Bresnick S D, Ryan A F
Department of Surgery, UCSD Medical School.
Laryngoscope. 1989 Dec;99(12):1293-8. doi: 10.1288/00005537-198912000-00015.
Swallowing of upper respiratory pathogens which may at another time be involved in otitis media with effusion (OME) undoubtedly occurs in many patients. In order to explore the possible immunologic consequences to the middle ear (ME) of such gut exposure, guinea pigs were fed antigen either before or after systemic sensitization. A ME immune response was then elicited by ME antigenic challenge. Feeding before systemic sensitization induced systemic tolerance and blunted both the ME immune response and immune-mediated OME. Feeding after systemic sensitization amplified ME immunity and increased immune-mediated OME. Gut immunization, therefore, provides a potent modulation of ME immune response. Depending upon its timing, pathogen swallowing could produce immune hyporesponsiveness, with lowered resistance to infection but reduced immune-mediated inflammation. Alternatively, swallowing could result in immune hyperresponsiveness, with increased resistance but also increased inflammation.
许多患者无疑会吞咽上呼吸道病原体，而这些病原体在其他时候可能会引发渗出性中耳炎（OME）。为了探究这种肠道暴露对中耳（ME）可能产生的免疫后果，在豚鼠全身致敏之前或之后给它们喂食抗原。然后通过中耳抗原攻击引发中耳免疫反应。在全身致敏之前喂食会诱导全身耐受，并减弱中耳免疫反应和免疫介导的OME。在全身致敏之后喂食会增强中耳免疫力并增加免疫介导的OME。因此，肠道免疫可有效调节中耳免疫反应。根据其发生时间，吞咽病原体可能会导致免疫低反应性，抗感染能力降低但免疫介导的炎症减少。或者，吞咽可能导致免疫高反应性，抵抗力增加但炎症也增加。
