Wigand M, Hoffmann T K, Ryan A F, Wollenberg B, Leichtle A
Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
Dept. of Otolaryngology, University of California San Diego, (UCSD), San Diego, USA.
HNO. 2018 Jun;66(6):464-471. doi: 10.1007/s00106-018-0501-x.
Otitis media (OM) belongs to the most common pediatric diseases and causes more medical contacts, surgical interventions, and drug prescriptions than any other infectious disease. Recent findings have identified a critical role of innate immunity in recovery from OM. The middle ear mucosa identifies invading pathogens by sensing pathogen-associated molecule patterns (PAMPs) via pattern recognition receptors such as the Toll-like receptors (TLRs). They generate immediate antimicrobial responses and cytokine release, leading to an inflammatory reaction as seen in acute or chronic OM. Cross-talk between TLRs can enhance or suppress the healing process in the middle ear. In order to prevent over-activation on the one hand and insufficient immune response on the other, the signaling network between different TLRs must be integrated and controlled by positive and negative feedback loops. This guarantees a proper immune response in the middle ear after infection. In this review, we focus on the involvement of the innate immune system and TLRs in OM, as well on their relevance for new vaccination strategies and immunotherapies.
中耳炎（OM）属于最常见的儿科疾病，与其他任何传染病相比，它导致更多的医疗就诊、手术干预和药物处方。最近的研究发现，先天免疫在中耳炎的恢复中起着关键作用。中耳黏膜通过Toll样受体（TLR）等模式识别受体感知病原体相关分子模式（PAMP），从而识别入侵的病原体。它们产生即时的抗菌反应和细胞因子释放，导致在急性或慢性中耳炎中所见的炎症反应。TLR之间的相互作用可以增强或抑制中耳的愈合过程。为了一方面防止过度激活，另一方面防止免疫反应不足，不同TLR之间的信号网络必须由正反馈和负反馈回路进行整合和控制。这确保了感染后中耳有适当的免疫反应。在这篇综述中，我们重点关注先天免疫系统和TLR在中耳炎中的作用，以及它们与新疫苗策略和免疫疗法的相关性。
