1
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Lee CM, Go YY, Song JJ. Inhibition of lipopolysaccharide-induced inflammation by trophoblast-conditioned medium and trophoblast-derived extracellular vesicles in human middle ear epithelial cells. Sci Rep 2023; 13:19822. [PMID: 37963902 PMCID: PMC10645728 DOI: 10.1038/s41598-023-46731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
Otitis media is a common disease but can cause severe inner ear inflammation and hearing loss if it persists for more than two weeks. This study elucidates the inflammation-inhibiting efficacy of conditioned medium (CM) and extracellular vesicles (EVs) derived from human trophoblast (TB) cells in lipopolysaccharide (LPS)-induced human middle ear epithelial cells (HMEECs). TB-conditioned medium (TB-CM) reduced the inflammatory response and regulated mucin and epithelial sodium channel genes in LPS-induced HMEECs. The underlying mechanism of cell migration during inflammatory healing in LPS-induced HMEECs treated with TB-CM was determined by RNA-sequencing analysis. Specifically, the NF-κB pathway related to the copper metabolism MURR1 domain protein was studied and verified through siRNA. This elucidation of the anti-inflammatory effect of TB-CM and TB-derived EVs demonstrates their clinical potential to treat chronic inflammation.
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Affiliation(s)
- Chan Mi Lee
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Young Go
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
- Center for Health Care Convergence at Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae-Jun Song
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
- Center for Health Care Convergence at Korea University Guro Hospital, Seoul, Republic of Korea.
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2
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Abdel-Razek O, Audlin J, Poe DS, Wang G. Surfactant proteins and innate immunity of otitis media. Innate Immun 2022; 28:213-223. [PMID: 36069032 PMCID: PMC9900255 DOI: 10.1177/17534259221123309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Otitis media (OM) is the most common disease among young children and one of the most frequent reasons to visit the pediatrician. Development of OM requires nasopharyngeal colonization by a pathogen which must gain access to the tympanic cavity through the eustachian tube (ET) along with being able to overcome the defense mechanisms of the immune system and middle ear mucosa. OM can be caused by viral or bacterial infection. The three main bacterial pathogens are Streptococcus pneumoniae, nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis. Innate immunity is important in OM resolution as the disease occurs in very young children before the development of specific immunity. Elements of innate immunity include natural barriers and pattern recognition receptors such as Toll like receptors (TLRs), and Nod like receptors (NLRs). Surfactant proteins A (SP-A) and D (SP-D) act as pattern recognition receptors and are found in the lung and many other tissues including the ET and the middle ear where they probably function in host defense. Surfactant has a potential for use in the treatment of OM due to surface tension lowering function in the ET, and the possible immune functions of SP-D and SP-A in the middle ear and ET.
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Affiliation(s)
- Osama Abdel-Razek
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA,Guirong Wang, Department of Surgery, UH Room 8715, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY, 13210, USA.
| | - Jason Audlin
- Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Guirong Wang
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
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3
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Xia A, Thai A, Cao Z, Chen X, Chen J, Bacacao B, Bekale LA, Schiel V, Bollyky PL, Maria PLS. Chronic suppurative otitis media causes macrophage-associated sensorineural hearing loss. J Neuroinflammation 2022; 19:224. [PMID: 36096817 PMCID: PMC9465898 DOI: 10.1186/s12974-022-02585-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic suppurative otitis media (CSOM) is the most common cause of permanent hearing loss in children in the developing world. A large component of the permanent hearing loss is sensory in nature and our understanding of the mechanism of this has so far been limited to post-mortem human specimens or acute infection models that are not representative of human CSOM. In this report, we assess cochlear injury in a validated Pseudomonas aeruginosa (PA) CSOM mouse model. Methods We generated persisters (PCs) and inoculated them into the mouse middle ear cavity. We tracked infection with IVIS and detected PA using RT-PCR. We assessed cochlear damage and innate immunity by Immunohistochemistry. Finally, we evaluated cytokines with multiplex assay and quantitative real-time PCR. Results We observed outer hair cell (OHC) loss predominantly in the basal turn of the cochlear at 14 days after bacterial inoculation. Macrophages, not neutrophils are the major immune cells in the cochlea in CSOM displaying increased numbers and a distribution correlated with the observed cochlear injury. The progression of the morphological changes suggests a transition from monocytes into tissue macrophages following infection. We also show that PA do not enter the cochlea and live bacteria are required for cochlear injury. We characterized cytokine activity in the CSOM cochlea. Conclusions Taken together, this data shows a critical role for macrophages in CSOM-mediated sensorineural hearing loss (SNHL). Supplementary Information The online version contains supplementary material available at 10.1186/s12974-022-02585-w.
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Huang C, Wang Q, Pan X, Li W, Liu W, Jiang W, Huang L, Peng A, Zhang Z. Up-Regulated Expression of Interferon-Gamma, Interleukin-6 and Tumor Necrosis Factor-Alpha in the Endolymphatic Sac of Meniere's Disease Suggesting the Local Inflammatory Response Underlies the Mechanism of This Disease. Front Neurol 2022; 13:781031. [PMID: 35280304 PMCID: PMC8904419 DOI: 10.3389/fneur.2022.781031] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/27/2022] [Indexed: 12/20/2022] Open
Abstract
Background Immune mediated inflammatory changes affecting the endolymphatic sac (ES) may underlie the pathology of Meniere's disease (MD). The aim of the present study was to explore the differentially expressed cytokines in ES luminal fluid (ELF) of patients with MD, and the correlation between the expression of cytokines in the ELF with that in the serum was determined by quantitatively analyzing the cytokines in human ELF and serum. Methods Human ELF, serum and ES tissues were collected from patients with unilateral MD and patients with acoustic neuroma (AN) during surgery. The Simoa Cytokine 6-Plex Panel kit was used to analyze the levels of cytokines in the ELF and blood samples of the patients. Immunohistochemistry and immunofluorescence were subsequently used to validate the relative expression levels of the cytokines in MD. Results Significant differences were identified in the expression levels of interferon-γ (IFN-γ) (P < 0.001), interleukin (IL)-6 (P = 0.008) and tumor necrosis factor-α (TNF-α) (P = 0.036) in the luminal fluid of the ES comparing between the MD and AN groups. By contrast, the levels of IFN-γ, IL-10, IL-12p70, IL-17A, IL-6 and TNF-α in the serum of the MD group were not significantly different from those of either the AN group or healthy control subjects. In addition, no significant correlations in the expression levels of cytokines compared between the ELF and serum were found for the patients in either the MD or the AN group. Finally, the detection of positive expression of TNF-α, IL-6 and IFN-γ in the epithelial cells of the majority of ES specimens from patients with MD confirmed the up-regulated expression of these cytokines in the ES of patients with MD. Conclusions The identification of up-regulated expression levels of TNF-α, IL-6 and IFN-γ in the ELF in the present study has provided direct evidence for an increased immunologic activity in the microenvironment of the ES in patients with unilateral MD, may suggest the local inflammatory response underlies the mechanism of this disease.
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Affiliation(s)
- Chao Huang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qin Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xueying Pan
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Li
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenqi Jiang
- Department of Anesthesiology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Li Huang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Anquan Peng
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhiwen Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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5
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Evaluation of vestibular function in children with purulent media otitis by computer stabilometry. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.002172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the research – assessment of vestibular function in children with acute purulent otitis media by computer static stabilometry compared with typically developed children of the same age.
Materials and methods: 22 children with purulent otitis media aged 4 to 7 years and 30 practically healthy peers were examined by static stabilometry on the device “MPFI stabilograph 1” (Kharkiv, Ukraine). Indicators of variation and shape of the pressure center distribution, spectral-correlation indicators of stabilograms, as well as integral indicators of stability (length, velocity and angle of postural oscillations) were taken into account and the equilibrium functions of the two sensory states (open and closed eyes) are calculated in the StabiliS software.
