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Mohamed NM, Abdelhamid AM, Aref M, Abdelhafeez M, Faris Alotabi H, Mohammed Abdelrahman DS, Elwany NE. Role of cytokines and Th17/Tregs imbalance in the pathogenesis of otitis media with effusion. Modulation of Notch1/Hes1/mTORC1/S6k1 signalling pathway underlies the protective effect of astaxanthin. Int Immunopharmacol 2024; 128:111521. [PMID: 38246005 DOI: 10.1016/j.intimp.2024.111521] [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: 08/22/2023] [Revised: 12/26/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
Otitis media with effusion (OME) is a recurrent middle ear inflammatory condition. It may be complicated by acquired hearing loss and speech impairment especially in children. Accordingly, the current study aimed to assess the role of cytokines and the imbalance of Th17/Tregs in the pathogenesis of OME. Additionally, the protective effect of astaxanthin and its mechanisms related to Notch1/ Hes1/mTORC1/S6K1 signalling were investigated. METHODS Forty-eight children were grouped as follow: G1: control healthy group G2: acute otitis media (AOM) group, G3: OME group. In the lipopolysaccharide (LPS) induced OME rat model, 15 rats were randomised into: G1: normal control group, G2: LPS group, and G3: astaxanthin treated group. RESULTS Biochemical analysis of the children's peripheral blood samples showed that IL1β, IL-2, IL-4, IL-6, IL-17, and IL-23 were significantly elevated, while TGF-β was significantly decreased in AOM and OME patients (group 2 and 3). In the LPS- induced OME rat model, astaxanthin treatment resulted in suppression of IL-17, IL-6, TNF-α, Muc5A, TFF3, NICD, Hes1, mTORC1, and S6K1 in rat middle ear mucosa. Furthermore, astaxanthin significantly downregulated RORγ while upregulating FoxP3 and restored the balance between Th17/Tregs. Moreover, astaxanthin improved the histopathological picture of the inflamed middle ear mucosa. CONCLUSIONS Proinflammatory cytokines as well as Th17/Tregs imbalance play a crucial role in the pathogenesis of AOM and OME. Additionally, astaxanthin alleviated LPS- induced OME in rats through suppression of Notch1/ Hes1/mTORC1/S6K1 pathway, and regulation of Th17/Tregs.
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Affiliation(s)
- Noura Mostafa Mohamed
- Department of Basic Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, 11671 Riyadh, Saudi Arabia.
| | | | - Mohamed Aref
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Zagazig University, Egypt.
| | - Marwa Abdelhafeez
- Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Hadil Faris Alotabi
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, 11671 Riyadh, Saudi Arabia.
| | - Doaa Sayed Mohammed Abdelrahman
- Department of Clinical Science, College of Medicine, Princess Nourah bint Abdulrahman University, 11671 Riyadh, Saudi Arabia.
| | - Nisreen E Elwany
- Clinical Pharmacology Department, Faculty of Medicine, Zagazig University, Egypt.
