Liu Keyi, Casey Janet, Pichichero Michael
Rochester General Research Institute, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA.
Clin Vaccine Immunol. 2010 Dec;17(12):1909-16. doi: 10.1128/CVI.00194-10. Epub 2010 Oct 6.
Acute otitis media (AOM) is an inflammatory reaction in the middle ear, most often occurring in young children. Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis are the most common bacteria isolated. Intercellular adhesion molecule 1 (ICAM-1) is involved in the innate immune response to infection by microorganisms, in effective antigen presentation, and in subsequent T-cell activation. Here we prospectively studied levels of serum soluble ICAM-1 (sICAM-1) before, at the time of, and after antimicrobial treatment of AOM in a group of 138 children ages 6 to 30 months. Middle ear fluids were collected by tympanocentesis to identify otopathogens. We found that (i) serum levels of sICAM-1 were significantly higher in S. pneumoniae-, nontypeable H. influenzae-, and M. catarrhalis-infected children than in well children (P < 0.001), confirming that a systemic inflammatory response occurs during AOM; (ii) sICAM-1 levels varied from no elevation (110 ng/ml) to elevation to high levels (maximum, 1,470 ng/ml) among children with AOM; (iii) in paired samples, sICAM-1 levels increased 4- to 20-fold when children developed AOM compared to their sICAM-1 levels before infection; and (iv) the level of sICAM-1 returned to the pre-AOM level at the convalescent stage of AOM after successful antimicrobial therapy. We conclude that AOM often causes a systemic inflammatory reaction, as measured by elevation of the serum sICAM-1 level, and that a high variability in sICAM-1 responses occurs with the presence of otopathogens during AOM.
急性中耳炎（AOM）是中耳的一种炎症反应，最常发生于幼儿。肺炎链球菌、不可分型流感嗜血杆菌和卡他莫拉菌是最常见的分离出的细菌。细胞间黏附分子1（ICAM-1）参与对微生物感染的固有免疫反应、有效的抗原呈递以及随后的T细胞活化。在此，我们前瞻性地研究了138名6至30个月大儿童在AOM抗菌治疗前、治疗时及治疗后的血清可溶性ICAM-1（sICAM-1）水平。通过鼓膜穿刺术收集中耳液以鉴定耳病原体。我们发现：（i）肺炎链球菌、不可分型流感嗜血杆菌和卡他莫拉菌感染的儿童血清sICAM-1水平显著高于健康儿童（P<0.001），证实AOM期间会发生全身炎症反应；（ii）AOM患儿中sICAM-1水平从无升高（110 ng/ml）到升高至高水平（最高1470 ng/ml）不等；（iii）在配对样本中，与感染前的sICAM-1水平相比，儿童患AOM时sICAM-1水平升高了4至20倍；（iv）成功进行抗菌治疗后，在AOM的恢复期，sICAM-1水平恢复到AOM前的水平。我们得出结论，AOM常引起全身炎症反应，可通过血清sICAM-1水平升高来衡量，且在AOM期间存在耳病原体时，sICAM-1反应存在高度变异性。