Results: purulent otitis media causes posterior displacement of the absolute coordinates of the pressure center. In the state with closed eyes, children with purulent otitis differ from their healthy coevals by 14 of 24 stabilometric parameters, including stabilogram length, speed, angle and amplitude of oscillations, giving way to them in the stability of equilibrium. Children with purulent otitis media are more sensitive to the visual canal of postural control than their coevals. Involvement of visual afferents in postural control significantly improves balance maintenance in children with purulent otitis by reducing deviations of postural oscillations, which is reflected in the probable changes of 9 out of 24 stabilometric parameters compared to control.
Conclusions: In preschool age, purulent otitis media leads to latent vestibular dysfunction, which is manifested by a violation of the stability of the vertical posture in a state with closed eyes and is compensated by visual-vestibulo-proprioceptive integration in the process of postural control.
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6
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Massa HM, Spann KM, Cripps AW. Innate Immunity in the Middle Ear Mucosa. Front Cell Infect Microbiol 2021; 11:764772. [PMID: 34778109 PMCID: PMC8586084 DOI: 10.3389/fcimb.2021.764772] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/11/2021] [Indexed: 01/14/2023] Open
Abstract
Otitis media (OM) encompasses a spectrum of clinical presentations ranging from the readily identifiable Acute OM (AOM), which is characterised by otalgia and fever, to chronic otitis media with effusion (COME) where impaired hearing due to middle ear effusion may be the only clinical symptom. Chronic suppurative OM (CSOM) presents as a more severe form of OM, involving perforation of the tympanic membrane. The pathogenesis of OM in these varied clinical presentations is unclear but activation of the innate inflammatory responses to viral and/or bacterial infection of the upper respiratory tract performs an integral role. This localised inflammatory response can persist even after pathogens are cleared from the middle ear, eustachian tubes and, in the case of respiratory viruses, even the nasal compartment. Children prone to OM may experience an over exuberant inflammatory response that underlies the development of chronic forms of OM and their sequelae, including hearing impairment. Treatments for chronic effusive forms of OM are limited, with current therapeutic guidelines recommending a "watch and wait" strategy rather than active treatment with antibiotics, corticosteroids or other anti-inflammatory drugs. Overall, there is a clear need for more targeted and effective treatments that either prevent or reduce the hyper-inflammatory response associated with chronic forms of OM. Improved treatment options rely upon an in-depth understanding of OM pathogenesis, particularly the role of the host innate immune response during acute OM. In this paper, we review the current literature regarding the innate immune response within the middle ear to bacterial and viral otopathogens alone, and as co-infections. This is an important consideration, as the role of respiratory viruses as primary pathogens in OM is not yet fully understood. Furthermore, increased reporting from PCR-based diagnostics, indicates that viral/bacterial co-infections in the middle ear are more common than bacterial infections alone. Increasingly, the mechanisms by which viral/bacterial co-infections may drive or maintain complex innate immune responses and inflammation during OM as a chronic response require investigation. Improved understanding of the pathogenesis of chronic OM, including host innate immune response within the middle ear is vital for development of improved diagnostic and treatment options for our children.
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Affiliation(s)
- Helen M Massa
- School of Pharmacy and Medical Science, Griffith University, Gold Coast, QLD, Australia
| | - Kirsten M Spann
- Centre for Immunology and Infection Control, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Allan W Cripps
- Menzies Health Institute Queensland, School of Medicine, Griffith University, Gold Coast, QLD, Australia.,School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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7
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Bae SH, Yoo JE, Hong JW, Park HR, Noh B, Kim H, Kang M, Hyun YM, Gee HY, Choi JY, Jung J. LCCL peptide cleavage after noise exposure exacerbates hearing loss and is associated with the monocyte infiltration in the cochlea. Hear Res 2021; 412:108378. [PMID: 34735822 DOI: 10.1016/j.heares.2021.108378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/30/2021] [Accepted: 10/19/2021] [Indexed: 12/19/2022]
Abstract
Acoustic trauma induces an inflammatory response in the cochlea, resulting in debilitating hearing function. Clinically, amelioration of inflammation substantially prevents noise-induced hearing loss. The Limulus factor C, Cochlin, and Lgl1 (LCCL) peptide plays an important role in innate immunity during bacteria-induced inflammation in the cochlea. We aimed to investigate the LCCL-induced innate immune response to noise exposure and its impact on hearing function. METHODS We used Coch (encodes cochlin harboring LCCL peptide) knock-out and p.G88E knock-in mice to compare the immune responses before and after noise exposure. We explored their hearing function and hair cell degeneration. Moreover, we investigated distinct characteristics of immune responses upon noise exposure using flow cytometry and RNA sequencing. RESULTS One day after noise exposure, the LCCL peptide cleaved from cochlin increased over time in the perilymph space. Both Coch-/- and CochG88E/G88E mutant mice revealed more preserved hearing following acoustic trauma compared to wild-type mice. The outer hair cells were more preserved in Coch-/- than in wild-type mice upon noise exposure. The RNA sequencing data demonstrated significantly upregulated cell migration gene ontology in wild-type mice than in Coch-/- mice following noise exposure, indicating that the infiltration of immune cells was dependent on cochlin. Notably, infiltrated monocytes from blood (C11b+/Ly6G-/Ly6C+) were remarkably higher in wild-type mice than in Coch-/- mice at 1 day after noise exposure. CONCLUSIONS Noise-induced hearing loss was attributed to over-stimulated cochlin, and led to the cleavage and secretion of LCCL peptide in the cochlea. The LCCL peptide recruited more monocytes from the blood vessels upon noise stimulation, thus highlighting a novel therapeutic target for noise-induced hearing loss.
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Key Words
- AIED, Autoimmune Inner Ear Disease
- Acoustic trauma, animal study, inflammatory response, LCCL peptide, noise-induced hearing loss, Abbreviations, ABR, auditory brainstem response
- CCL2, C-C motif chemokine ligand 2
- DEGs, differentially expressed genes
- EDTA, ethylenediaminetetraacetic acid
- IL-1β, interleukin-1β
- IL-6, interleukin-6
- KO, knock-out
- LCCL, Limulus factor C, Cochlin, and Lgl1
- NIHL, noise-induced hearing loss
- RNA-seq, RNA sequencing
- RT-PCR, real-time polymerase chain reaction
- SDS, sodium dodecyl sulfate
- SPL, sound pressure level
- Tnf-α, tumor necrosis factor alpha
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Affiliation(s)
- Seong Hoon Bae
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Eun Yoo
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Won Hong
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Haeng Ran Park
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byunghwa Noh
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyoyeol Kim
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minjin Kang
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Min Hyun
- Department of Anatomy, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heon Yung Gee
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea.
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8
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Wu L, Vasilijic S, Sun Y, Chen J, Landegger LD, Zhang Y, Zhou W, Ren J, Early S, Yin Z, Ho WW, Zhang N, Gao X, Lee GY, Datta M, Sagers JE, Brown A, Muzikansky A, Stemmer-Rachamimov A, Zhang L, Plotkin SR, Jain RK, Stankovic KM, Xu L. Losartan prevents tumor-induced hearing loss and augments radiation efficacy in NF2 schwannoma rodent models. Sci Transl Med 2021; 13:eabd4816. [PMID: 34261799 PMCID: PMC8409338 DOI: 10.1126/scitranslmed.abd4816] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/10/2020] [Accepted: 05/20/2021] [Indexed: 12/14/2022]
Abstract
Hearing loss is one of the most common symptoms of neurofibromatosis type 2 (NF2) caused by vestibular schwannomas (VSs). Fibrosis in the VS tumor microenvironment (TME) is associated with hearing loss in patients with NF2. We hypothesized that reducing the fibrosis using losartan, an FDA-approved antihypertensive drug that blocks fibrotic and inflammatory signaling, could improve hearing. Using NF2 mouse models, we found that losartan treatment normalized the TME by (i) reducing neuroinflammatory IL-6/STAT3 signaling and preventing hearing loss, (ii) normalizing tumor vasculature and alleviating neuro-edema, and (iii) increasing oxygen delivery and enhancing efficacy of radiation therapy. In preparation to translate these exciting findings into the clinic, we used patient samples and data and demonstrated that IL-6/STAT3 signaling inversely associated with hearing function, that elevated production of tumor-derived IL-6 was associated with reduced viability of cochlear sensory cells and neurons in ex vivo organotypic cochlear cultures, and that patients receiving angiotensin receptor blockers have no progression in VS-induced hearing loss compared with patients on other or no antihypertensives based on a retrospective analysis of patients with VS and hypertension. Our study provides the rationale and critical data for a prospective clinical trial of losartan in patients with VS.