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Samuels TL, Khampang P, Espahbodi M, McCormick CA, Chun RH, McCormick ME, Yan K, Kerschner JE, Johnston N. Association of Pepsin With Inflammatory Signaling and Effusion Viscosity in Pediatric Otitis Media. Laryngoscope 2021; 132:470-477. [PMID: 34272879 DOI: 10.1002/lary.29749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/11/2021] [Accepted: 07/06/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Otitis media (OM) is a common inflammatory disease spectrum. Cytokine signaling, neutrophil activity, and mucin hypersecretion during recurrent and chronic OM contribute to persistent, viscous middle ear (ME) effusions, hearing loss, and potential for developmental delay. Extraesophageal reflux (EER), specifically pepsin, triggers inflammatory signaling in respiratory mucosa and is associated with OM. The objective of this study was to investigate the association of pepsin with ME inflammatory signaling and the outcomes and examine causality in vitro. STUDY DESIGN Cross-sectional study. METHODS ME fluid (MEF) and preoperative audiometric data were collected from 30 pediatric subjects undergoing tympanostomy tube placement for recurrent OM or OM with effusion. MEF viscosity was characterized by the surgeon. Pepsin, inflammatory molecules, and mucin were assayed by enzyme-linked immunosorbent assay (ELISA). ME epithelial primary culture was exposed to 0.1 to 1 mg/ml pepsin at pH 5, 6, and 7 for 30 minutes, and cytokine expression was assayed via qPCR. RESULTS Pepsin was observed in the MEF of 77% of patients (range 71-2,734 ng/ml). Pepsin correlated with effusion viscosity, interleukins -6 and -8, neutrophil elastase, and mucin 5B (P < .05). Pepsin-negative MEF was more frequently absent of interleukin 8 or mucin 5B (P < .05). Weak acid was generally insufficient to elicit cytokine expression in ME cells in vitro, however, pepsin induced IL6, IL8, and TNF at pH 7 (P < .05) and weak acid (pH 6) facilitated a response at lower pepsin concentration. CONCLUSIONS Pepsin may contribute to inflammatory signaling, persistent viscous effusion, and poorer OM outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Tina L Samuels
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Mana Espahbodi
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Caroline A McCormick
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Robert H Chun
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Michael E McCormick
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Ke Yan
- Pediatrics Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Joseph E Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.,Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Nikki Johnston
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.,Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
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Stabenau KA, Zimmermann MT, Mathison A, Zeighami A, Samuels TL, Chun RH, Papsin BC, McCormick ME, Johnston N, Kerschner JE. RNA Sequencing and Pathways Analyses of Middle Ear Epithelia From Patients With Otitis Media. Laryngoscope 2021; 131:2590-2597. [PMID: 33844317 DOI: 10.1002/lary.29551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/04/2021] [Accepted: 03/23/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Otitis media (OM) is the most common pediatric diagnosis in the United States. However, our understanding of the molecular pathogenesis of OM remains relatively poor. Investigation of molecular pathways involved in OM may improve the understanding of this disease process and elucidate novel therapeutic targets. In this study, RNA sequencing (RNA-Seq) was used to discern cellular changes associated with OME compared to healthy middle ear epithelium (MEE). STUDY DESIGN Ex vivo case-control translational. METHODS Middle ear epithelia was collected from five pediatric patients diagnosed with OME undergoing tympanostomy tube placement and five otherwise healthy pediatric patients undergoing cochlear implantation. Specimens underwent RNA-Seq and pathways analyses. RESULTS A total of 1,292 genes exhibited differential expression in MEE from OME patients compared to controls including genes involved in inflammation, immune response to bacterial OM pathogens, mucociliary clearance, regulation of proliferation and transformation, and auditory cell differentiation. Top networks identified in OME were organismal injury and abnormalities, cell morphology, and auditory disease. Top Ingenuity canonical pathways identified were axonal guidance signaling, which contains genes associated with auditory development and disease and nicotine degradation II and III pathways. Associated upstream regulators included β-estradiol, dexamethasone, and G-protein-coupled estrogen receptor-1 (GPER1), which are associated with otoprotection or inflammation during insult. CONCLUSIONS RNA-Seq demonstrates differential gene expression in MEE from patients with OME compared to healthy controls with important implications for infection susceptibility, hearing loss, and a role for tobacco exposure in the development and/or severity of OME in pediatric patients. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Kaleigh A Stabenau
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Michael T Zimmermann
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.,Clinical and Translational Science Institute, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Angela Mathison
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Atefeh Zeighami
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Tina L Samuels
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Robert H Chun
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Blake C Papsin
- Archie's Cochlear Implant Laboratory, Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael E McCormick
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Nikki Johnston
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.,Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Joseph E Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
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Giese APJ, Ali S, Isaiah A, Aziz I, Riazuddin S, Ahmed ZM. Genomics of Otitis Media (OM): Molecular Genetics Approaches to Characterize Disease Pathophysiology. Front Genet 2020; 11:313. [PMID: 32391049 PMCID: PMC7191070 DOI: 10.3389/fgene.2020.00313] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/16/2020] [Indexed: 12/21/2022] Open
Abstract
Otitis media (OM) is an infective and inflammatory disorder known to be a major cause of hearing impairment across all age groups. Both acute and chronic OM result in substantial healthcare utilization related to antibiotic prescription and surgical procedures necessary for its management. Although several studies provided evidence of genetics playing a significant role in the susceptibility to OM, we had limited knowledge about the genes associated with OM until recently. Here we have summarized the known genetic factors that confer susceptibility to various forms of OM in mice and in humans and their genetic load, along with associated cellular signaling pathways. Spotlighted in this review are fucosyltransferase (FUT) enzymes, which have been implicated in the pathogenesis of OM. A comprehensive understanding of the functions of OM-associated genes may provide potential opportunities for its diagnosis and treatment.
