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Kurabi A, Dewan K, Kerschner JE, Leichtle A, Li JD, Santa Maria PL, Preciado D. PANEL 3: Otitis media animal models, cell culture, tissue regeneration & pathophysiology. Int J Pediatr Otorhinolaryngol 2024; 176:111814. [PMID: 38101097 DOI: 10.1016/j.ijporl.2023.111814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To review and summarize recently published key articles on the topics of animal models, cell culture studies, tissue biomedical engineering and regeneration, and new models in relation to otitis media (OM). DATA SOURCE Electronic databases: PubMed, National Library of Medicine, Ovid Medline. REVIEW METHODS Key topics were assigned to the panel participants for identification and detailed evaluation. The PubMed reviews were focused on the period from June 2019 to June 2023, in any of the objective subject(s) or keywords listed above, noting the relevant references relating to these advances with a global overview and noting areas of recommendation(s). The final manuscript was prepared with input from all panel members. CONCLUSIONS In conclusion, ex vivo and in vivo OM research models have seen great advancements in the past 4 years. From the usage of novel genetic and molecular tools to the refinement of in vivo inducible and spontaneous mouse models, to the introduction of a wide array of reliable middle ear epithelium (MEE) cell culture systems, the next five years are likely to experience exponential growth in OM pathophysiology discoveries. Moreover, advances in these systems will predictably facilitate rapid means for novel molecular therapeutic studies.
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Affiliation(s)
- Arwa Kurabi
- Department of Otolaryngology, University of California San Diego, School of Medicine, La Jolla, CA, USA.
| | - Kalyan Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Joseph E Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anke Leichtle
- Department of Otorhinolaryngology, University of Luebeck, Luebeck, Germany
| | - Jian-Dong Li
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Peter Luke Santa Maria
- Department of Otolaryngology - Head & Neck Surgery, Stanford University, Stanford, CA, USA
| | - Diego Preciado
- Children's National Hospital, Division of Pediatric Otolaryngology, Washington, DC, USA
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Niedzielski A, Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Bogusławska J. Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001710. [PMID: 37045541 PMCID: PMC10106074 DOI: 10.1136/bmjpo-2022-001710] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/18/2023] [Indexed: 04/14/2023] Open
Abstract
Adenoids (nasopharyngeal tonsils), being part of Waldeyer's ring, are masses of lymphoid tissues located at the junction of the roof and the posterior wall of the nasopharynx. Adenoids play an important role in the development of the immune system and serve as a defence against infections, being the first organs that come into contact with respiratory and digestive antigens. The causes of adenoid hypertrophy are not fully known. They are most likely associated with aberrant immune reactions, infections, environmental exposures and hormonal or genetic factors. The aim of this review is to summarise the current knowledge of adenoid hypertrophy in children and associated diseases. Adenoid hypertrophy has many clinical manifestations that are frequent in the paediatric population and is accompanied by various comorbidities.
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Affiliation(s)
- Artur Niedzielski
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warszawa, Poland
- Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
| | - Lechosław Paweł Chmielik
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warszawa, Poland
- Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
| | | | - Anna Kasprzyk
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warszawa, Poland
- Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
| | - Joanna Bogusławska
- Department of Biochemistry and Molecular Biology, Centre of Postgraduate Medical Education, Warszawa, Poland
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The association of iron deficiency anemia on chronic suppurative otitis media in children: A case-control study. Ann Med Surg (Lond) 2021; 72:103105. [PMID: 34900249 PMCID: PMC8640113 DOI: 10.1016/j.amsu.2021.103105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background Chronic suppurative otitis media (CSOM) is the most common infectious disease in the world and the leading cause of hearing loss in children in developing countries. Iron deficiency anemia (IDA) is often found in children with CSOM. Objective This study was conducted to determine the association between IDA and the incidence of CSOM in children. Method This research is a case-control study using consecutive sampling. Participants were divided into case group which are children diagnosed with CSOM (n = 42) and control group which are children with normal ear (n = 42). All participants were examined for serum iron (FE), hemoglobin (Hb), total iron-binding capacity (TIBC), and ferritin levels. The analysis used in this study includes the chi-square test or fisher extract test and independence t-test or Man Whitney test with p < 0.05. Result The measurement results obtained values of Hb (13.00 ± 1.34 g/dL; p < 0.001), FE (95.13 ± 40.84 g/dL; p < 0.001), TIBC (354.18 ± 62.44 g/dL; p = 0.016), and ferritin levels (17.57 ± 8.55 g/dL; p < 0.001). Participants who experienced IDA were 21.43% which in the case group was 31.0% and control group was 11.9% (OR = 3.32; p = 0.033). Conclusion IDA can increase the incidence of CSOM in children. Iron deficiency anemia is a risk factor for CSOM in Children. Children with iron deficiency anemia have a 3-fold risk of experiencing CSOM. Supplement iron needs to be given as a preventative for CSOM in children.
