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Kurabi A, Hur DG, Pak K, Gibson M, Webster NJG, Baird A, Eliceiri BP, Ryan AF. The ECRG4 cleavage product augurin binds the endotoxin receptor and influences the innate immune response during otitis media. Front Genet 2022; 13:932555. [PMID: 36092940 PMCID: PMC9461705 DOI: 10.3389/fgene.2022.932555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Otitis media (OM), the most common disease of childhood, is typically characterized by bacterial infection of the middle ear (ME). Prominent features of OM include hyperplasia of the ME mucosa, which transforms from a monolayer of simple squamous epithelium with minimal stroma into a full-thickness respiratory epithelium in 2-3 days after infection. Analysis of the murine ME transcriptome during OM showed down-regulation of the tumor suppressor gene Ecrg4 that was temporally related to mucosal hyperplasia and identified stromal cells as the primary ECRG4 source. The reduction in Ecrg4 gene expression coincided with the cleavage of ECRG4 protein to release an extracellular fragment, augurin. The duration of mucosal hyperplasia during OM was greater in Ecrg4 -/- mice, the number of infiltrating macrophages was enhanced, and ME infection cleared more rapidly. ECRG4-null macrophages showed increased bacterial phagocytosis. Co-immunoprecipitation identified an association of augurin with TLR4, CD14 and MD2, the components of the lipopolysaccharide (LPS) receptor. The results suggest that full-length ECRG4 is a sentinel molecule that potentially inhibits growth of the ME stroma. Processing of ECRG4 protein during inflammation, coupled with a decline in Ecrg4 gene expression, also influences the behavior of cells that do not express the gene, limiting the production of growth factors by epithelial and endothelial cells, as well as the activity of macrophages.
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Affiliation(s)
- Arwa Kurabi
- Department of Otolaryngology, University of California, San Diego, La Jolla, CA, United States,*Correspondence: Arwa Kurabi,
| | - Dong Gu Hur
- Department of Otolaryngology, University of California, San Diego, La Jolla, CA, United States,Department of Otorhinolaryngology, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Kwang Pak
- Department of Otolaryngology, University of California, San Diego, La Jolla, CA, United States
| | - Madeline Gibson
- Department of Otolaryngology, University of California, San Diego, La Jolla, CA, United States
| | - Nicholas J. G. Webster
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States,San Diego Veterans Administration Healthcare System, San Diego, CA, United States
| | - Andrew Baird
- Department of Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Brian P. Eliceiri
- Department of Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Allen F. Ryan
- Department of Otolaryngology, University of California, San Diego, La Jolla, CA, United States,San Diego Veterans Administration Healthcare System, San Diego, CA, United States
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Sakamoto T, Pak K, Chavez E, Ryan AF, Kurabi A. HB-EGF Plays a Pivotal Role in Mucosal Hyperplasia During Otitis Media Induced by a Viral Analog. Front Cell Infect Microbiol 2022; 12:823714. [PMID: 35281434 PMCID: PMC8904902 DOI: 10.3389/fcimb.2022.823714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/31/2022] [Indexed: 01/26/2023] Open
Abstract
Otitis media (OM), the most common childhood illness, can be caused by bacterial and/or viral infection. Hyperplasia of the middle ear (ME) mucosa is an important component of OM that contributes to its deleterious sequelae. Our previous research revealed that ME mucosal hyperplasia in bacterially induced OM was associated with expression of the heparin-binding epidermal growth factor (HB-EGF) gene, and that HB-EGF induced the proliferation of ME mucosal explants in culture. We used single-cell RNA-Seq to identify ME cells that express Hbegf and related genes involved in mediating responses to this factor. To determine the degree to which a viral infection might induce mucosal hyperplasia, and to assess the role of HB-EGF in hyperplasia in vivo, we used, Poly(I:C) to simulate a ME viral infection, Western blotting to confirm ME protein expression, and a specific inhibitor to block the effects of HB-EGF during OM. Genes for HB-EGF and its receptor were expressed in the ME primarily by epithelial, stromal and endothelial cells. Poly(I:C) induced prominent ME mucosal hyperplasia, peaking two days after ME injection. Immunostaining revealed that cleavage of proHB-EGF into its soluble form (sHB-EGF) was strongly induced in response to Poly(I:C). Inhibition of the sHB-EGF receptor dramatically reduced the hyperplastic response of the mucosa. The results demonstrate that a synthetic analog of viral double-stranded RNA interaction can induce OM including a strong proliferative response of the ME mucosa, independent of bacteria. They also indicate that HB-EGF is the dominant growth factor responsible for ME mucosal hyperplasia in vivo.
