[Correlation of immunoglobulins, the complement system and inflammatory mediators with reference to the pathogenesis of serous otitis media].

Otitis media with effusion (OME) is a very common pediatric disease of unknown etiology which sometimes leads to chronic recurrent OME. The author investigated 90 secretions (39 serous/51 mucous) of 61 children whose ages ranged from 1 to 14 years (mean = 4.9 +/- 2.2) for correlations of Immunoglobulins A, E, G, M, the complement system and mediators of inflammation: histamine, Bradykinin, PGE2 and LTC4. A highly significant increase in IgA and IgG and a decrease in IgM and IgE were found in the secretions as compared to the serum concentrations. These data support the hypothesis that there is an independent mucosal immune response in the middle ear. The protein concentration was significantly higher in the mucous than in the serous secretion; for the other parameters determined only a slight tendency toward higher levels in serous secretions was found. There was a slight positive correlation between IgA and IgG in serum, and in particular in the serous secretions. A slightly negative correlation between IgM and IgE was found only in serum. The secretion showed highly significant correlations between the following: IgG:IgM, IgG:IgA, IgA:IgM, IgG:Kinin, C3c:Kinin and lg Histamine:lg PGE2. The correlations were stronger in serous than in mucous secretions. Only in mucous secretions there were any significant correlations between IgE:IgG, lg IgE:lg Kinin, and a negative correlation between IgE:C3c. Serous and mucous secretions represent different stages of inflammation. The kallikrein kinin system, complement-system, and the arachidonic acid cascade, especially the cyclo-oxygenase pathway, play a role in OME. Bradykinin showed a connection between the activated complement system and the immune system.(ABSTRACT TRUNCATED AT 250 WORDS)