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Affiliation(s)
- Limeng Wu
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Sasa Vasilijic
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
| | - Yao Sun
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jie Chen
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lukas D Landegger
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
| | - Yanling Zhang
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Wenjianlong Zhou
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jun Ren
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Samuel Early
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, UC San Diego Medical Center, San Diego, CA 92103, USA
| | - Zhenzhen Yin
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - William W Ho
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Na Zhang
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China
| | - Xing Gao
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Grace Y Lee
- St. Mark's School, Southborough, MA 01772, USA
| | - Meenal Datta
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jessica E Sagers
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
| | - Alyssa Brown
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
| | - Alona Muzikansky
- Division of Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | | | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China
| | - Scott R Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Rakesh K Jain
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Konstantina M Stankovic
- Eaton-Peabody Laboratories and Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA.
| | - Lei Xu
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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9
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Ghosh S, Stansak K, Walters BJ. Cannabinoid Signaling in Auditory Function and Development. Front Mol Neurosci 2021; 14:678510. [PMID: 34079440 PMCID: PMC8165240 DOI: 10.3389/fnmol.2021.678510] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/15/2021] [Indexed: 12/20/2022] Open
Abstract
Plants of the genus Cannabis have been used by humans for millennia for a variety of purposes. Perhaps most notable is the use of certain Cannabis strains for their psychoactive effects. More recently, several biologically active molecules within the plants of these Cannabis strains, called phytocannabinoids or simply cannabinoids, have been identified. Furthermore, within human cells, endogenous cannabinoids, or endocannabinoids, as well as the receptors and secondary messengers that give rise to their neuromodulatory effects, have also been characterized. This endocannabinoid system (ECS) is composed of two primary ligands-anandamide and 2-arachidonyl glycerol; two primary receptors-cannabinoid receptors 1 and 2; and several enzymes involved in biosynthesis and degradation of endocannabinoid ligands including diacylglycerol lipase (DAGL) and monoacylglycerol lipase (MAGL). Here we briefly summarize cannabinoid signaling and review what has been discerned to date with regard to cannabinoid signaling in the auditory system and its roles in normal physiological function as well as pathological conditions. While much has been uncovered regarding cannabinoid signaling in the central nervous system, less attention has been paid to the auditory system specifically. Still, evidence is emerging to suggest that cannabinoid signaling is critical for the development, maturation, function, and survival of cochlear hair cells (HCs) and spiral ganglion neurons (SGNs). Furthermore, cannabinoid signaling can have profound effects on synaptic connectivity in CNS structures related to auditory processing. While clinical cases demonstrate that endogenous and exogenous cannabinoids impact auditory function, this review highlights several areas, such as SGN development, where more research is warranted.
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Affiliation(s)
- Sumana Ghosh
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kendra Stansak
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Bradley J Walters
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, United States
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10
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Nystagmus in adult patients with acute otitis media or otitis media with effusion without dizziness. PLoS One 2021; 16:e0250357. [PMID: 33983960 PMCID: PMC8118351 DOI: 10.1371/journal.pone.0250357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/05/2021] [Indexed: 11/19/2022] Open
Abstract
The present study aimed to investigate the incidence and patterns of nystagmus in adult patients with acute otitis media (AOM) or otitis media with effusion (OME) without dizziness or vertigo, and discuss possible mechanisms. From February 2018 to November 2018, 34 consecutive patients with AOM or OME without dizziness were included. Nystagmus was examined with video Frenzel glasses. Of 34 adult AOM or OME patients without dizziness, nystagmus was observed in 28 patients (82%). In unilateral AOM or OME (n = 30), the most commonly observed nystagmus pattern was irritative-type direction-fixed nystagmus (n = 13), followed by paretic-type direction-fixed nystagmus (n = 8), and direction-changing positional nystagmus (n = 4). In bilateral AOM or OME (n = 4), direction-fixed nystagmus and direction-changing positional nystagmus were observed in two and one patients, respectively. Nystagmus was observed in as many as 82% of adult AOM or OME patients even though they did not complain of dizziness, and the pattern of nystagmus was either direction-fixed or direction-changing. Direct effect of inflammatory mediators penetrated from the middle ear and biochemical alteration in the inner ear fluids due to blood-perilymph barrier dysfunction may result in the presence of nystagmus in AOM or OME patients without dizziness.
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11
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Chai Y, He W, Yang W, Hetrick AP, Gonzalez JG, Sargsyan L, Wu H, Jung TTK, Li H. Intratympanic Lipopolysaccharide Elevates Systemic Fluorescent Gentamicin Uptake in the Cochlea. Laryngoscope 2021; 131:E2573-E2582. [PMID: 33956344 PMCID: PMC8453712 DOI: 10.1002/lary.29610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022]
Abstract
Objectives/Hypothesis Lipopolysaccharide (LPS), a key component of bacterial endotoxins, activates macrophages and triggers the release of inflammatory cytokines in mammalian tissues. Recent studies have shown that intratympanic injection of LPS simulates acute otitis media (AOM) and results in morphological and functional changes in the inner ear. Here we established an AOM mouse model with LPS to investigate the uptake of ototoxic gentamicin in the inner ear, and elucidated the underlying mechanism by focusing on cochlear inflammation as a result of AOM. Study Design Preclinical rodent animal model. Methods Fluorescently tagged gentamicin (GTTR) was systemically administered to mice with AOM. Iba1‐positive macrophage morphology and inner ear cytokine profile were evaluated by immunofluorescence technique and a mouse cytokine array kit, respectively. Results We observed characteristic symptoms of AOM in the LPS‐treated ears with elevated hearing thresholds indicating a conductive hearing loss. More importantly, the LPS‐induced AOM activated cochlear inflammatory responses, manifested by macrophage infiltration, particularly in the organ of Corti and the spiral ligament, in addition to the up‐regulation of proinflammatory cytokines. Meanwhile, GTTR uptake in the stria vascularis and sensory hair cells from all the LPS‐treated ears was significantly enhanced at 24, 48, and 72‐hour post‐treatment, as the most prominent enhancement was observed in the 48‐hour group. Conclusion In summary, this study suggests that the pathological cochlea is more susceptible to ototoxic drugs, including aminoglycosides, and justified the clinical concern of aminoglycoside ototoxicity in the AOM treatment. Laryngoscope, 131:E2573–E2582, 2021
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Affiliation(s)
- Yongchuan Chai
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Weiwei He
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Weiqiang Yang
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Alisa P Hetrick
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Jessica G Gonzalez
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Liana Sargsyan
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Hao Wu
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Timothy T K Jung
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Hongzhe Li
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
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12
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Clinical evaluation of the vestibular impairment using video head impulse test In children with acute otitis media. Int J Pediatr Otorhinolaryngol 2021; 141:110568. [PMID: 33341714 DOI: 10.1016/j.ijporl.2020.110568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The objectives of the present study were to evaluate the vestibular impairment in children with acute otitis media (AOM) and dizziness by using video head impulse test (vHIT) and to compare their results with healthy children. METHODS The study included two groups of subjects. The patient group consisted of 34 pediatric patients with AOM and dizziness and the control group consisted of 35 healthy children, age between 4 and 15. The age, gender, mean vHIT gains and gain asymmetry values were compared between groups for each canal. In both groups, mean vHIT gains were compared between the right and left sides. Additionally, mean vHIT gains and the presence of saccades according to AOM stages were analyzed. RESULTS The comparison of vHIT gains between affected and unaffected sides in patients revealed a significant decrease only in the anterior canal plane on the affected side. Covert saccades were observed in 32% of the patients. When comparing the AOM stages and the presence of saccades in patients, no difference was detected between stages. CONCLUSION vHIT is a useful vestibular test for the evaluation of vestibular impairment in children with an applicability rate of 92% in healthy children and 70% in patients with AOM and dizziness. The patients with AOM and dizziness are presented with a decrease in vHIT gains and the presence of cover saccades only in vertical canal planes, supporting that slight vestibular impairment in these patients may represent pathologic vHIT results only in vertical canal planes.