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Affiliation(s)
- Takashi Sakamoto
- Department of Surgery, School of Medicine, University of California, San Diego, CA, United States
- Department of Otolaryngology, School of Medicine, University of California, San Diego, CA, United States
- Department of Surgical Sciences, University of Tokyo, Tokyo, Japan
| | - Kwang Pak
- Department of Surgery, School of Medicine, University of California, San Diego, CA, United States
- Department of Otolaryngology, School of Medicine, University of California, San Diego, CA, United States
- Research Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA, United States
| | - Eduardo Chavez
- Department of Surgery, School of Medicine, University of California, San Diego, CA, United States
- Department of Otolaryngology, School of Medicine, University of California, San Diego, CA, United States
| | - Allen F. Ryan
- Department of Surgery, School of Medicine, University of California, San Diego, CA, United States
- Department of Otolaryngology, School of Medicine, University of California, San Diego, CA, United States
- Research Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA, United States
- Department of Neurosciences, School of Medicine, University of California, San Diego, CA, United States
| | - Arwa Kurabi
- Department of Surgery, School of Medicine, University of California, San Diego, CA, United States
- Department of Otolaryngology, School of Medicine, University of California, San Diego, CA, United States
- Research Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA, United States
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Noel J, Suzukawa K, Chavez E, Pak K, Wasserman SI, Kurabi A, Ryan AF. A kinase inhibitor screen identifies signaling pathways regulating mucosal growth during otitis media. PLoS One 2020; 15:e0235634. [PMID: 32760078 PMCID: PMC7410257 DOI: 10.1371/journal.pone.0235634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022] Open
Abstract
Otitis media, the most common disease of childhood, is characterized by extensive changes in the morphology of the middle ear cavity. This includes hyperplasia of the mucosa that lines the tympanic cavity, from a simple monolayer of squamous epithelium into a greatly thickened, respiratory-type mucosa. The processes that control this response, which is critical to otitis media pathogenesis and recovery, are incompletely understood. Given the central role of protein phosphorylation in most intracellular processes, including cell proliferation and differentiation, we screened a library of kinase inhibitors targeting members of all the major families in the kinome for their ability to influence the growth of middle ear mucosal explants in vitro. Of the 160 inhibitors, 30 were found to inhibit mucosal growth, while two inhibitors enhanced tissue proliferation. The results suggest that the regulation of infection-mediated tissue growth in the ME mucosa involves multiple cellular processes that span the kinome. While some of the pathways and processes identified have been previously implicated in mucosa hyperplasia others are novel. The results were used to generate a global model of growth regulation by kinase pathways. The potential for therapeutic applications of the results are discussed.