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Nicholas BD, Kiprovski A, Perez D, Mehta R, Murphy MK, Li Z, Tampio A. Changes in Eustachian Tube Mucosa in Mice After Short-Term Tobacco and E-cigarette Smoke Exposure. Laryngoscope 2021; 132:648-654. [PMID: 34599608 DOI: 10.1002/lary.29887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/05/2021] [Accepted: 08/30/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To evaluate histologic changes in middle ear and eustachian tube (ET) mucosa of mice after exposure to tobacco or electronic cigarette (e-cigarette) smoke. To determine whether there were any mitigating effects of middle ear application of anti-IL-13 or the epidermal growth factor receptor antagonist AG1478 on noted changes within ET mucosa. STUDY DESIGN Controlled animal study. METHODS Fifty BALB/cJ mice were randomly assigned to one of five groups: A control group with no smoke exposure, two groups exposed to tobacco smoke, and two groups exposed to e-cigarette vapor. Within the exposed groups after 4 weeks of exposure, one ear was infiltrated with a saline hydrogel and the other ear with hydrogel of either Anti-IL-13 or AG1478. After four more weeks of exposure, the animals were euthanized and the ETs were evaluated for mucosal changes. RESULTS Compared to control animals with no smoke exposure, there were significant decreases in the numbers of goblet cells within the ET mucosa of mice exposed to tobacco smoke and e-cigarette vapor. No significant differences in cilia, mucin, or squamous metaplasia were noted. Neither anti-IL-13 nor AG178 significantly altered goblet cell count in the ET mucosa of mice exposed to tobacco smoke; however, both agents significantly increased goblet cells within the ET mucosa of mice exposed to e-cigarette vapor. CONCLUSION Short-term tobacco smoke and e-cigarette vapor significantly decrease goblet cell count in mouse ET mucosa. Middle ear application of both anti-IL-13 and AG1478 resulted in an increase in goblet cell count among mice exposed to e-cigarette vapor, but not to tobacco smoke. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
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Affiliation(s)
- Brian D Nicholas
- Department of Otolaryngology-Head and Neck Surgery, Upstate Medical University, Syracuse, New York, U.S.A
| | | | - Diandra Perez
- Department of Pathology, Upstate Medical University, Syracuse, New York, U.S.A
| | - Rohin Mehta
- Department of Pathology, Upstate Medical University, Syracuse, New York, U.S.A
| | - Michael K Murphy
- Department of Otolaryngology-Head and Neck Surgery, Upstate Medical University, Syracuse, New York, U.S.A
| | - Zhenfeng Li
- Department of Applied Statistics, Syracuse University, Syracuse, New York, U.S.A
| | - Alex Tampio
- Department of Otolaryngology-Head and Neck Surgery, Upstate Medical University, Syracuse, New York, U.S.A
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Espahbodi M, Samuels TL, McCormick C, Khampang P, Yan K, Marshall S, McCormick ME, Chun RH, Harvey SA, Friedland DR, Johnston N, Kerschner JE. Analysis of Inflammatory Signaling in Human Middle Ear Cell Culture Models of Pediatric Otitis Media. Laryngoscope 2020; 131:410-416. [PMID: 32433794 DOI: 10.1002/lary.28687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Cell culture models are valuable tools for investigation of the molecular pathogenesis of diseases including otitis media (OM). Previous study indicates that age-, sex-, and race-associated differences in molecular signaling may impact disease pathophysiology. Currently, a singular immortalized middle ear epithelial (MEE) cell line exists, HMEEC-1, derived from an adult without known middle ear disease. In this study, HMEEC-1 and primary MEE cultures from pediatric patients with and without OM were stimulated with inflammatory cytokines or OM-pathogenic bacterial lysates to examine differences in the response of molecules associated with OM pathogenesis. STUDY DESIGN Case-control