Surarto Bakti, Purnami Nyilo, Hutahaen Fransiska, Mahardhika M Reza
Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, 60285 Indonesia.
Indian J Otolaryngol Head Neck Surg. 2020 Mar;72(1):1-7. doi: 10.1007/s12070-019-01704-z. Epub 2019 Jul 30.
Bone destruction in patients with chronic suppurative otitis media (CSOM) and cholesteatoma is considered to be quite high. Bone destruction is caused by various inflammatory cytokines and osteoclasts including IL-1α and TNF-α. The imbalance between the resorption process by osteoclasts and the process of bone formation is also a causative factor for bone destruction. On top of that, the large number of patients is not supported by an equal amount of medical facilities and personnel to conduct operative procedures. To analyze the associated of IL-1α level and TNF-α expression on the severity of bone destruction in CSOM and cholesteatoma patients. The total number of the subjects was 46 patients which group I (TNF-α) consisted of 26 individuals and group II (IL-1α) contained 26 individuals as well. The analysis was conducted in 2 different places (Solo, Indonesia and Surabaya, Indonesia). IL-1α expression was assessed by using ELISA kit at the absorbance rate of 450 nm whereas the rabbit anti-TNF-α polyclonal antibody was applied to examine TNF-α. The assessment of bone destruction was carried out during the operative procedure in Dr. Soetomo General Hospital Surabaya, Indonesia. Group I assessment resulted in severe bone destruction of 65.39% whilst group II showed severe bone destruction of 65.00%. This study revealed that TNF-α was categorized as strong positive (34.62%), moderate positive (42.30%), weak positive (19.23%), and negative (3.85%) with the value of r = 0.775; ≤ 0.001. On the other hand, the rate of IL-1α was attained as follows: 14.93 ± 4.36 pg/ml, 22.75 ± 12.18 pg/ml, and 31.98 ± 14.16 pg/ml with the value of r = 0.625; = 0.003. There is a significant association between expression of TNF-α and IL-1α level on the severity of bone destruction in CSOM and cholesteatoma patients. Hence, it has been proven that it is necessary to develop an additional therapeutic interventions to reduce TNF-α and IL-1α in CSOM and cholesteatoma patients.
慢性化脓性中耳炎(CSOM)和胆脂瘤患者的骨质破坏被认为相当严重。骨质破坏是由多种炎性细胞因子和破骨细胞引起的,包括白细胞介素-1α(IL-1α)和肿瘤坏死因子-α(TNF-α)。破骨细胞的吸收过程与骨形成过程之间的失衡也是骨质破坏的一个致病因素。除此之外,大量患者却没有与之匹配的医疗设施和人员来开展手术操作。为了分析CSOM和胆脂瘤患者中IL-1α水平和TNF-α表达与骨质破坏严重程度的相关性。研究对象总数为46例患者,其中第一组(TNF-α组)有26例个体,第二组(IL-1α组)也有26例个体。分析在两个不同地点(印度尼西亚梭罗和印度尼西亚泗水)进行。使用酶联免疫吸附测定(ELISA)试剂盒在450nm吸光度率下评估IL-1α表达,而应用兔抗TNF-α多克隆抗体检测TNF-α。在印度尼西亚泗水苏托莫综合医院的手术过程中对骨质破坏进行评估。第一组评估结果显示严重骨质破坏率为65.39%,而第二组显示严重骨质破坏率为65.00%。本研究表明,TNF-α分为强阳性(34.62%)、中度阳性(42.30%)、弱阳性(19.23%)和阴性(3.85%),r值为0.775;P≤0.001。另一方面,IL-1α的水平如下:14.93±4.36pg/ml、22.75±12.18pg/ml和31.98±14.16pg/ml,r值为0.625;P = 0.003。CSOM和胆脂瘤患者中TNF-α表达与IL-1α水平和骨质破坏严重程度之间存在显著相关性。因此,已证明有必要开发额外的治疗干预措施以降低CSOM和胆脂瘤患者中的TNF-α和IL-1α。