Kim So Young, Son Bu-Soon, Park Hee-Jin, Oh Seung Ha, Lee Jun Ho, Suh Myung-Hwan, Park Moo Kyun
Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Department of Environment Health Science, Soonchunhyang University, South Korea.
Int J Pediatr Otorhinolaryngol. 2017 Feb;93:157-162. doi: 10.1016/j.ijporl.2016.12.036. Epub 2016 Dec 27.
Volatile organic compounds (VOCs) induce inflammatory responses. Tobacco smoke contains numerous VOCs and is a risk factor for otitis media effusion (OME); however, no previous studies have investigated the association between VOCs and OME.
We used urinary metabolites and exposure to environmental risk factors to investigate the association between VOC and polycyclic aromatic hydrocarbon exposure and recurrent OME in children.
Children with recurrent OME who visited the Otorhinolaryngology Department of Seoul National University Hospital between November 2014 and June 2015 were prospectively enrolled in the study. Recurrent OME was defined as more than two OME episodes over a 6-month period lasting longer than 2 months. The control group consisted of children without OME in the last year. Demographic information, including age, sex, and previous medical history was obtained, and endoscopic examinations of the tympanic membrane were performed. Urinary concentrations of 1-hydroxypyrene, 2-naphthol, hippuric acid, trans, trans-muconic acid (t,t-MA), mandelic acid, phenyl glyoxylic acid, and methyl hippuric acid were analyzed using high-performance liquid chromatography/tandem mass spectroscopy. Environmental factors assessed included house type, age, renovations, the presence of furniture <6 months old, proximity to a road, and exposure to passive smoking.
We enrolled 11 children with OME and 39 controls. Age and sex did not differ between groups. Exposure to passive smoking was significantly more common in the OME group than in the controls (P < 0.001). Urinary concentrations of t.t.-MA were significantly higher in the OME group (126.33 μg/g cr) than in controls (52.661 μg/g cr; P = 0.003). Other metabolites including 1-hydroxypyrene, 2-naphthol, hippuric acid, mandelic acid, phenyl glyoxylic acid, and methyl hippuric acid did not demonstrated significant relation with the OME.
Levels of t,t-MA, a biomarker of benzene exposure, were significantly higher in the OME group than in controls. Passive smoking was significantly more common in the OME group. Our findings suggest that high t,t-MA levels which were probably originated from passive smoking and other pollutants could be indicative OME in children.
挥发性有机化合物（VOCs）可引发炎症反应。烟草烟雾含有多种挥发性有机化合物，是中耳积液（OME）的一个风险因素；然而，此前尚无研究调查挥发性有机化合物与中耳积液之间的关联。
我们通过尿液代谢物以及环境风险因素暴露情况，来研究挥发性有机化合物和多环芳烃暴露与儿童复发性中耳积液之间的关联。
2014年11月至2015年6月期间，到首尔国立大学医院耳鼻喉科就诊的复发性中耳积液患儿被前瞻性纳入本研究。复发性中耳积液定义为在6个月内出现超过两次中耳积液发作，且每次发作持续时间超过2个月。对照组由过去一年中无中耳积液的儿童组成。收集人口统计学信息，包括年龄、性别和既往病史，并进行鼓膜内镜检查。采用高效液相色谱/串联质谱法分析尿液中1-羟基芘、2-萘酚、马尿酸、反式，反式-粘康酸（t，t-MA）、扁桃酸、苯甲酰甲酸和甲基马尿酸的浓度。评估的环境因素包括房屋类型、年龄、装修情况、是否存在使用不足6个月的家具、与道路的距离以及被动吸烟暴露情况。
我们纳入了11名中耳积液患儿和39名对照组儿童。两组之间年龄和性别无差异。中耳积液组中被动吸烟暴露情况显著比对照组更常见（P < 0.001）。中耳积液组尿液中t，t-MA的浓度（126.33μg/g肌酐）显著高于对照组（52.661μg/g肌酐；P = 0.003）。其他代谢物，包括1-羟基芘、2-萘酚、马尿酸、扁桃酸、苯甲酰甲酸和甲基马尿酸，与中耳积液未显示出显著关联。
中耳积液组中作为苯暴露生物标志物的t，t-MA水平显著高于对照组。中耳积液组中被动吸烟情况显著更常见。我们的研究结果表明，可能源自被动吸烟和其他污染物的高t，t-MA水平可能提示儿童中耳积液。