series. METHODS MEE cultures were established from patients aged <6 years: two with recurrent OM (ROM), two with OM with effusion (OME), and one patient without OM who was undergoing cochlear implant surgery control undergoing cochlear implantation (Peds CI). Primary MEE cultures and HMEEC-1 cells were stimulated with tumor necrosis factor-α, interleukin (IL)-1β, or nontypeable Haemophilus influenzae lysate. TNFA, IL1B, IL6, IL8, IL10, and MUC5B were assayed via quantitative polymerase chain reaction. IL-8 was assayed by enzyme-linked immunosorbent assay. RESULTS Gene/protein target expressions were frequently higher in pediatric OM lines than in HMEEC-1 and Peds CI. HMEEC-1 cells were frequently less responsive to stimuli than all pediatric lines. OME lines were often more responsive than ROM lines. CONCLUSIONS OM may be associated with specific molecular phenotypes that are retained in primary cell culture. Adult-derived HMEEC-1 cells differ significantly in baseline expression and response of OM-associated molecules relative to pediatric MEE cells. Work is underway to immortalize pediatric OM MEE cultures as improved tools for the OM research community. LEVEL OF EVIDENCE 4 Laryngoscope, 131:410-416, 2021.
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Affiliation(s)
- Mana Espahbodi
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Tina L Samuels
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Caroline McCormick
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Pawjai Khampang
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Ke Yan
- Department of Pediatrics Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Samuel Marshall
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Michael E McCormick
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Robert H Chun
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Steven A Harvey
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - David R Friedland
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Nikki Johnston
- Department of Otolaryngology, 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, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.,Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
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Lee HH, Chin A, Pak K, Wasserman SI, Kurabi A, Ryan AF. Role of the PI3K/AKT pathway and PTEN in otitis media. Exp Cell Res 2019; 387:111758. [PMID: 31837294 DOI: 10.1016/j.yexcr.2019.111758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/06/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
Mucosal hyperplasia is common sequela of otitis media (OM), leading to the secretion of mucus and the recruitment of leukocytes. However, the pathogenic mechanisms underlying hyperplasia are not well defined. Here, we investigated the role of the AKT pathway in the development of middle mucosal hyperplasia using in vitro mucosal explants cultures and an in vivo rat model. The Akt inhibitor MK2206 treatment inhibited the growth of middle ear mucosal explants in a dose-dependent manner. In vivo, MK2206 also reduced mucosal hyperplasia. Unexpectedly, while PTEN is generally thought to act in opposition to AKT, the PTEN inhibitor BPV reduced mucosal explant growth in vitro. The results indicate that both AKT and PTEN are mediators of mucosal growth during OM, and could be potential therapeutic targets.
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Affiliation(s)
- Hwan Ho Lee
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA
| | - Anthony Chin
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA
| | - Kwang Pak
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA
| | - Stephen I Wasserman
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA
| | - Arwa Kurabi
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA
| | - Allen F Ryan
- Division of Otolaryngology, Department of Surgery, University of California, San Diego and San Diego VA Healthcare System, La Jolla, CA, 92093, USA.
