Karma P, Sipilä M, Luotonen J, Pukander J, Koskela M
Department of Clinical Sciences, University of Tampere, Finland.
Acta Otolaryngol. 1988 May-Jun;105(5-6):522-8. doi: 10.3109/00016488809119513.
Forty-one infants, who during their first (initial) acute otitis media (AOM) had culturable S. pneumoniae (Pn) in 57 middle ear fluids (MEFs) which prolonged or recurred during the follow-up, were observed for 7-15 months for the presence of Pn, Pn-antigens (Pn-ags) and initial-type/group Pn-antibodies (Pn-abs) in these MEFs. Initially, Pn-abs were found in only 3 MEFs. During the follow-up a total of 20 ears (35%) were, at various time-intervals, positive for Pn-abs; they belonged to all three major Ig-classes, but were often slight in quantity. Most regularly, and often with distinct positivity, Pn-abs were found to type 3, 9N and 14. Secretory abs were detected in 5 ears. Within one month after initial AOM, Pn-abs appeared in 9 of the 41 ears with MEF (22%); six of them cleared soon after that. MEFs with Pn-abs usually did not show initial-type Pn/Pn-ag, but new Pn/Pn-ag could later be simultaneously present in recurrent MEF. So, pneumococcal AOM may cause a local and/or systemically mediated immune response in the middle ear in infants. The response may protect the ear from homologous, but still be present in apparently non-homologous otitis media.
41名婴儿在首次（初始）急性中耳炎（AOM）发作时，其57份中耳积液（MEF）中培养出肺炎链球菌（Pn），这些积液在随访期间出现迁延不愈或复发的情况。对这些MEF进行了7至15个月的观察，以检测其中Pn、Pn抗原（Pn-ags）和初始型/群Pn抗体（Pn-abs）的存在情况。最初，仅在3份MEF中发现了Pn-abs。在随访期间，共有20只耳朵（35%）在不同时间间隔对Pn-abs呈阳性；它们属于所有三种主要的免疫球蛋白类别，但数量往往较少。最常见且通常呈明显阳性的Pn-abs为3型、9N型和14型。在5只耳朵中检测到了分泌性抗体。在初始AOM后的1个月内，41只存在MEF的耳朵中有9只（22%）出现了Pn-abs；其中6只在之后不久就转阴了。含有Pn-abs的MEF通常未显示初始型Pn/Pn-ag，但新的Pn/Pn-ag可能随后同时出现在复发性MEF中。因此，肺炎球菌性AOM可能在婴儿中耳引起局部和/或全身介导的免疫反应。这种反应可能会保护耳朵免受同源感染，但在明显非同源的中耳炎中也可能存在。