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Affiliation(s)
- Julia Noel
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
| | - Keigo Suzukawa
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
| | - Eduardo Chavez
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
| | - Kwang Pak
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
| | | | - Arwa Kurabi
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
| | - Allen F. Ryan
- Department of Surgery/Otolaryngology, UC San Diego, San Diego, CA, United States of America
- San Diego VA Healthcare System, San Diego, CA, United States of America
- * E-mail:
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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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Hicks LD, Minnick MF. Human vascular endothelial cells express epithelial growth factor in response to infection by Bartonella bacilliformis. PLoS Negl Trop Dis 2020; 14:e0008236. [PMID: 32302357 PMCID: PMC7190185 DOI: 10.1371/journal.pntd.0008236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/29/2020] [Accepted: 03/18/2020] [Indexed: 12/16/2022] Open
Abstract
Bartonella are Gram-negative bacterial pathogens that trigger pathological angiogenesis during infection of humans. Bartonella bacilliformis (Bb) is a neglected tropical agent endemic to South America, where it causes Carrión’s disease. Little is known about Bb’s virulence determinants or how the pathogen elicits hyperproliferation of the vasculature, culminating in Peruvian warts (verruga peruana) of the skin. In this study, we determined that active infection of human umbilical vein endothelial cells (HUVECs) by live Bb induced host cell secretion of epidermal growth factor (EGF) using ELISA. Killed bacteria or lysates of various Bb strains did not cause EGF production, suggesting that an active infection was necessary for the response. Bb also caused hyperproliferation of infected HUVECs, and the mitogenic response could be inhibited by the EGF-receptor (EGFR) inhibitor, AG1478. Bb strains engineered to overexpress recombinant GroEL, evoked greater EGF production and hyperproliferation of HUVECs compared to control strains. Conditioned (spent) media from cultured HUVECs that had been previously infected by Bb were found to be mitogenic for naïve HUVECs, and the response could be inhibited by EGFR blocking with AG1478. Bb cells and cell lysates stimulated HUVEC migration and capillary-like tube formation in transmigration and Matrigel assays, respectively. To our knowledge, this is the first demonstration of EGF production by Bb-infected endothelial cells; an association that could contribute to hyperproliferation of the vascular bed during bartonellosis. Bartonella are bacteria that infect the circulatory system and, unlike other bacteria, cause blood vessels to grow uncontrollably in the skin, spleen and liver of humans. In many respects, the process resembles the aberrant blood vessel formation that occurs during tumor formation. This study found that when Bartonella bacilliformis (Bb) infects vascular endothelial cells (VECs) that line the circulatory system, it causes them to overproduce a protein called epidermal growth factor (EGF) which, in turn, causes the cells to multiply more rapidly than usual. We also found that VECs migrate towards the bacterium and form capillary-like tubes; processes that occur during an actual infection. This cause-effect has not been previously reported, and it may help to explain the pathology observed in humans infected by Bb.
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Affiliation(s)
- Linda D. Hicks
- Program in Cellular, Molecular & Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, Montana, United States of America
| | - Michael F. Minnick
- Program in Cellular, Molecular & Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, Montana, United States of America
- * E-mail:
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Mitochondrial Damage and Necroptosis in Aging Cochlea. Int J Mol Sci 2020; 21:ijms21072505. [PMID: 32260310 PMCID: PMC7177801 DOI: 10.3390/ijms21072505] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/14/2022] Open
Abstract
Age-related hearing loss (ARHL) is an irreversible, progressive neurodegenerative disorder and is presently untreatable. Previous studies using animal models have suggested mitochondrial damage and programmed cell death to be involved with ARHL. Thus, we further investigated the pathophysiologic role of mitochondria and necroptosis in aged C57BL/6J male mice. Aged mice (20 months old) exhibited a significant loss of hearing, number of hair cells, neuronal fibers, and synaptic ribbons compared to young mice. Ultrastructural analysis of aged cochleae revealed damaged mitochondria with absent or disorganized cristae. Aged mice also showed significant decrease in cochlear blood flow, and exhibited increase in gene expression of proinflammatory cytokines (IL-1β, IL-6, and TNF-α), receptor-interacting serine/threonine-protein kinase 1 and 3 (RIPK1 and RIPK3) and the pseudokinase mixed-lineage kinase domain-like (MLKL). Immunofluorescence (IF) assays of cytochrome C oxidase I (COX1) confirmed mitochondrial dysfunction in aged cochleae, which correlated with the degree of mitochondrial morphological damage. IF assays also revealed localization and increased expression of RIPK3 in sensorineural tissues that underwent significant necroptosis (inner and outer hair cells and stria vascularis). Together, our data shows that the aging cochlea exhibits damaged mitochondria, enhanced synthesis of proinflammatory cytokines, and provides new evidence of necroptosis in the aging cochlea in in vivo.