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The prolactin inducible protein/gross cystic disease fluid protein-15 deficient mice develop anomalies in lymphoid organs. Immunobiology 2019; 224:811-816. [DOI: 10.1016/j.imbio.2019.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/10/2019] [Indexed: 01/06/2023]
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Hong W, Khampang P, Kerschner AR, Mackinnon AC, Yan K, Simpson PM, Kerschner JE. Antibiotic modulation of mucins in otitis media; should this change our approach to watchful waiting? Int J Pediatr Otorhinolaryngol 2019; 125:134-140. [PMID: 31302575 PMCID: PMC6742428 DOI: 10.1016/j.ijporl.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/05/2019] [Accepted: 07/02/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Gel-forming mucins (GFMs) play important roles in otitis media (OM) pathogenesis. Increased mucin expression is activated by pathogens and proinflammatory cytokines. Bacterial biofilms influence inflammation and resolution of OM and may contribute to prolonged mucin production. The influence of specific pathogens on mucin expression and development of chronic OM with effusion (OME) remains an area of significant knowledge deficit. OBJECTIVES To assess the relationship between GFM expression, specific pathogens, middle ear mucosal (MEM) changes, biofilm formation, and antibiotic utilization. METHODS Mixed gender chinchillas were inoculated with nontypeable Haemophilus influenzae (NTHi) strain 86028NP or Streptococcus pneumoniae (SP) strain TIGR4 via transbulla injection. Antibiotic was administered on day 3-5 post inoculation. GFM expression was measured by quantitative PCR. Biofilm formation was identified and middle ear histologic changes were measured. RESULTS SP infection resulted in higher incidence of biofilm and ME effusion compared with NTHi infection. However, NTHi persisted in the ME longer than SP with no substantive bacterial clearance detected on day 10 compared with complete bacterial clearance on day 10 for 50-60% of the SP-infected chinchillas. Both infections increased MEM inflammatory cell infiltration and thickening. NTHi upregulated the Muc5AC, Muc5B and Muc19 expression on day 10 (p = 0.0004, 0.003, and 0.002 respectively). SP-induced GFM upregulations were trended toward significant. In both NTHi and SP infections, the degree of GFM upregulation had a direct relationship to increased MEM hypertrophy, inflammatory cell infiltration and biofilm formation. Antibiotic treatment reduced the incidence of ME effusion and biofilm, limited the MEM changes and reversed the GFM upregulation. In NTHi infection, the rate of returning to baseline level of GFMs in treated chinchillas was quicker than those without treatment. CONCLUSIONS In an animal model of OM, GFM genes are upregulated in conjunction with MEM hypertrophy and biofilm formation. This upregulation is less robust and more quickly ameliorated to a significant degree in the NTHi infection with appropriate antibiotic therapy. These findings contribute to the understanding of pathogen specific influences on mucin expression during OM pathogenesis and provide new data which may have implications in clinical approach for OM treatment.
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Affiliation(s)
- Wenzhou Hong
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | - Abigail R Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | | | - Ke Yan
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, USA
| | - Pippa M Simpson
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, USA
| | - Joseph E Kerschner
- Division of Pediatric Otolaryngology, Medical College of Wisconsin, USA; Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA.
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Ye M, Li X. Effect of vascular endothelial growth factor and its receptors in adult otitis media with effusion. Eur Arch Otorhinolaryngol 2019; 276:1889-1895. [PMID: 30919059 DOI: 10.1007/s00405-019-05400-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/19/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Some studies have demonstrated that vascular endothelial growth factor (VEGF) plays a critical role in the pathogenesis of otitis media with effusion (OME) in animal models. However, the levels of VEGF and its receptors in adult OME have not been clarified. Our study was designed to detect the levels of VEGF and its receptors in adult OME and explore their relationship with effusion types, duration and prognosis of OME. METHODS 61 patients with secretory otitis media were enrolled including 21 males and 40 females, with an average age of 54.7 ± 17.5 years. The middle-ear effusions were collected by tympanocentesis or myringotomy. The protein concentrations were determined by enzyme-linked immunosorbent assay and messenger RNA by real-time quantitative PCR. RESULTS VEGF level was higher in AOME group, but not correlated with the recurrence of OME. VEGFR1 and VEGFR2 levels were lower in recurrent group compared with non-recurrent group. VEGFR2 level was higher in serous effusions than mucoid effusions. VEGF messenger RNA was positively correlated both with HIF-1α and MUC5B. CONCLUSIONS VEGF and its receptors function to induce the production of middle-ear effusions (MEEs) at acute stage of OME rather than chronic or recurrent stage, which is mainly mediated by HIF-1α pathway. The formation of mucoid effusions is associated with MUC5B and VEGFR2, but not with duration and recurrence of OME.
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Affiliation(s)
- Mengxiao Ye
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, People's Republic of China
| | - Xiping Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, People's Republic of China.
