Effects of keratin on bone resorption in experimental otitis media.

Keratin debris is a constant feature in middle-ear cholesteatoma. Keratin prepared from rat skin induced a foreign-body granuloma in the subcutaneous space in the rat. In vitro this granuloma produced high levels of bone-resorbing factors: prostaglandin E2, osteoclast-activating factor, and leucine aminopeptidase. In the in vivo study, keratin-induced granuloma in the rat middle ear caused partial resorption of the cochlear wall. Macrophages, fibroblasts, and osteoclastlike cells were found at bone-resorption areas. These cells appeared to be responsible for bone resorption through production of prostaglandin E2, osteoclast-activating factor, and proteases.