Yen P T, Huang T S
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Sep;21(3):306-11.
Impairment of the mucociliary system of the middle ear epithelium is a key step in developing otitis media with effusion. Effective propulsion of the viscoelastic gel layer of mucus requires a control of the depth of the periciliary sol layer by means of epithelial ion transport. In a previous study, we successfully demonstrated modulation of ion transport via short-circuit current changes by specific stimulation of adenosine triphosphate (ATP) receptors in a middle ear cell line.
Otitis media with effusion was developed in gerbils by infusing Escherichia coli E.coli lipopolysaccaride. In group A, E. coli lipopolysaccharide was first infused, and after establishment of middle ear fluid, the right ear was infused with 10(-4) M ATP, while the left ear remained as the control. In group B, the right ear was infused first with 10(-4) M ATP followed by bilateral infusion with endotoxin. The morphology of the middle ear mucosa was studied using scanning electron microscopy (SEM).
Group A showed fluid clearance in 5 out of 15 ATP-treated right ears while 3 out of 15 left ears showed clearance. Group B showed persistent presence of fluid in 11 out of 15 ATP-treated right ears, while the left ears showed fluid in 13 out of 15. SEM study consistently demonstrated scanty cilia in the non-ATP treated ears, but in ATP-treated ears the cilia remained abundant.
Although the results showed that ATP could not effectively prevent or clear middle ear effusion, the SEM result showed a marked beneficial effect of ATP on preserving ciliary configuration.
中耳上皮黏液纤毛系统受损是分泌性中耳炎发展的关键步骤。黏液黏弹性凝胶层的有效推进需要通过上皮离子转运来控制纤毛周围溶胶层的深度。在先前的一项研究中,我们通过特异性刺激中耳细胞系中的三磷酸腺苷(ATP)受体,成功证明了通过短路电流变化对离子转运的调节作用。
通过向沙土鼠注入大肠杆菌脂多糖来诱发分泌性中耳炎。在A组中,首先注入大肠杆菌脂多糖,在中耳积液形成后,右耳注入10⁻⁴ M ATP,而左耳作为对照。在B组中,右耳先注入10⁻⁴ M ATP,然后双侧注入内毒素。使用扫描电子显微镜(SEM)研究中耳黏膜的形态。
A组中,15只接受ATP治疗的右耳中有5只出现液体清除,而15只左耳中有3只出现清除。B组中,15只接受ATP治疗的右耳中有11只持续存在液体,而15只左耳中有13只出现液体。SEM研究一致表明,未接受ATP治疗的耳朵中纤毛稀少,但接受ATP治疗的耳朵中纤毛仍然丰富。
尽管结果表明ATP不能有效预防或清除中耳积液,但SEM结果显示ATP对保持纤毛形态有显著的有益作用。