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Santos-Cortez RLP, Bhutta MF, Earl JP, Hafrén L, Jennings M, Mell JC, Pichichero ME, Ryan AF, Tateossian H, Ehrlich GD. Panel 3: Genomics, precision medicine and targeted therapies. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109835. [PMID: 32007292 PMCID: PMC7155947 DOI: 10.1016/j.ijporl.2019.109835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To review the most recent advances in human and bacterial genomics as applied to pathogenesis and clinical management of otitis media. DATA SOURCES PubMed articles published since the last meeting in June 2015 up to June 2019. REVIEW METHODS A panel of experts in human and bacterial genomics of otitis media was formed. Each panel member 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 panel met at the 20th International Symposium on Recent Advances in Otitis Media in June 2019, discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. CONCLUSION Trans-disciplinary approaches applying pan-omic technologies to identify human susceptibility to otitis media and to understand microbial population dynamics, patho-adaptation and virulence mechanisms are crucial to the development of novel, personalized therapeutics and prevention strategies for otitis media. IMPLICATIONS FOR PRACTICE In the future otitis media prevention strategies may be augmented by mucosal immunization, combination vaccines targeting multiple pathogens, and modulation of the middle ear microbiome. Both treatment and vaccination may be tailored to an individual's otitis media phenotype as defined by molecular profiles obtained by using rapidly developing techniques in microbial and host genomics.
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Affiliation(s)
- Regie Lyn P. Santos-Cortez
- Department of Otolaryngology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19 Ave., Aurora, CO 80045, USA
| | - Mahmood F. Bhutta
- Department of ENT, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK
| | - Joshua P. Earl
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease; Department of Microbiology and Immunology; Drexel University College of Medicine, 245 N. 15 St., Philadelphia, PA 19102, USA
| | - Lena Hafrén
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Tukholmankatu 8A, 00290 Helsinki, Finland
| | - Michael Jennings
- Institute for Glycomics, Gold Coast campus, Griffith University, QLD 4222, Australia
| | - Joshua C. Mell
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease; Department of Microbiology and Immunology; Drexel University College of Medicine, 245 N. 15 St., Philadelphia, PA 19102, USA
| | - Michael E. Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Ave., Rochester, NY 14621, USA
| | - Allen F. Ryan
- Department of Surgery/Otolaryngology, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Hilda Tateossian
- Mammalian Genetics Unit, MRC Harwell Institute, Harwell, Oxford, Didcot OX11 0RD, UK
| | - Garth D. Ehrlich
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease; Department of Microbiology and Immunology; Drexel University College of Medicine, 245 N. 15 St., Philadelphia, PA 19102, USA
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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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Lim HW, Pak K, Kurabi A, Ryan AF. Lack of the hyaluronan receptor CD44 affects the course of bacterial otitis media and reduces leukocyte recruitment to the middle ear. BMC Immunol 2019; 20:20. [PMID: 31226944 PMCID: PMC6588864 DOI: 10.1186/s12865-019-0302-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 06/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND CD44 is a multifunctional molecule that plays major roles in both leukocyte recruitment and tissue proliferation. Since mucosal hyperplasia and leukocyte infiltration of the middle ear cavity are major features of otitis media, we evaluated the role of CD44 in the pathophysiology and course of this disease in a mouse model of middle ear infection. Expression of genes related to CD44 function were evaluated using gene arrays in wild-type mice. The middle ears of mice deficient in CD44 were inoculated with non-typeable Haemophilus influenzae. Histopathology and bacterial clearance were compared to that seen in wild-type controls. RESULTS We observed strong up-regulation of CD44 and of genes related to its role in leukocyte extravasation into the middle ear, during the course of acute otitis media. Mice deficient in CD44 exhibited reduced early mucosal hyperplasia and leukocyte recruitment, followed by delayed resolution of infection and persistent inflammation. CONCLUSIONS CD44 plays an important role in OM pathogenesis by altering the mucosal growth and neutrophil enlistment. Targeted therapies based on CD44 could be useful adjuncts to the treatment of middle ear infections.
