict the presence of bacterial AOM, the likely Otopathogen, and the recurrent OM-prone child.
Clinical Significance:
1.5(1) AOM is a widespread pediatric infection with a substantial economic burden. (2) Three serum cytokines can discriminate between URI and AOM, reducing over diagnosis. (3) Prediction of responsible pathogen enables targeted antibiotic prescription.