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13
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Monsanto RDC, Penido NDO, Uchiyama M, Schachern P, Paparella MM, Cureoglu S. Quantitative assessment of cochlear and vestibular ganglion neurons in temporal bones with chronic otitis media. Eur Arch Otorhinolaryngol 2020; 278:331-338. [PMID: 32488375 PMCID: PMC10123924 DOI: 10.1007/s00405-020-06094-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In this study, we aimed to determine whether or not COM leads to loss of spiral and Scarpa ganglion neurons. METHODS From the human temporal bone (HTB) collection at the University of Minnesota we selected human temporal bones with COM, defined as the presence of clinically intractable tissue abnormalities in the middle ear (cholesteatoma, perforation of the eardrum, granulation tissue, fibrosis, tympanosclerosis, and cholesterol granuloma). We also selected HTBs from donors with no ear diseases as controls. We quantitatively analyzed the number of spiral and Scarpa ganglion cells and compared the results obtained in the control and study groups. RESULTS In both COM and control groups we observed a significant negative correlation between age and number of both spiral (R = -0.632; P < 0.001; 95% CI - 0.766 to - 0.434) and Scarpa ganglion (R = - 0.404; P = 0.008; 95% CI - 0.636 to - 0.051) cells. We did not find any significant differences in the number of spiral ganglion cells (in total or per segment) or in the density of Scarpa ganglion cells (in each vestibular nerve or both) in the COM group as compared with controls (P > 0.05). CONCLUSIONS AND RELEVANCE Our results did not demonstrate significant loss of cochlear or vestibular peripheral ganglion neuron loss in HTBs with COM as compared with controls.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), R dos Otonis, 700 - piso superior - Vila Clementino, São Paulo, SP, 04037-004, Brazil.
| | - Norma de Oliveira Penido
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), R dos Otonis, 700 - piso superior - Vila Clementino, São Paulo, SP, 04037-004, Brazil
| | - Mio Uchiyama
- Department of Otolaryngology, Showa University, Tokyo, Japan.,Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Patricia Schachern
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Michael M Paparella
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.,Paparella Ear Head and Neck Institute, Minneapolis, MN, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
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14
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Direction-Changing Positional Nystagmus in Acute Otitis Media Complicated by Serous Labyrinthitis: New Insights into Positional Nystagmus. Otol Neurotol 2020; 40:e393-e398. [PMID: 30870366 DOI: 10.1097/mao.0000000000002104] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To demonstrate characteristic nystagmus findings in acute otitis media (AOM) complicated by serous labyrinthitis and discuss the mechanism of direction-changing positional nystagmus (DCPN) in this condition. PATIENTS A patient with AOM complicated by serous labyrinthitis on the left side. INTERVENTION Video nystagmography and 3D fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). MAIN OUTCOME MEASURES Characterize positional nystagmus in a head-roll test observing the change of nystagmus direction in process of time and compare findings of temporal bone 3D FLAIR MRI. RESULTS A previously healthy 50-year-old man who complained of acute otalgia, hearing loss, and vertigo was diagnosed with AOM complicated by serous labyrinthitis on the left side. A head-roll test performed on the day when vertigo developed showed persistent geotropic DCPN. While pre- and postcontrast T1-weighted MRI showed no signal abnormality in both inner ears, 10-minute delay postcontrast 3D FLAIR image showed enhancement in the inner ear on the left side. Four-hour-delay postcontrast 3D FLAIR images showed more conspicuous enhancement of the whole cochlea, vestibule, and semicircular canals on the left side. CONCLUSIONS In AOM complicated by serous labyrinthitis, density of perilymph may increase due to direct penetration of cytokines and other inflammatory mediators from the middle ear into perilymph and breakdown of blood-labyrinth barrier that causes vascular leakage of serum albumin into perilymph. The density difference between perilymph and endolymph makes the semicircular canal gravity sensitive. A buoyant force is also generated by gravity, causing indentation of endolymphatic membrane in the ampulla and cupula displacement. Thus, at the early stage of serous labyrinthitis, a head-roll test may elicit persistent geotropic DCPN, of which the direction can be changed over time.
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15
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Abstract
In children with normal hearing, inflammatory disorders caused by infections of the middle ear (otitis media) are the most common ear illnesses. Many of older adults experience some level of hearing loss. Several factors can lead to either a partial loss or the total inability to hear (deafness) including exposure to noise, a hereditary predisposition, chronic infections, traumas, medications, and aging.
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16
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Landegger LD, Vasilijic S, Fujita T, Soares VY, Seist R, Xu L, Stankovic KM. Cytokine Levels in Inner Ear Fluid of Young and Aged Mice as Molecular Biomarkers of Noise-Induced Hearing Loss. Front Neurol 2019; 10:977. [PMID: 31632328 PMCID: PMC6749100 DOI: 10.3389/fneur.2019.00977] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022] Open
Abstract
Sensorineural hearing loss (SNHL) is the most common sensory deficit worldwide, frequently caused by noise trauma and aging, with inflammation being implicated in both pathologies. Here, we provide the first direct measurements of proinflammatory cytokines in inner ear fluid, perilymph, of adolescent and 2-year-old mice. The perilymph of adolescent mice exposed to the noise intensity resulting in permanent auditory threshold elevations had significantly increased levels of IL-6, TNF-α, and CXCL1 6 h after exposure, with CXCL1 levels being most elevated (19.3 ± 6.2 fold). We next provide the first immunohistochemical localization of CXCL1 in specific cochlear supporting cells, and its presumed receptor, Duffy antigen receptor for chemokines (DARC), in hair cells and spiral ganglion neurons. Our results demonstrate the feasibility of molecular diagnostics of SNHL using only 0.5 μL of perilymph, and motivate future sub-μL based diagnostics of human SNHL based on liquid biopsy of the inner ear to guide therapy, promote hearing protection, and monitor response to treatment.
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Affiliation(s)
- Lukas D Landegger
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Sasa Vasilijic
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - Takeshi Fujita
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - Vitor Y Soares
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - Richard Seist
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - Lei Xu
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Program in Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, United States.,Program in Therapeutic Science, Harvard Medical School, Boston, MA, United States
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17
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Sone M. Inner ear disturbances related to middle ear inflammation. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 79:1-7. [PMID: 28303055 PMCID: PMC5346614 DOI: 10.18999/nagjms.79.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The inner and middle ear are connected mainly through round and oval windows, and inflammation in the middle ear cavity can spread into the inner ear, which might induce a disturbance. In cases with intractable otitis media, attention should also be paid to symptoms related to the inner ear. In this paper, middle ear inflammation and related inner ear disturbances are reviewed with a focus on representative middle ear diseases (such as acute otitis media, chronic otitis media, otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis, eosinophilic otitis media, cholesteatoma with labyrinthine fistula, and reflux-related otitis media). Their clinical concerns are then discussed with reference to experimental studies. In these diseases, early diagnosis and adequate treatment are required to manage not only middle ear but also inner ear conditions.
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Affiliation(s)
- Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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18
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Ren Y, Stankovic KM. The Role of Tumor Necrosis Factor Alpha (TNFα)in Hearing Loss and Vestibular Schwannomas. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018; 6:15-23. [PMID: 31485383 DOI: 10.1007/s40136-018-0186-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose of review The aim of this review is to highlight relevant literature on the role of tumor necrosis factor alpha (TNFα) in sensorineural hearing loss (SNHL) and vestibular schwannomas (VS). Recent Findings A comprehensive review of publically available databases including PubMed was performed. The mechanism by which hearing loss occurs in VS is still unknown and likely multifactorial. Genetic differences between VSs and tumor secreted proteins may be responsible, at least in part, for VS-associated SNHL. TNFα has pleotropic roles in promoting inflammation, maintaining cellular homeostasis, inducing apoptosis, and mediating ototoxicity in patients with sporadic VS. TNFα-targeted therapies have shown efficacy in both animal models of sensorineural hearing loss and clinical trials in patients with immune-mediated hearing loss. Efforts are underway to develop novel nanotechnology-based methods to target TNFα and other pathogenic molecules in VS. Summary Development of molecularly targeted therapies against TNFα represents an important area of research in ameliorating VS-associated hearing loss.
