Yellon R F, Leonard G, Marucha P T, Craven R, Carpenter R J, Lehmann W B, Burleson J A, Kreutzer D L
University of Connecticut Health Center Division of Otolaryngology, Farmington 06032.
Laryngoscope. 1991 Feb;101(2):165-9. doi: 10.1288/00005537-199102000-00011.
Retention of inflammatory mediators and cells in the middle ear cleft during chronic otitis media with effusion (COME), results in ongoing inflammation with the potential for pathologic changes and hearing loss. Cytokines are glycoproteins produced by macrophages and other cells. Activities of cytokines include fever production, osteoclast, fibroblast, phagocyte and cytotoxic cell activation, regulation of antibody formation, and inhibition of cartilage, bone and endothelial cell growth. Using enzyme-linked immunospecific assays we measured levels of six cytokines in middle ear effusions (MEE) from children with COME. Significant levels of four cytokines: interleukin-1-beta (greater than 50 pg/ml), interleukin-2 (greater than 300 pg/ml), tumor necrosis factor-alpha (greater than 40 pg/ml), and gamma-interferon (greater than 6.25 pg/ml) were found in 51%, 54%, 63%, and 19% of MEE, respectively. In contrast, levels of a fifth cytokine, granulocyte-macrophage colony-stimulating factor, and a sixth cytokine, interleukin-4, were undetectable. Age was observed to have a significant effect on the levels of specific cytokines. Interleukin-1 (IL-1) correlated inversely (P less than .02) with age such that the younger the child, the higher the level of IL-1 in MEE. Tumor necrosis factor-alpha (TNF) correlated directly (P less than .005) with age such that the older the child, the higher the level of TNF in MEE. Children undergoing tympanostomy on multiple occasions had average MEE TNF levels (234.2 +/- 109.1 pg/mg total protein) that were nearly 14 times higher (P less than .005) than those from children undergoing their first tympanostomy (16.9 +/- 3.0 pg/mg total protein). Thus IL-1 correlated with the early stages of COME, while TNF correlated with persistence of disease. The presence of these cytokines in MEE may be responsible for the mucosal damage, bone erosion, fibrosis, and resulting hearing loss seen in some cases of COME.
在分泌性中耳炎（COME）期间，炎症介质和细胞潴留在中耳裂，导致炎症持续存在，并有发生病理改变和听力损失的可能。细胞因子是由巨噬细胞和其他细胞产生的糖蛋白。细胞因子的活性包括发热、破骨细胞、成纤维细胞、吞噬细胞和细胞毒性细胞的激活、抗体形成的调节以及软骨、骨和内皮细胞生长的抑制。我们使用酶联免疫特异性测定法测量了COME患儿中耳积液（MEE）中六种细胞因子的水平。在51%、54%、63%和19%的MEE中分别发现了四种细胞因子的显著水平：白细胞介素-1-β（大于50 pg/ml）、白细胞介素-2（大于300 pg/ml）、肿瘤坏死因子-α（大于40 pg/ml）和γ-干扰素（大于6.25 pg/ml）。相比之下，第五种细胞因子粒细胞-巨噬细胞集落刺激因子和第六种细胞因子白细胞介素-4的水平无法检测到。观察到年龄对特定细胞因子的水平有显著影响。白细胞介素-1（IL-1）与年龄呈负相关（P小于0.02），即儿童越小，MEE中IL-1的水平越高。肿瘤坏死因子-α（TNF）与年龄呈正相关（P小于0.005），即儿童越大，MEE中TNF的水平越高。多次接受鼓膜造口术的儿童的平均MEE TNF水平（234.2±109.1 pg/mg总蛋白）比首次接受鼓膜造口术的儿童（16.9±3.0 pg/mg总蛋白）高近14倍（P小于0.005）。因此，IL-1与COME的早期阶段相关，而TNF与疾病的持续存在相关。MEE中这些细胞因子的存在可能是COME某些病例中出现黏膜损伤、骨质侵蚀、纤维化以及听力损失的原因。