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Tian C, Harris BS, Johnson KR. Ectopic Mineralization and Conductive Hearing Loss in Enpp1asj Mutant Mice, a New Model for Otitis Media and Tympanosclerosis. PLoS One 2016; 11:e0168159. [PMID: 27959908 PMCID: PMC5154548 DOI: 10.1371/journal.pone.0168159] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/27/2016] [Indexed: 01/14/2023] Open
Abstract
Otitis media (OM), inflammation of the middle ear, is a common cause of hearing loss in children and in patients with many different syndromic diseases. Studies of the human population and mouse models have revealed that OM is a multifactorial disease with many environmental and genetic contributing factors. Here, we report on otitis media-related hearing loss in asj (ages with stiffened joints) mutant mice, which bear a point mutation in the Enpp1 gene. Auditory-evoked brainstem response (ABR) measurements revealed that around 90% of the mutant mice (Enpp1asj/asj) tested had moderate to severe hearing impairment in at least one ear. The ABR thresholds were variable and generally elevated with age. We found otitis media with effusion (OME) in all of the hearing-impaired Enpp1asj/asj mice by anatomic and histological examinations. The volume and inflammatory cell content of the effusion varied among the asj mutant mice, but all mutants exhibited a thickened middle ear epithelium with fibrous polyps and more mucin-secreting goblet cells than controls. Other abnormalities observed in the Enpp1 mutant mice include over-ossification at the round window ridge, thickened and over-calcified stapedial artery, fusion of malleus and incus, and white patches on the inside of tympanic membrane, some of which are typical symptoms of tympanosclerosis. An excessive yellow discharge was detected in the outer ear canal of older asj mutant mice, with 100% penetrance by 5 months of age, and contributes to the progressive nature of the hearing loss. This is the first report of hearing loss and ear pathology associated with an Enpp1 mutation in mice. The Enpp1asj mutant mouse provides a new animal model for studying tympanosclerotic otitis and otitis media with effusion, and also provides a specific model for the hearing loss recently reported to be associated with human ENPP1 mutations causing generalized arterial calcification of infancy and hypophosphatemic rickets.
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MESH Headings
- Animals
- Ear, Middle/pathology
- Ear, Middle/ultrastructure
- Genotype
- Hearing Loss, Conductive/genetics
- Hearing Loss, Conductive/pathology
- Inflammation
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Mice, Transgenic
- Microscopy, Electron, Scanning
- Mutation
- Myringosclerosis/genetics
- Myringosclerosis/pathology
- Otitis Media/genetics
- Otitis Media/pathology
- Phosphoric Diester Hydrolases/genetics
- Pyrophosphatases/genetics
- Rickets, Hypophosphatemic/genetics
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Affiliation(s)
- Cong Tian
- The Jackson Laboratory, Bar Harbor, Maine, United States of America
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, Maine, United States of America
- * E-mail:
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Nazeen S, Palmer NP, Berger B, Kohane IS. Integrative analysis of genetic data sets reveals a shared innate immune component in autism spectrum disorder and its co-morbidities. Genome Biol 2016; 17:228. [PMID: 27842596 PMCID: PMC5108086 DOI: 10.1186/s13059-016-1084-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/12/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a common neurodevelopmental disorder that tends to co-occur with other diseases, including asthma, inflammatory bowel disease, infections, cerebral palsy, dilated cardiomyopathy, muscular dystrophy, and schizophrenia. However, the molecular basis of this co-occurrence, and whether it is due to a shared component that influences both pathophysiology and environmental triggering of illness, has not been elucidated. To address this, we deploy a three-tiered transcriptomic meta-analysis that functions at the gene, pathway, and disease levels across ASD and its co-morbidities. RESULTS Our analysis reveals a novel shared innate immune component between ASD and all but three of its co-morbidities that were examined. In particular, we find that the Toll-like receptor signaling and the chemokine signaling pathways, which are key pathways in the innate immune response, have the highest shared statistical significance. Moreover, the disease genes that overlap these two innate immunity pathways can be used to classify the cases of ASD and its co-morbidities vs. controls with at least 70 % accuracy. CONCLUSIONS This finding suggests that a neuropsychiatric condition and the majority of its non-brain-related co-morbidities share a dysregulated signal that serves as not only a common genetic basis for the diseases but also as a link to environmental triggers. It also raises the possibility that treatment and/or prophylaxis used for disorders of innate immunity may be successfully used for ASD patients with immune-related phenotypes.