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Affiliation(s)
- Yin Ren
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA.,Department of Otolaryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Konstantina M Stankovic
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA.,Department of Otolaryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.,Eaton Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA.,Harvard Program in Speech and Hearing Bioscience and Technology, 25 Shattuck Street, Boston, MA 02115, USA
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19
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Zernotti ME, Pawankar R, Ansotegui I, Badellino H, Croce JS, Hossny E, Ebisawa M, Rosario N, Sanchez Borges M, Zhang Y, Zhang L. Otitis media with effusion and atopy: is there a causal relationship? World Allergy Organ J 2017; 10:37. [PMID: 29158869 PMCID: PMC5684754 DOI: 10.1186/s40413-017-0168-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 09/13/2017] [Indexed: 12/14/2022] Open
Abstract
Otitis Media with Effusion (OME) is an inflammatory condition of the middle ear cleft, acute or chronic, with collection of fluid in the middle ear with an intact tympanic membrane. It is a very common disease in childhood, the most frequent cause of hearing loss in childhood and often requiring surgery. OME is called chronic when the fluid in the middle ear persists for more than three months or when the episodes recur six or more times in one year. The current article covers various aspects of OME including definition, epidemiology. Pathomechanisms, risk factors, role of allergy in OME, impact of upper airway disease on OME, eosinophilic otitis media and management of OME.
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Affiliation(s)
- Mario E. Zernotti
- Department of Otolaryngology, Catholic University of Córdoba, Córdoba, Argentina
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Ignacio Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - Hector Badellino
- Department of Pediatric Respiratory Medicine, Regional Eastern Clinic, San Francisco, Córdoba, Argentina
| | | | - Elham Hossny
- Pediatric Allergy Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt
| | - Motohiro Ebisawa
- Department of Pediatrics, National Sagamihara Hospital, Sagamihara-shi, Kanagawa Japan
| | | | - Mario Sanchez Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Yuan Zhang
- Department of Otolaryngology – Head and Neck Surgery, Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology – Head and Neck Surgery, Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
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20
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Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion. The Journal of Laryngology & Otology 2017; 131:907-913. [DOI: 10.1017/s0022215117001700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2–11 years.Methods:A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry.Results:The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months.Conclusion:Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.
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21
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Koo JW, Quintanilla-Dieck L, Jiang M, Liu J, Urdang ZD, Allensworth JJ, Cross CP, Li H, Steyger PS. Endotoxemia-mediated inflammation potentiates aminoglycoside-induced ototoxicity. Sci Transl Med 2016. [PMID: 26223301 DOI: 10.1126/scitranslmed.aac5546] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The ototoxic aminoglycoside antibiotics are essential to treat severe bacterial infections, particularly in neonatal intensive care units. Using a bacterial lipopolysaccharide (LPS) experimental model of sepsis, we tested whether LPS-mediated inflammation potentiates cochlear uptake of aminoglycosides and permanent hearing loss in mice. Using confocal microscopy and enzyme-linked immunosorbent assays, we found that low-dose LPS (endotoxemia) greatly increased cochlear concentrations of aminoglycosides and resulted in vasodilation of cochlear capillaries without inducing paracellular flux across the blood-labyrinth barrier (BLB) or elevating serum concentrations of the drug. Additionally, endotoxemia increased expression of both serum and cochlear inflammatory markers. These LPS-induced changes, classically mediated by Toll-like receptor 4 (TLR4), were attenuated in TLR4-hyporesponsive mice. Multiday dosing with aminoglycosides during chronic endotoxemia induced greater hearing threshold shifts and sensory cell loss compared to mice without endotoxemia. Thus, endotoxemia-mediated inflammation enhanced aminoglycoside trafficking across the BLB and potentiated aminoglycoside-induced ototoxicity. These data indicate that patients with severe infections are at greater risk of aminoglycoside-induced hearing loss than previously recognized.
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Affiliation(s)
- Ja-Won Koo
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Kumiro, Bundang-gu, Seongnam 463-707, Republic of Korea
| | - Lourdes Quintanilla-Dieck
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Meiyan Jiang
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Jianping Liu
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Zachary D Urdang
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Jordan J Allensworth
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Campbell P Cross
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Hongzhe Li
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - Peter S Steyger
- Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
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22
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Anti-inflammatory and anti-oxidative effects of alpha-lipoic acid in experimentally induced acute otitis media. J Laryngol Otol 2016; 130:616-23. [DOI: 10.1017/s0022215116001183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:To investigate the anti-inflammatory, anti-oxidative and tissue protective effects, as well as the potential therapeutic role, of alpha-lipoic acid in experimentally induced acute otitis media.Methods:Twenty-five guinea pigs were assigned to one of five groups: a control (non-otitis) group, and otitis-induced groups treated with saline, penicillin G, alpha-lipoic acid, or alpha-lipoic acid plus penicillin G. Tissue samples were histologically analysed, and oxidative parameters in tissue samples were measured and compared between groups.Results:The epithelial integrity was better preserved, and histological signs of inflammation and secretory metaplasia were decreased, in all groups compared to the saline treated otitis group. In the alpha-lipoic acid plus penicillin G treated otitis group, epithelial integrity was well preserved and histological findings of inflammation were significantly decreased compared to the saline, penicillin G and alpha-lipoic acid treated otitis groups. The most favourable oxidative parameters were observed in the control group, followed by the alpha-lipoic acid plus penicillin G treated otitis group.Conclusion:Alpha-lipoic acid, with its antioxidant, anti-inflammatory and tissue protective properties, may decrease the clinical sequelae and morbidity associated with acute otitis media.
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23
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Intratympanic Steroid Treatments May Improve Hearing via Ion Homeostasis Alterations and Not Immune Suppression. Otol Neurotol 2016; 36:1089-95. [PMID: 25692799 DOI: 10.1097/mao.0000000000000725] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS The inner ear (IE) endothelium is capable of responding to therapeutic steroids by altering the local expression of cytokine and ion homeostasis genes that impact inflammation and fluid regulation. BACKGROUND Glucocorticoids are often given transtympanically for hearing disorders because of their anti-inflammatory effects, but their direct impact on IE ion homeostasis and cytokine gene expression has not been studied. METHODS The middle ears of Balb/c mice were transtympanically injected with 5 μL of phosphate-buffered saline, prednisolone (Pred), or dexamethasone (Dex). Untreated mice were used as controls. Mice were euthanized at 6, 24, and 72 hours; the cochleas were harvested; and total RNA was isolated from the IE tissues. Expression of eight cytokine genes and 24 ion homeostasis genes was analyzed with quantitative real time reverse transcription polymerase chain reaction. RESULTS Phosphate-buffered saline caused upregulation of inflammatory cytokine genes that peaked at 6 hours. Surprisingly, Pred and Dex also caused upregulation of most cytokine genes. Interestingly, ion homeostasis genes were predominantly upregulated with Dex and Pred, with Pred having a larger effect. CONCLUSION In the murine model, intratympanic steroids caused an initial upregulation of inflammatory cytokine genes in the IE, as well as predominant upregulation of ion homeostasis genes. These findings suggest that glucocorticoids do not suppress IE inflammation but rather cause an initial inflammatory response in the IE. Thus, inflammatory gene suppression is not a likely mechanism for their hearing restorative effects. On the other hand, these steroids have a significant mineralocorticoid function, as demonstrated by increased function of ion homeostasis genes, implicating their ionic and fluid regulatory properties as a mechanism for their therapeutic effects.
