Experimental studies on immunogenesis of otitis media with effusion

Proteases and protease inhibitors in immune complex otitis media in chinchillas

Using an immune complex-induced (IC) otitis media model in chinchillas sensitized with human serum albumin (HSA), we measured the levels of protease activity, protease inhibitors, and HSA in the middle ear fluid (MEF). The effect of a corticosteroid agent (triamcinolone) on the degree of IC otitis media also was studied. The levels of protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin in the MEF were significantly higher than in nonsensitized animals. Fibrinolytic (plasminogen activator [PA]) activity was detected in the MEF; however, only a small level of activity of nonspecific proteases was detected because of the significant level of antitryptic activity in the MEF. The levels of protease inhibitors and PA activity were significantly reduced by the steroid treatment. It is concluded that protease inhibitors play an important role in the protection of the middle ear mucosa and that corticosteroid treatment can reduce the severity of IC otitis media.

The relationship between antigen levels and middle ear inflammation in antigen-induced otitis media in the chinchilla

The relationship between antigen levels in middle ear effusions (MEE) and the degree of middle ear inflammation was studied in an antigen-induced otitis media model, using chinchillas sensitized with human serum albumin (HSA). The degree of middle ear inflammation was evaluated by both tympanometric analysis, and cytological and biochemical analyses of the MEE. Middle ear inflammation develops after HSA challenge with a remarkable decrease in HSA levels in the MEE. This inflammation persists even when HSA levels are no longer detectable in the MEE. These findings show that local challenges with an antigen induce a certain degree of middle ear inflammation, which continues even after complete elimination of the antigen from the middle ear through an immunological defense mechanism.

Round window membrane permeability to human serum albumin in antigen-induced otitis media

The round window membrane (RWM) permeability to human serum albumin (HSA) was investigated in both normal chinchillas and chinchillas sensitized with HSA. The effect of a corticosteroid agent (triamcinolone) on the RWM permeability was also analyzed. It was found that HSA could not be detected in either the perilymph or the cerebrospinal fluid of normal chinchillas within 1 hour after instillation into the middle ear bulla. Perilymph levels of HSA peaked 24 hours after instillation. In antigen-induced otitis media, the HSA level in the perilymph at 12 hours after challenge was significantly higher than that in normal chinchillas (P less than .01), but it did not increase with the development of otitis media. A significant difference of HSA level in the perilymph of animals with and without steroid treatment was noted (P less than .025 at 24 hours and P less than .05 at 48 hours). It is concluded that little HSA passes through the normal RWM in a short time and that the RWM permeability to HSA increases in the early stage (about 12 hours) of antigen-induced otitis media. Corticosteroids can affect the RWM permeability to HSA by reducing the level of antigen-induced otitis media.