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Affiliation(s)
- Sumaiya Nazeen
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, 02139 MA USA
| | - Nathan P. Palmer
- Department of Biomedical Informatics, Harvard Medical School, 25 Shattuck Street, Boston, 02115 MA USA
| | - Bonnie Berger
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, 02139 MA USA
- Department of Mathematics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, 02139 MA USA
| | - Isaac S. Kohane
- Department of Biomedical Informatics, Harvard Medical School, 25 Shattuck Street, Boston, 02115 MA USA
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Kerschner JE, Khampang P, Hong W. Dexamethasone modulation of MUC5AC and MUC2 gene expression in a generalized model of middle ear inflammation. Laryngoscope 2016; 126:E248-54. [PMID: 26525635 PMCID: PMC4854820 DOI: 10.1002/lary.25762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/27/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the effect of dexamethasone on basal and proinflammatory cytokine-induced gel-forming mucin expression in human middle ear epithelial cell line (HMEEC-1). METHODS HMEEC-1 was exposed to proinflammatory cytokines, tumor necrosis factor-alpha (TNF-), and interleukin-1 beta (IL-1β) to identify optimal mucin induction. The HMEEC-1 was incubated with dexamethasone in the steady state and in the presence of proinflammatory cytokine stimulation. Expression of MUC2 and MUC5AC was determined by quantitative polymerase chain reaction. RESULTS Proinflammatory cytokines, TNF-α and IL-1β, induced MUC2 and MUC5AC expression in HMEEC-1. Dexamethasone reduced steady state mRNA level of MUC5AC in a time-dependent (P < 0.05) and dose-dependent (P < 0.0001) manner. MUC2 was effectively suppressed at all time points tested (P < 0.05). Temporal difference between dexamethasone suppression of MUC2 and MUC5AC was demonstrated. Dexamethasone inhibits the proinflammatory cytokine-induced expression of both MUC2 and MUC5AC. CONCLUSION This work provides a conclusive picture of the ability of using glucocorticoids to downregulate mucin gene expression in human MEE using a generalizable model of inflammation that is applicable to multiple potential causes of MEE mucosal hypertrophy. This data adds to the promising potential of future interventions for patients with chronic otitis media. LEVEL OF EVIDENCE N/A. Laryngoscope, 126:E248-E254, 2016.
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Affiliation(s)
- Joseph E. Kerschner
- Division of Pediatric Otolaryngology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
| | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
| | - Wenzhou Hong
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
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Histopathologic changes in the middle ear mucosa after exposure to pepsin and unconjugated bile acid. J Craniofac Surg 2015; 25:e536-40. [PMID: 25364974 DOI: 10.1097/scs.0000000000001041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE An increasing number of studies indicate that pepsin and bile acid cause damage to the ear, nose, and throat structures as a result of extraesophageal reflux. The aim of this study was to evaluate and compare the damaging effect of bile acids and pepsin on the middle ear mucosa. MATERIAL AND METHODS Twenty-nine healthy rats were included in this study. The animals were divided into 5 groups. A single daily dose of 40 μmol/L chenodeoxycholic acid, 40 μg/mL pepsin, and saline were injected separately into the right middle ear of the rats. On day 30, all rats were decapitated, and formalin-fixed, paraffin-embedded samples of the middle ear both from the control and experimental rats were prepared. A semiquantitative analysis was performed. RESULTS Inflammatory response was seen in all middle ear mucosa of rats except control group 1. The degree of inflammatory response was higher in the bile acid group when compared with the other groups. Epithelial metaplastic changes with varying number of goblet cells were observed in both the bile acid- and pepsin-injected groups. These metaplastic changes were also higher in the bile acid-induced group than in the pepsin-injected group. CONCLUSIONS This is the first study on the middle ear mucosal damage of both pepsin and bile acid. Our results demonstrate that bile acids were associated with more extensive mucosal injury at pH 7 in comparison to pepsin in a rat animal model. Inflammatory response and metaplastic changes may play an important role in the etiology of middle ear pathologies.