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24
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Relationship Between Otorhinolaryngologic Diseases and Obesity. Clin Exp Otorhinolaryngol 2015; 8:194-7. [PMID: 26330910 PMCID: PMC4553346 DOI: 10.3342/ceo.2015.8.3.194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 03/26/2014] [Accepted: 04/22/2014] [Indexed: 01/16/2023] Open
Abstract
Objectives Obesity rates have been increasing for all population groups worldwide, leading to the increased development of various diseases. This study was designed is to identify the relationships between obesity and several important otorhinolaryngologic diseases, including chronic otitis media (COM), chronic rhinosinusitis, and chronic tonsillitis. Methods Mean body mass index (BMI) was compared in patients with COM, rhinosinusitis, and tonsillitis and in a control group. The relationships among the prevalence rates of overweight and obesity, morbidity period, and BMI were assessed in each group. Results Mean BMIs in the COM, rhinosinusitis, and tonsillitis groups were 24.45±2.72 kg/m2, 24.68±3.25 kg/m2, and 24.67±3.82 kg/m2, respectively, with each significantly higher than in the control group (23.22±3.01 kg/m2, P<0.05). The rates of obesity in the COM, rhinosinusitis, and tonsillitis groups were 37.5%, 42.9%, and 40.1%, respectively, each significantly higher than in the control group (24.3%, P<0.05). However, the rates of overweight did not differ significantly in the COM, rhinosinusitis, and tonsillitis compared with the control group (P>0.05 each). Conclusion Mean BMI and the prevalence of obesity were elevated in the three groups of patients with representative otorhinolaryngologic inflammatory diseases, including COM, chronic rhinosinusitis, and chronic tonsillitis.
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Pro-inflammatory interleukins in middle ear effusions from atopic and non-atopic children with chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2015; 273:1369-78. [DOI: 10.1007/s00405-015-3683-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
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Abstract
Mucosal immune responses within the middle ear and eustachian tube generally provide an effective and efficient response to the presence of microbial pathogens, with approximately 80% of clinically recognizable middle ear infections resolved within 7 days. Particularly for young children aged less than 3 years of age, the proximity and direct connection of the middle ear, via the eustachian tube, to the nasopharynx provide increased risk of commensal bacteria and upper respiratory tract viruses infecting the middle ear. Mucosal immunological defense in the middle ear and eustachian tube utilizes a number of mechanisms, including physicochemical barriers of mucus and the mucosal epithelial cells and innate immune responses such as inflammation, cellular infiltration, effusion, and antimicrobial protein secretions, in addition to adaptive host immune responses. Recent advances in otopathogen recognition via microbial pattern recognition receptors and elucidation of complex signaling cascades have improved understanding of the coordination and regulation of the middle ear mucosal response. These advances support vaccine development aiming to reduce the risk of otitis media in children.
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Verhoeven D, Pichichero ME. Divergent mucosal and systemic responses in children in response to acute otitis media. Clin Exp Immunol 2014; 178:94-101. [PMID: 24889648 DOI: 10.1111/cei.12389] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2014] [Indexed: 12/21/2022] Open
Abstract
Acute otitis media (AOM), induced by respiratory bacteria, is a significant cause of children seeking medical attention worldwide. Some children are highly prone to AOMs, suffering three to four recurrent infections per year (prone). We previously determined that this population of children could have diminished anti-bacterial immune responses in peripheral blood that could fail to limit bacterial colonization in the nasopharynx (NP). Here, we examined local NP and middle ear (ME) responses and compared them to peripheral blood to examine whether the mucosa responses were similar to the peripheral blood responses. Moreover, we examined differences in effector cytokine responses between these two populations in the NP, ME and blood compartments at the onset of an AOM caused by either Streptococcus pneumoniae or non-typeable Haemophilus influenzae. We found that plasma effector cytokines patterned antigen-recall responses of CD4 T cells, with lower responses detected in prone children. ME cytokine levels did not mirror blood, but were more similar to the NP. Interferon (IFN)-γ and interleukin (IL)-17 in the NP were similar in prone and non-prone children, while IL-2 production was higher in prone children. The immune responses diverged in the mucosal and blood compartments at the onset of a bacterial ME infection, thus highlighting differences between local and systemic immune responses that could co-ordinate anti-bacterial immune responses in young children.
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Affiliation(s)
- D Verhoeven
- Rochester General Research Institute, Rochester General Hospital, Rochester, NY, USA
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Efficacy and safety of AM-101 in the treatment of acute inner ear tinnitus--a double-blind, randomized, placebo-controlled phase II study. Otol Neurotol 2014; 35:589-97. [PMID: 24603353 PMCID: PMC3966923 DOI: 10.1097/mao.0000000000000268] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective To evaluate the efficacy and safety of intratympanic AM-101 in patients with persistent acute inner ear tinnitus after acute acoustic trauma, idiopathic sudden sensorineural hearing loss (ISSNHL), or acute otitis media. Study Design Prospective, double-blind, randomized, placebo-controlled study with follow-up visits on Days 7, 30, and 90. Setting Twenty-eight European sites (academic tertiary referral centers and private ENT practices). Patients 248 patients aged 16 to 65 years. Interventions Three intratympanic injections of AM-101 (0.27 or 0.81 mg/ml) or placebo over 3 consecutive days. Main Outcome Measures Efficacy was assessed by changes in minimum masking level (MML; primary end point), loudness match, tinnitus loudness, tinnitus annoyance, and sleep difficulties on a 0 to 100 numerical rating scale, THI-12 questionnaire, and patient global impression of change. Safety was evaluated using the frequency of clinically relevant hearing deterioration and adverse events. Results The study overall failed to demonstrate a treatment benefit based on the change in MML. However, AM-101 0.81 mg/ml showed statistically significantly better improvement for tinnitus loudness, annoyance, sleep difficulties, and tinnitus impact in patients with tinnitus after noise trauma or otitis media. The subgroup of ISSNHL-related tinnitus patients did not show conclusive results. The study drug and I.T. injections were well tolerated. Conclusion The study established proof of concept for AM-101 in the treatment of tinnitus arising from cochlear glutamate excitotoxicity. Patient-reported outcomes seem to be more relevant and reliable efficacy measures for assessing treatment-related changes in tinnitus than psychoacoustic tests.
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Kurabi A, Lee J, Wong C, Pak K, Hoffman HM, Ryan AF, Wasserman SI. The inflammasome adaptor ASC contributes to multiple innate immune processes in the resolution of otitis media. Innate Immun 2014; 21:203-14. [PMID: 24652041 DOI: 10.1177/1753425914526074] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study was designed to understand the contribution of the inflammasome and IL-1β activation in otitis media (OM). We examined the middle ear (ME) response to non-typeable Haemophilus influenzae (NTHi) in wild type (WT) mice using gene microarrays and a murine model of acute OM. Expression of members of the NOD domain-like receptor family of inflammasome genes was significantly up-regulated early in NTHi infection of the ME, potentially activating specific downstream regulatory cascades that contribute to the proliferative inflammatory response observed during OM. Expression of the pro-forms of the inflammasome targets IL-1β and IL-18 were also up-regulated. To evaluate the role of inflammasome-mediated cytokine maturation, NTHi-induced OM was examined in Asc(-/-)-deficient mice and compared with that seen in WT mice. Mice lacking the Asc gene showed near absence of IL-1β maturation in the ME and a reduction in leukocyte recruitment and infiltration to the cavity, and their macrophages exhibited reduced phagocytosis of NTHi. These inflammatory defects were linked to an increase in the degree and duration of mucosal epithelial hyperplasia in the ME of Asc(-/-) mice, as well as a delay in bacterial clearance from their MEs. These data demonstrate an important role for the inflammasome and cytokine processing in the course and resolution of OM.
