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Published on: January 21, 2018
Inflammatory Cytokines in Middle Ear Effusion of Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps With
Anna Suikkila1, Annina Lyly, Terhi Savinko2
1Department of Otorhinolaryngology-Head and Neck surgery, University of Helsinki and Helsinki University Hospital.
Objective:
To measure the inflammatory cytokines of middle ear effusion (MEE) in otitis media (OM) associated with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) with or without nonsteroidal anti-inflammatory drug (NSAID) sensitivity to strengthen our assumption that OM is part of the same inflammatory entity. The potential individual differences between MEE inflammatory cytokines could be used in clinical practice for more individual characterization of the inflammation.
Study Design:
Case-control study.
Setting:
Tertiary referral center.
Patients:
Convenience sample of 24 case patients with otitis media with effusion (OME) or chronic otitis media (COM), asthma, and CRSwNP, 14 of whom had NSAID intolerance, and 8 controls with OME but no history of asthma, CRSwNP, or NSAID intolerance.
Intervention:
Diagnostic.
Main Outcome And Measure:
Inflammatory cytokines including interleukins (IL)-4, IL-5, IL-6, IL-13, and interferon gamma (IFN-γ) in middle ear effusion.
Results:
The MEE mass fractions of IL-5 ( p = 0.003) and IFN-γ ( p = 0.048) were higher among our case patients with OME/COM than among the controls. For IL-4 and IL-13, the mass fractions were also higher among the case patients than the controls, but this difference was not statistically significant ( p = 0.199 and p = 0.617, respectively). We found no difference between the IL-6 mass fractions of the groups. We found notable heterogeneity in individual patients' cytokine levels.
Conclusions:
According to our findings, OM, when present, should be considered part of the respiratory inflammatory process associated with asthma and CRSwNP. The individual differences in MEE cytokine levels could be useful as biomarkers.
Insights
Otitis media (OM) in patients with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) shows elevated inflammatory cytokines, suggesting it is part of the same respiratory inflammatory process. Individual cytokine profiles may aid in personalized inflammation characterization.
Area of Science:
- Immunology
- Otolaryngology
- Respiratory Medicine
Background:
- Otitis media (OM) is a common condition, but its association with other inflammatory respiratory diseases like asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) is not fully understood.
- Nonsteroidal anti-inflammatory drug (NSAID) sensitivity is sometimes observed in patients with these conditions, hinting at shared underlying inflammatory pathways.
Purpose of the Study:
- To investigate the inflammatory cytokine profiles in middle ear effusion (MEE) of patients with OM co-occurring with asthma and CRSwNP.
- To determine if OM is part of a broader respiratory inflammatory entity and explore the potential of MEE cytokines for individual inflammation characterization.
Main Methods:
- A case-control study was conducted at a tertiary referral center.
- 24 patients with OM (OME/COM), asthma, and CRSwNP (14 with NSAID intolerance) and 8 controls with OME but without these comorbidities were analyzed.
- Diagnostic analysis measured inflammatory cytokines (IL-4, IL-5, IL-6, IL-13, IFN-γ) in middle ear effusion.
Main Results:
- Patients with OM, asthma, and CRSwNP exhibited significantly higher levels of IL-5 and IFN-γ in their MEE compared to controls.
- Elevated levels of IL-4 and IL-13 were observed in cases, though not statistically significant.
- No significant difference in IL-6 levels was found between groups, but considerable heterogeneity in individual cytokine levels was noted.
Conclusions:
- OM, when associated with asthma and CRSwNP, should be viewed as an integral component of the shared respiratory inflammatory process.
- The distinct patterns of MEE inflammatory cytokines present an opportunity for developing biomarkers for personalized inflammation assessment in clinical practice.
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