Skotnicka Bozena, Hassmann Elzbieta
Department of Pediatric Otolaryngology, Medical Academy of Białystok, Poland.
Int J Pediatr Otorhinolaryngol. 2008 Jan;72(1):13-7. doi: 10.1016/j.ijporl.2007.09.005. Epub 2007 Oct 31.
The recognition of inflammatory mediators in middle ear effusions and their correlation with clinical parameters may allow better understanding of many complex events leading to development of permanent sequelae of otitis media and hopefully help to develop future interventions. The aim of the study was to evaluate the presence and level of proinflammatory interleukin (IL) 1beta, IL-6 and immunoregulatory IL-10 in the middle ear effusions, their mutual correlation and relationship with age, duration of the illness, number of episodes of acute otitis media, and presence of retraction pockets.
The study included 25 children (41 ears), who had been scheduled for myringotomy with the insertion of tympanostomy tubes due to otitis media with effusion. The interview (duration of the illness, number of episodes of acute otitis media), clinical and audiological examination was conducted according to the developed examination check list. Middle ear effusions (MEE) were collected aseptically, the samples centrifuged and supernatant frozen at a temperature of -80 degrees C. The IL-1beta, IL-6 and IL-10 were assayed using enzyme-linked immunosorbent assay (ELISA) kits incorporating monoclonal antibodies and the ETI system reader. The nonparametric Mann-Whitney U test was used for statistical analysis and Pearson's linear correlation coefficient was calculated.
IL-1beta was detected in 80% of examined effusions, IL-6 in 78%, and IL-10 in 88%. There was a strong statistical correlation between IL-1beta and IL-6 concentrations (r=0.627, P=0.000), as well as IL-6 and IL-10 (r=0.66, P=0.000) No statistically significant correlation was found between levels of cytokines and clinical parameters.
Proinflammatory and immunoregulatory cytokines participate in middle ear inflammatory response. The lack of direct correlation between IL-1beta and IL-10 may be responsible for chronic character of the disease. As no correlation between the levels of cytokines and clinical parameters was found it seems that the time of duration of inflammation rather than its intensity measured by levels of cytokines is the main factor in development of middle ear mucosa pathology.
识别中耳积液中的炎症介质及其与临床参数的相关性，可能有助于更好地理解导致中耳炎永久性后遗症发生的许多复杂事件，并有望有助于开发未来的干预措施。本研究的目的是评估促炎白细胞介素（IL）-1β、IL-6和免疫调节性IL-10在中耳积液中的存在情况和水平，它们之间的相互关系以及与年龄、病程、急性中耳炎发作次数和中耳陷窝存在情况的关系。
本研究纳入了25名儿童（41只耳），这些儿童因中耳积液性中耳炎而计划接受鼓膜切开术并插入鼓膜造口管。根据制定的检查清单进行访谈（病程、急性中耳炎发作次数）、临床和听力学检查。无菌收集中耳积液（MEE），样本离心后，将上清液在-80℃下冷冻。使用包含单克隆抗体的酶联免疫吸附测定（ELISA）试剂盒和ETI系统读数仪测定IL-1β、IL-6和IL-10。采用非参数曼-惠特尼U检验进行统计分析，并计算皮尔逊线性相关系数。
在80%的检测积液中检测到IL-1β，78%检测到IL-6，88%检测到IL-10。IL-1β和IL-6浓度之间存在很强的统计学相关性（r=0.627，P=0.000），IL-6和IL-10之间也存在相关性（r=0.66，P=0.000）。细胞因子水平与临床参数之间未发现统计学上的显著相关性。
促炎和免疫调节细胞因子参与中耳炎症反应。IL-1β和IL-10之间缺乏直接相关性可能是该疾病慢性特征的原因。由于未发现细胞因子水平与临床参数之间存在相关性，似乎炎症持续时间而非细胞因子水平所衡量的炎症强度是中耳黏膜病理发展的主要因素。