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Affiliation(s)
- Arwa Kurabi
- School of Medicine, Department of Surgery, Division of Otolaryngology, University of California San Diego, La Jolla, CA, USA
| | - Jasmine Lee
- Department of Biology, University of California La Jolla, La Jolla, CA, USA
| | - Chelsea Wong
- Department of Biology, University of California La Jolla, La Jolla, CA, USA
| | - Kwang Pak
- School of Medicine, Department of Surgery, Division of Otolaryngology, University of California San Diego, La Jolla, CA, USA San Diego Veterans Administration Healthcare System, San Diego, CA, USA
| | - Hal M Hoffman
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, CA, USA Ludwig Institute of Cancer Research, San Diego Branch, La Jolla, CA, USA
| | - Allen F Ryan
- School of Medicine, Department of Surgery, Division of Otolaryngology, University of California San Diego, La Jolla, CA, USA San Diego Veterans Administration Healthcare System, San Diego, CA, USA
| | - Stephen I Wasserman
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, CA, USA
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Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media - prevention and treatment. Infect Drug Resist 2014; 7:15-24. [PMID: 24453496 PMCID: PMC3894142 DOI: 10.2147/idr.s39637] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.
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Affiliation(s)
- Ali Qureishi
- Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK
| | - Yan Lee
- NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK
| | | | - John P Birchall
- Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UK
| | - Matija Daniel
- NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK
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MacArthur CJ, Hausman F, Kempton JB, Choi D, Trune DR. Otitis media impacts hundreds of mouse middle and inner ear genes. PLoS One 2013; 8:e75213. [PMID: 24124478 PMCID: PMC3790799 DOI: 10.1371/journal.pone.0075213] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/11/2013] [Indexed: 12/14/2022] Open
Abstract
Objective Otitis media is known to alter expression of cytokine and other genes in the mouse middle ear and inner ear. However, whole mouse genome studies of gene expression in otitis media have not previously been undertaken. Ninety-nine percent of mouse genes are shared in the human, so these studies are relevant to the human condition. Methods To assess inflammation-driven processes in the mouse ear, gene chip analyses were conducted on mice treated with trans-tympanic heat-killed Hemophilus influenza using untreated mice as controls. Middle and inner ear tissues were separately harvested at 6 hours, RNA extracted, and samples for each treatment processed on the Affymetrix 430 2.0 Gene Chip for expression of its 34,000 genes. Results Statistical analysis of gene expression compared to control mice showed significant alteration of gene expression in 2,355 genes, 11% of the genes tested and 8% of the mouse genome. Significant middle and inner ear upregulation (fold change >1.5, p<0.05) was seen in 1,081 and 599 genes respectively. Significant middle and inner ear downregulation (fold change <0.67, p<0.05) was seen in 978 and 287 genes respectively. While otitis media is widely believed to be an exclusively middle ear process with little impact on the inner ear, the inner ear changes noted in this study were numerous and discrete from the middle ear responses. This suggests that the inner ear does indeed respond to otitis media and that its response is a distinctive process. Numerous new genes, previously not studied, are found to be affected by inflammation in the ear. Conclusion Whole genome analysis via gene chip allows simultaneous examination of expression of hundreds of gene families influenced by inflammation in the middle ear. Discovery of new gene families affected by inflammation may lead to new approaches to the study and treatment of otitis media.
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Affiliation(s)
- Carol J. MacArthur
- Department of Otolaryngology Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, United States of America
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Fran Hausman
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - J. Beth Kempton
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Dongseok Choi
- Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Dennis R. Trune
- Department of Otolaryngology Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, United States of America
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
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Inner ear tissue remodeling and ion homeostasis gene alteration in murine chronic otitis media. Otol Neurotol 2013; 34:338-46. [PMID: 23269288 DOI: 10.1097/mao.0b013e31827b4d0a] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
HYPOTHESIS Studies were designed to ascertain the impact of chronic middle ear infection on the numerous ion and water channels, transporters, and tissue remodeling genes in the inner and middle ear. BACKGROUND Permanent sensorineural hearing loss is a significant problem resulting from chronic middle ear disease, although the inner ear processes involved are poorly defined. Maintaining a balanced ionic composition of endolymph in the inner ear is crucial for hearing; thus, it was hypothesized that this may be at risk with inflammation. METHODS Inner and middle ear RNA collected separately from 6-month-old C3H/HeJ mice with prolonged middle ear disease were subjected to qRT-PCR for 8 common inflammatory cytokine genes, 24 genes for channels controlling ion (sodium, potassium, and chloride) and water (aquaporin) transport, tight junction claudins, and gap junction connexins, and 32 tissue remodeling genes. Uninfected Balb/c mice were used as controls. RESULTS Significant increase in inner ear inflammatory and ion homeostasis (claudin, aquaporin, and gap junction) gene expression, and both upregulation and downregulation of tissue remodeling gene expression occurred. Alteration in middle ear ion homeostasis and tissue remodeling gene expression was noted in the setting of uniform upregulation of cytokine genes. CONCLUSION Chronic inflammatory middle ear disease can impact inner ear ion and water transport functions and induce tissue remodeling. Recognizing these inner ear mechanisms at risk may identify potential therapeutic targets to maintain hearing during prolonged otitis media.
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Cayé-Thomasen P, Hermansson A, Bakaletz L, Hellstrøm S, Kanzaki S, Kerschner J, Lim D, Lin J, Mason K, Spratley J. Panel 3: Recent advances in anatomy, pathology, and cell biology in relation to otitis media pathogenesis. Otolaryngol Head Neck Surg 2013; 148:E37-51. [PMID: 23536531 DOI: 10.1177/0194599813476257] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The pathogenesis of otitis media (OM) involves a number of factors related to the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx. Although some issues of pathogenesis are fairly well established, others are only marginally indicated by current knowledge, and yet others remain undisclosed. The objective of this article is to provide a state-of-the-art review on recent scientific achievements in the pathogenesis of OM, as related to anatomy, pathology, and cell biology. DATA SOURCES PubMed, Ovid Medline, and Cochrane Library. REVIEW METHODS Articles published on the pathogenesis of OM and the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx between January 2007 and June 2011 were identified. Among almost 1900 abstracts, the authors selected 130 articles for full article review and inclusion in this report. RESULTS New knowledge on a number of issues emerged, including cell-specific expression and function of fluid transportation and innate immune system molecules, mucous cell metaplasia, mucin expression, bacterial adherence, and epithelial internalization, as well as the occurrence, composition, dynamics, and potential role of bacterial biofilm. In addition, the potential role of gastroesophageal reflux disease and cigarette smoke exposure has been explored further. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Over the past 4 years, considerable scientific progress has been made on the pathogenesis of OM, as related to issues of anatomy, pathology, and cell biology. Based on these new achievements and a sustained lack of essential knowledge, suggestions for future research are outlined.
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Affiliation(s)
- Per Cayé-Thomasen
- Department of Oto-rhino-laryngology, Head and Neck Surgery, University Hospital of Copenhagen, Copenhagen, Denmark.
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Li JD, Hermansson A, Ryan AF, Bakaletz LO, Brown SD, Cheeseman MT, Juhn SK, Jung TTK, Lim DJ, Lim JH, Lin J, Moon SK, Post JC. Panel 4: Recent advances in otitis media in molecular biology, biochemistry, genetics, and animal models. Otolaryngol Head Neck Surg 2013; 148:E52-63. [PMID: 23536532 DOI: 10.1177/0194599813479772] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Otitis media (OM) is the most common childhood bacterial infection and also the leading cause of conductive hearing loss in children. Currently, there is an urgent need for developing novel therapeutic agents for treating OM based on full understanding of molecular pathogenesis in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. OBJECTIVE To provide a state-of-the-art review concerning recent advances in OM in the areas of molecular biology, biochemistry, genetics, and animal model studies and to discuss the future directions of OM studies in these areas. DATA SOURCES AND REVIEW METHODS A structured search of the current literature (since June 2007). The authors searched PubMed for published literature in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. RESULTS Over the past 4 years, significant progress has been made in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. These studies brought new insights into our understanding of the molecular and biochemical mechanisms underlying the molecular pathogenesis of OM and helped identify novel therapeutic targets for OM. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our understanding of the molecular pathogenesis of OM has been significantly advanced, particularly in the areas of inflammation, innate immunity, mucus overproduction, mucosal hyperplasia, middle ear and inner ear interaction, genetics, genome sequencing, and animal model studies. Although these studies are still in their experimental stages, they help identify new potential therapeutic targets. Future preclinical and clinical studies will help to translate these exciting experimental research findings into clinical applications.