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Affiliation(s)
- Arnaud P J Giese
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Saadat Ali
- The Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Amal Isaiah
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ishrat Aziz
- Department of Biotechnology, Virtual University of Pakistan, Lahore, Pakistan
| | - Saima Riazuddin
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Zubair M Ahmed
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
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Preciado D, Granath A, Lin J, Val S, Kurabi A, Johnston N, Vijayasekaran S, Valdez T, Depireux D, Hermansson A. Panel 8: Report on Recent Advances in Molecular and Cellular Biochemistry. Otolaryngol Head Neck Surg 2017; 156:S106-S113. [PMID: 28372528 DOI: 10.1177/0194599816658290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To update the medical literature on recent cellular and molecular advances in otitis media disease models with a principal focus on developments in the past 5 years. We also aim to explain recent translational advances in cellular and molecular biology that have influenced our understanding and management of otitis media. Data Sources PubMed-indexed peer-reviewed articles. Review Methods A comprehensive review of the literature was conducted with the term otitis media and the following search terms: molecular biology, cell biology, innate immunity, oxidative stress, mucins, molecular diagnostics. Included articles were published in the English language from January 1, 2010, to July 31, 2015. Implications for Practice The molecular understanding of otitis media disease progression has rapidly advanced over the last 5 years. The roles of inflammation, mucins, and cell signaling mechanisms have been elucidated and defined. Advances in the field provide a plethora of opportunities for innovative molecular targeting in the development of novel therapeutic strategies for otitis media.
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Affiliation(s)
- Diego Preciado
- 1 Shiekh Zayed Institute for Pediatric Surgical Innovation, Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA
| | - Anna Granath
- 2 Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Jizhen Lin
- 3 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stéphanie Val
- 1 Shiekh Zayed Institute for Pediatric Surgical Innovation, Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA
| | - Arwa Kurabi
- 4 Division of Otolaryngology, Department of Surgery, University of California, San Diego, California, USA
| | - Nikki Johnston
- 5 Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shyan Vijayasekaran
- 6 Department of Surgery, Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Tulio Valdez
- 7 Division of Pediatric Otolaryngology, Connecticut Children's Hospital, Hartford, Connecticut, USA
| | - Didier Depireux
- 8 Institute for Systems Research, University of Maryland, College Park, Maryland, USA
| | - Ann Hermansson
- 9 Departments of Otolaryngology, Oral and Maxillofacial Surgery, and Pediatrics, Lund University, Lund, Sweden
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Lin J, Hafrén H, Kerschner J, Jian-Dong L, Brown S, Zheng QY, Preciado D, Nakamura Y, Huang Q, Zhang Y. Panel 3: Genetics and Precision Medicine of Otitis Media. Otolaryngol Head Neck Surg 2017; 156:S41-S50. [PMID: 28372532 PMCID: PMC6211190 DOI: 10.1177/0194599816685559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/01/2016] [Indexed: 12/31/2022]
Abstract
Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.
