Rochester General Hospital Research Institute, University of Rochester Medical Center, New York.
Department of Biostatistics and Computational Biology, University of Rochester Medical Center, New York.
Clin Infect Dis. 2019 Apr 24;68(9):1566-1574. doi: 10.1093/cid/ciy750.
Viral upper respiratory infections (URIs) are common and often precipitate acute otitis media (AOM), caused by bacterial otopathogens, in young children. Acute inflammatory responses initiated in the early phase of viral URI contribute to preventing the development of AOM. Stringently-defined otitis-prone (sOP) children are susceptible to recurrent AOM.
We assessed proinflammatory cytokine and chemokine levels in the nasopharynxes during viral URIs, and examined the different nasopharyngeal responses between viral URI events and the following AOM episodes in both sOP and non-otitis-prone (NOP) children.
The sOP children exhibited significantly more AOM episodes per child (8.86-fold higher), viral URIs (P < .0001), and viral URIs followed by AOMs (P < .0001) than the NOP children. The sOP children had lower nasal proinflammatory levels of interleukin (IL)-6 (P = .05), IL-10 (P = .001), tumor necrosis factor (TNF)-α (P = .004), and regulated on activation, normal T-cell-expressed and -secreted (RANTES; P = .002) than NOP children during viral URIs. NOP children had higher levels of IL-6 (P = .02), IL-10 (P = .02), interferon-γ (P = .003), TNF-α (P = .006), IL-1β (P = .022), monocyte chemoattractant protein 1 (P = .028), RANTES (P = .005), IL-2 (P = .002), and IL-17 (P = .007) during viral URIs versus AOMs following the URIs, when compared to sOP children.
We conclude that sOP children have more frequent viral URIs than NOP children, due to deficient antiviral nasopharyngeal proinflammatory cytokine and chemokine responses.
病毒性上呼吸道感染（URIs）很常见，并且经常在幼儿中引发细菌性耳病原体引起的急性中耳炎（AOM）。病毒 URIs 早期引发的急性炎症反应有助于防止 AOM 的发展。严格定义的易患（sOP）儿童易发生复发性 AOM。
我们评估了病毒性 URIs 期间鼻咽部的促炎细胞因子和趋化因子水平，并检查了 sOP 和非易患（NOP）儿童中病毒 URI 事件与随后 AOM 发作之间的不同鼻咽反应。
sOP 儿童的每个孩子的 AOM 发作次数（高 8.86 倍）、病毒 URIs（P <.0001）和病毒 URIs 后 AOM （P <.0001）均明显高于 NOP 儿童。sOP 儿童在病毒 URIs 期间的鼻内促炎水平较低，白细胞介素（IL）-6（P =.05）、IL-10（P =.001）、肿瘤坏死因子（TNF）-α（P =.004）和调节激活，正常 T 细胞表达和分泌（RANTES；P =.002）低于 NOP 儿童。NOP 儿童在病毒 URIs 期间的 IL-6（P =.02）、IL-10（P =.02）、干扰素-γ（P =.003）、TNF-α（P =.006）、IL-1β（P =.022）、单核细胞趋化蛋白 1（P =.028）、RANTES（P =.005）、IL-2（P =.002）和 IL-17（P =.007）水平均高于 sOP 儿童。
我们得出的结论是，由于抗病毒鼻内促炎细胞因子和趋化因子反应不足，sOP 儿童比 NOP 儿童更频繁地发生病毒性 URIs。