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Affiliation(s)
- Jian-Dong Li
- Center for Inflammation, Immunity & Infection, and Department of Biology, Georgia State University, Atlanta, Georgia 30303, USA.
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Abstract
Cytokines are a group of diverse molecules that influence the function of every organ system. They are most well studied in their effects on the immune system and their integral role in mediating inflammation. The common cold and otitis media are two such disease states, and much has been learned about the various effects of cytokines in each disease. Most often the viruses isolated include rhinovirus (RV), respiratory syncytial virus (RSV), adenovirus, coronavirus, and picornavirus. Otitis media, sinusitis, bronchiolitis, pneumonia, and asthma exacerbation are commonly accepted as complications of viral upper respiratory tract infections. Furthermore, otitis media and upper respiratory infections are inextricably linked in that the majority (>70 %) of cases of acute otitis media occur as complications of the common cold. Cytokine polymorphisms have been associated with the severity of colds as well as the frequency of otitis media. This article attempts to update the reader on various studies that have recently been published regarding the role of cytokines in these two disease entities.
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Affiliation(s)
- Todd M Wine
- Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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MacArthur CJ, Hausman F, Kempton B, Lighthall J, Trune DR. Otitis media: molecular impact of inflammation in the middle and inner ear--cytokines, steroids, and ion homeostasis. Laryngoscope 2013; 122 Suppl 4:S59-60. [PMID: 23254604 DOI: 10.1002/lary.23818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 11/10/2022]
Affiliation(s)
- C J MacArthur
- Oregon Health and Science University, Oregon Hearing Research Center, Portland, Oregon, USA.
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Campos EC, Gattegna R, Raimondi MC, Pirodda A. Angiogenesis: possible analogies between the eye and the inner ear. Med Hypotheses 2012; 78:644-5. [PMID: 22348992 DOI: 10.1016/j.mehy.2012.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
Abstract
Angiogenesis is a phenomenon concerning both physiological conditions linked to development and pathological conditions; in the latter it is aimed at providing an enhancement in blood supply to tumours, on one hand, and to restore the circulation in peripheral arterial and ischemic diseases, on the other hand, thus resulting in a controversial effect depending on the circumstances. When occurring in the eye, angiogenesis clearly proved to represent a threaten, whereas an univocal interpretation of the action of angiogenesis on the inner ear homeostasis is still lacking despite the morphologic and functional analogies between eye and labyrinth. These analogies can raise same doubt on the supposed role of angiogenesis in terms of preserving the function of a threatened inner ear: even this organ could be further damaged by microvascular disorders and/or mechanical changes able to jeopardize its architecture and consequently its function. If a parallelism between ear and eye is extendable to this aspect, this could open new perspectives in the treatment of certain affections of the inner ear by borrowing therapeutic strategies that have given appreciable and consolidate responses in the treatment of degenerative retinopathy.
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Affiliation(s)
- Emilio Carlo Campos
- Department of Specialist Surgical and Anesthesiological Sciences, University of Bologna, Italy
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Sautter NB, Delaney KL, Hausman FA, Trune DR. Tissue remodeling in the acute otitis media mouse model. Int J Pediatr Otorhinolaryngol 2011; 75:1368-71. [PMID: 21889218 PMCID: PMC3197788 DOI: 10.1016/j.ijporl.2011.07.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/20/2011] [Accepted: 07/24/2011] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Otitis media is an infectious, inflammatory process involving the middle ear space. Chronic inflammation is associated with fibrosis, scarring and osteogenesis within the middle ear, which may contribute to subsequent hearing loss and increase the difficulty of treatment. METHODS Heat-killed Streptococcus pneumoniae was injected into the middle ears of 8-12 week old Balb/c mice. Control mice were treated with PBS middle ear injections. Middle ears were harvested at 1, 3, 5 and 7 days following injection (n=8 for each time point). The middle ears were processed using standard RT-PCR techniques. Up- and down-regulation of mRNA expression of various members of the Bone Morphogenetic Protein (BMP), Fibroblast Growth Factor (FGF) and Matrix Metalloproteinase (MMP) families was quantified and compared to PBS treated controls (n=8 for each time point). RESULTS Significant upregulation of MMP2, MMP3 and MMP9 was observed at varying time points (p<0.05). Significant downregulation of BMP3, BMP4, BMP5 BMP6 and BMP8a was seen at varying time points (p<0.05). Significant downregulation of FGF3, FGF6, FGF10 and FGFr1 was observed at varying time points (p<0.05). No significant expression of BMP8b, BMP9, BMP10, FGF5, FGF8, MMP1a, MMP7 and MMP14 was detected within the middle ear. CONCLUSIONS Inflammation within the middle ear following injection of bacterial products results in changes in the regulation of several tissue remodeling cytokines and proteinases in the mouse model. Further understanding of these molecular processes may allow for the development of treatment modalities aimed at preventing middle ear tissue remodeling.
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Affiliation(s)
- Nathan B. Sautter
- Oregon Health Sciences University, Department of Otolaryngology – Head and Neck Surgery, Portland, OR
| | | | - Frances A. Hausman
- Oregon Hearing Research Center, Oregon Health Sciences University, Portland, OR
| | - Dennis R. Trune
- Oregon Hearing Research Center, Oregon Health Sciences University, Portland, OR
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Trune DR, Larrain BE, Hausman FA, Kempton JB, MacArthur CJ. Simultaneous measurement of multiple ear proteins with multiplex ELISA assays. Hear Res 2010; 275:1-7. [PMID: 21144888 DOI: 10.1016/j.heares.2010.11.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 11/09/2010] [Accepted: 11/29/2010] [Indexed: 10/18/2022]
Abstract
A recent advancement in enzyme-linked immunosorbent assay (ELISA) technology is the multiplex antibody array that measures multiple proteins simultaneously within a single sample. This allows reduction in sample volume, time, labor, and material costs, while increasing sensitivity over single ELISA. Current multiplex platforms include planar-based systems using microplates or slides, or bead-based suspension assay with microspheres. To determine the applicability of this technology for ear research, we used 3 different multiplex ELISA-based immunoassay arrays from 4 different companies to measure cytokine levels in mouse middle and inner ear tissue lysate extracts 24 h following transtympanic Haemophilus influenzae inoculation. Middle and inner ear tissue lysates were analyzed using testing services from Quansys Biosciences, Aushon Biosystems SearchLight (both microplate-based), MILLIPLEX MAP Sample (bead-based), and a RayBiotech, Inc (slide-based) kit. Samples were assayed in duplicate or triplicate. Results were compared to determine their relative sensitivity and reliability for measures of cytokines related to inflammation. The cytokine pg/ml amounts varied among the multiplex assays, so a comparison also was made of the mean fold increase in cytokines from untreated controls. Several cytokines and chemokines were elevated, the extent dependent upon the assay sensitivity. Those most significantly elevated were IL-1α, IL-1β, IL-6, TNFα, VEGF, and IL-8/MIP-2. The results of the multiplex systems were compared with single ELISA kits (IL-1β, IL-6) to assess sensitivity over the traditional method. Overall, the Quansys Biosciences and SearchLight arrays showed the greatest sensitivity, both employing the same multiplex methodology of a spotted array within a microplate well with chemiluminescent detection. They also were more sensitive than the traditional single ELISA performed with commercial kits and matched gene expression changes determined by quantitative RT-PCR. The Quansys array showed a limit of detection for ear IL-6 down to 2-4 pg/ml, indicating it is sufficiently sensitive to detect ear proteins present in low concentrations. Thus, the multiplex ELISA procedures appear suitable and reliable for the study of hearing related proteins, providing accurate, quantitative, reproducible results with considerable improvement in sensitivity and economy.
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Affiliation(s)
- Dennis R Trune
- Oregon Hearing Research Center, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code NRC04, Portland, OR 97239-3098, USA.
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