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Affiliation(s)
- Hyun Woo Lim
- Department of Surgery/Otolaryngology, University of California-San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0666 USA
- Department of Otolaryngology, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Kwang Pak
- Department of Surgery/Otolaryngology, University of California-San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0666 USA
| | - Arwa Kurabi
- Department of Surgery/Otolaryngology, University of California-San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0666 USA
| | - Allen F. Ryan
- Department of Surgery/Otolaryngology, University of California-San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0666 USA
- San Diego VA Medical Center, La Jolla, CA USA
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Apigetrin treatment attenuates LPS-induced acute otitis media though suppressing inflammation and oxidative stress. Biomed Pharmacother 2018; 109:1978-1987. [PMID: 30551453 DOI: 10.1016/j.biopha.2018.07.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 01/03/2023] Open
Abstract
The natural course of otitis media in children is acute and self-limiting. Nevertheless, about 10-20% children could experience recurrent or persistent otitis media. Thus, finding effective candidate to prevent acute otitis media is urgently required. In our study, mouse acute otitis media model was constructed by lipopolysaccharide (LPS) injection into the middle ear of mice via the tympanic membrane. Apigetrin (APT) is a flavonoid isolated from various herbal medicines, possessing anti-inflammatory and anti-oxidative bioactivities. However, if APT could attenuate acute otitis media in LPS-induced animal models, little is to be known. Hematoxylin and eosin (H&E) staining suggested that APT treatment reduced LPS-induced higher mucosa thickness. LPS-triggered inflammatory response was also inhibited by APT, as evidenced by the down-regulated neutrophils and macrophages. Additionally, the reduced inflammatory factors, including interleukin-1β (IL-lβ), tumor necrosis factor α (TNF-α), IL-6 and vascular endothelial growth factor (VEGF) were observed in APT-treated mice with acute otitis media. The process was associated with the inhibition of toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) pathway, which was proved by the blockage of TLR4, MyD88, p-IKKα, p-IκBα, and p-NF-κB using western blot analysis. Moreover, the production of reactive oxygen species (ROS) caused by LPS was also reduced by APT through promoting anti-oxidants, involving superoxide dismutase (SOD) activity, heme oxygenase-1 (HO-1), NADP(H) quinone oxidoreductase 1 (NQO-1) and nuclear factor erythroid 2-related factor 2 (Nrf2) expressions. In contrast, high levels of MDA and kelch-like ECH-associated protein 1 (Keap 1) in LPS-treated mice were down-regulated by APT, which might be associated with the inactivation of NF-κB. In vitro, APT exhibited anti-inflammatory and anti-oxidant effects with little cytotoxicity in LPS-stimulated cells. Together, the data above indicated that APT could ameliorate acute otitis media through inhibiting inflammation and oxidative stress.
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Animal models of acute otitis media - A review with practical implications for laboratory research. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:183-190. [PMID: 29656888 DOI: 10.1016/j.anorl.2017.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 06/08/2017] [Accepted: 06/12/2017] [Indexed: 11/23/2022]
Abstract
Considerable animal research has focused on developing new strategies for the prevention and treatment of acute otitis media (AOM). Several experimental models of AOM have thus been developed. A PubMed search of the English literature was conducted from 1975 to July 2016 using the search terms "animal model" and "otitis media" from which 91 published studies were included for analysis, yielding 123 animal models. The rat, mouse and chinchilla are the preferred animals for experimental AOM models with their individual advantages and disadvantages. The most common pathogens used to create AOM are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Streptococcus pneumoniae (types 3, 23 and 6A) and non-typeable Haemophilus influenzae (NTHi) are best options for inoculation into rat and mouse models. Adding viral pathogens such as RSV and Influenza A virus, along with creating ET dysfunction, are useful adjuncts in animal models of AOM. Antibiotic prophylaxis may interfere with the inflammatory response without a significant reduction in animal mortality.