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Affiliation(s)
- Jizhen Lin
- Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hena Hafrén
- Departments of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Joseph Kerschner
- Department of Otorhinolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Li Jian-Dong
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, USA
| | - Steve Brown
- Medical Research Council Harwell Institute, Oxfordshire, UK
| | - Qing Y. Zheng
- Department of Otolaryngology–Head and Neck Surgery, Case Western University, Cleveland, Ohio, USA
| | - Diego Preciado
- Shiekh Zayed Institute for Pediatric Surgical Innovation, Pediatric Otolaryngology, Children’s National Health System, Washington, DC, USA
| | | | - Qiuhong Huang
- Department of Otolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhang
- Department of Otolaryngology, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
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Liu X, Sheng HB, Ma R, Yang JM, Luo WW, Yang XY, Ren DD, Chi FL. Notch signaling is active in normal mouse middle ear epithelial cells. Exp Ther Med 2016; 11:1661-1667. [PMID: 27168786 PMCID: PMC4840515 DOI: 10.3892/etm.2016.3146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 09/28/2015] [Indexed: 12/30/2022] Open
Abstract
Mucous cell metaplasia/hyperplasia in the middle ear epithelium is associated with the occurrence of otitis media with effusion during infections. However, the mechanism by which Notch signaling regulates cell fate in the middle ear epithelium is unclear. The aim of the present study was to elucidate this mechanism by investigating the localization of Notch receptors, such as Notch1 and Notch2, and Notch ligands, such as Jagged1, in the normal mouse middle ear epithelium (NMMEE) using immunofluorescence. Furthermore, the mRNA expression levels of Notch receptors and ligands were evaluated using reverse transcription polymerase chain reaction (PCR). The effects of the γ-secretase inhibitor N-[N-(3,5-difluorophenacetyl)-L-alanyl]-S-phenylglycine tert-butyl ester (DAPT) on epithelial cell proliferation were determined using 5-ethynyl-2′-deoxyuridine (EdU) staining and immunofluorescence staining of the apoptosis marker caspase-3 and the epithelial proliferation marker pan-cytokeratine. In addition, the differentiation of the NMMEE cells was characterized by evaluating the mRNA expression levels of the mucous cell-associated genes Arg2, Muc2, Spdef, Spink4 and Tff1 using quantitative PCR. Notch1, Notch2 and Jagged1 were observed to be co-localized throughout the mouse middle ear epithelium. Furthermore, Notch1-4, Jagged1, Jagged2, Dll1 and Dll4 mRNAs were expressed in the NMMEE cells. The inhibition of Notch by DAPT resulted in fewer EdU-positive cells and the upregulation of the expression levels of various mucous cell-associated genes. The results indicate that DAPT suppresses the proliferation of NMMEE cells while promoting their differentiation into mucous cells. Therefore, DAPT may provide a specific therapeutic strategy for the reversal of multiple pathological processes that are associated with epithelium thickening in the middle ear.
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Affiliation(s)
- Xiang Liu
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Hai-Bin Sheng
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Rui Ma
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Department of Research Center, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China
| | - Juan-Mei Yang
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Wen-Wei Luo
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Xiao-Yu Yang
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Dong-Dong Ren
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
| | - Fang-Lu Chi
- Department of Otology and Skull Base Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China; Shanghai Auditory Medical Center, Ministry of Health, Fudan University, Shanghai 200031, P.R. China; Key Laboratory of Hearing Science, Ministry of Health, Fudan University, Shanghai 200031, P.R. China
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Role of innate immunity in the pathogenesis of otitis media. Int J Infect Dis 2014; 29:259-67. [PMID: 25447732 DOI: 10.1016/j.ijid.2014.10.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/29/2014] [Accepted: 10/02/2014] [Indexed: 12/12/2022] Open
Abstract
Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.
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