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Zhang X, Zheng T, Sang L, Apisa L, Zhao H, Fu F, Wang Q, Wang Y, Zheng Q. Otitis media induced by peptidoglycan-polysaccharide (PGPS) in TLR2-deficient (Tlr2(-/-)) mice for developing drug therapy. INFECTION GENETICS AND EVOLUTION 2015; 35:194-203. [PMID: 26296608 DOI: 10.1016/j.meegid.2015.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/12/2015] [Accepted: 08/17/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Toll like receptor 2 (TLR2) signaling can regulate the pathogenesis of otitis media (OM). However, the precise role of TLR2 signaling in OM has not been clarified due to the lack of an optimal animal model. Peptidoglycan-polysaccharide (PGPS) of the bacterial cell wall can induce inflammation by activating the TLR2 signaling. This study aimed at examining the pathogenic characteristics of OM induced by PGPS in Tlr2(-/-) mice, and the potential therapeutic effect of sodium aescinate (SA) in this model. METHODS Wild-type (WT) and Tlr2(-/-) mice were inoculated with streptococcal PGPS into their middle ears (MEs) and treated intravenously with vehicle or SA daily beginning at 3days prior to PGPS for 6 consecutive days. The pathologic changes of individual mice were evaluated longitudinally. RESULTS In comparison with WT mice, Tlr2(-/-) mice were susceptible to PGPS-induced OM. Tlr2(-/-) mice displayed greater hearing loss, tympanic membrane damage, ME mucosal thickening, longer inflammation state, cilia and goblet cell loss. SA-treatment decreased neutrophil infiltration, modulated TLR2-related gene expression and improved ciliary organization. CONCLUSIONS PGPS induced a relatively stable OM in Tlr2(-/-) mice, providing a new model for OM research. Treatment with SA mitigated the pathogenic damage in the ME and may be valuable for intervention of OM.
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Affiliation(s)
- Xiaolin Zhang
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai 264003, Shandong, PR China; Department of Otolaryngology-HNS, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Tihua Zheng
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai 264003, Shandong, PR China
| | - Lu Sang
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai 264003, Shandong, PR China
| | - Luke Apisa
- Department of Otolaryngology-HNS, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Hongchun Zhao
- Department of Otolaryngology/Head and Neck Surgery, Institute of Otolaryngology, Affiliated Hospital of Binzhou Medical University, Binzhou 256600, Shandong, PR China
| | - Fenghua Fu
- Department of Pharmacology, School of Pharmacy, Yantai University, Yantai 264003, Shandong, PR China
| | - Qingzhu Wang
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai 264003, Shandong, PR China
| | - Yanfei Wang
- Department of Otolaryngology/Head and Neck Surgery, Institute of Otolaryngology, Affiliated Hospital of Binzhou Medical University, Binzhou 256600, Shandong, PR China.
| | - Qingyin Zheng
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai 264003, Shandong, PR China; Department of Otolaryngology-HNS, Case Western Reserve University, Cleveland, OH 44106, USA.
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Kerschner JE, Hong W, Khampang P, Johnston N. Differential response of gel-forming mucins to pathogenic middle ear bacteria. Int J Pediatr Otorhinolaryngol 2014; 78:1368-73. [PMID: 24958163 PMCID: PMC4104932 DOI: 10.1016/j.ijporl.2014.05.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/21/2014] [Accepted: 05/25/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the differential response of the secretory gel forming mucins (GFM) to the most common bacterial pathogens causing otitis media, Streptococcus pneumoniae (SP), nontypeable Haemophilus influenza (NTHi), and Moraxella catarrhalis (Mcat), in a culture model of human middle ear epithelium (HMEEC). METHODS In vitro cultured HMEEC was exposed to 5 μg/ml of bacterial whole cell lysate (WCL). RNA was extracted to generate cDNA. The expression levels of each of the targeted mucin transcripts, MUC2, MUC5AC, MUC5B and MUC19, were detected by quantitative PCR. RESULTS The submerged HMEEC exposed to NTHi-86028NP WCL demonstrated a significant increase of MUC2, MUC5AC and MUC5B as compared to the control non-treated cells while MUC19 transcript level remained unchanged. WCL of additional major OM pathogens significantly increase the transcription of these three mucin genes as well. A combination of NTHi and SP further synergistically induced MUC2 and MUC5AC gene expression however, not all NTHi strains synergized with SP in the induction. Addition of Mcat WCL to the synergized combination of NTHi and SP did not participate in the synergistic response of mucins. CONCLUSION The specific pathogen combinations were important in determining the degree of synergistic effects to GFM expression. The current data are substantive in guiding future work to extend our understanding of OM pathogens and GFMs.
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Affiliation(s)
- Joseph E. Kerschner
- Division of Pediatric Otolaryngology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226,Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
| | - Wenzhou Hong
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
| | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
| | - Nikki Johnston
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, Wisconsin 53226
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