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12
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Xie S, Wang X, Ren H, Liu X, Ren J, Liu W. HB-EGF expression as a potential biomarker of acquired middle ear cholesteatoma. Acta Otolaryngol 2017; 137:797-802. [PMID: 28498080 DOI: 10.1080/00016489.2017.1284343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONCLUSIONS The heparin-binding epidermal growth factor-like growth factor (HB-EGF) plays an essential role in the development and invasiveness of cholesteatoma. This study may help to realize the molecular mechanisms underlying the pathogenesis of cholesteatoma and make HB-EGF a promising target for drug intervention of cholesteatoma. OBJECTIVE To detect HB-EGF expression in human surgical specimens of acquired middle ear cholesteatoma and analyze its functional role as a regulator of epithelial keratinocytes hyperproliferation. METHODS A total of 34 patients who underwent surgical treatment for middle ear cholesteatoma were recruited in the study. The mRNA and protein expression of HB-EGF in middle ear cholesteatoma tissues and normal postauricular skin tissues was investigated by real-time quantitative reverse-transcription-polymerase chain reaction (RT-qPCR), immunohistochemical staining, and western blot. The correlation between bone resorption degree and HB-EGF expression was also analyzed. RESULTS On average, compared with normal postauricular skin, expression of HB-EGF mRNA in the cholesteatoma epithelium was significantly elevated 2.41-fold by RT-qPCR, and HB-EGF protein significantly upregulated 2.32-fold by western blot. Positive HB-EGF immunostaining observed in the basal and suprabasal layers of cholesteatoma epithelium was significantly stronger than in normal postauricular skin. Meanwhile, an obviously positive correlation between HB-EGF protein expression and bone resorption degree was discovered.
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Affiliation(s)
- Shumin Xie
- Department of Otolaryngology-Head and Neck Surgery, The Xiangya Hospital, Central South University, Hunan Provincial Key Lab of Otolaryngology Critical Diseases, Changsha, Hunan Province, PR China
| | - Xiaoli Wang
- Department of Pediatric Ophthalmology and Otorhinolaryngology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, PR China
| | - Hongmiao Ren
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, PR China
| | - Xiaoyu Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, PR China
| | - Jihao Ren
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, PR China
| | - Wei Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, PR China
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13
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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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Cho CG, Pak K, Webster N, Kurabi A, Ryan AF. Both canonical and non-canonical NF-κB activation contribute to the proliferative response of the middle ear mucosa during bacterial infection. Innate Immun 2016; 22:626-634. [PMID: 27655045 DOI: 10.1177/1753425916668581] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A major aspect of pathology in otitis media (OM), the most common childhood bacterial disease, is hyperplasia of the middle ear mucosa. Activation of innate immune receptors during OM leads to the activation of NF-κB, a pleiotropic transcription factor involved both in inflammation and tissue growth. To explore the role of NF-κB in mucosal hyperplasia during OM, we evaluated the expression of genes involved in two modes of NF-κB activation during a complete episode of acute, bacterial OM in mice. We also determined the effects of inhibitors of each pathway on infection-stimulated mucosal growth in vitro. A majority of the genes that mediate both the canonical and the non-canonical pathways of NF-κB activation were regulated during OM, many with kinetics related to the time course of mucosal hyperplasia. Inhibition of either pathway reduced the growth of cultured mucosal explants in a dose-dependent manner. However, inhibition of the canonical pathway produced a greater effect, suggesting that this mode of NF-κB activation dominates mucosal hyperplasia during OM.
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Affiliation(s)
- Chang Gun Cho
- 1 Department of Otolaryngology - Head and Neck Surgery, Dongguk University Ilsan Hospital, Korea.,2 Department of Surgery/Otolaryngology, University of California, San Diego (UCSD) School of Medicine and Veterans Administration (VA) Medical Center, USA
| | - Kwang Pak
- 2 Department of Surgery/Otolaryngology, University of California, San Diego (UCSD) School of Medicine and Veterans Administration (VA) Medical Center, USA
| | - Nicholas Webster
- 3 Department of Medicine/Endocrinology, UCSD School of Medicine and VA Medical Center, USA
| | - Arwa Kurabi
- 2 Department of Surgery/Otolaryngology, University of California, San Diego (UCSD) School of Medicine and Veterans Administration (VA) Medical Center, USA
| | - Allen F Ryan
- 2 Department of Surgery/Otolaryngology, University of California, San Diego (UCSD) School of Medicine and Veterans Administration (VA) Medical Center, USA
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15
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Santa Maria PL, Kim S, Yang YP. No systemic exposure of transtympanic heparin-binding epidermal growth factor like growth factor. Drug Chem Toxicol 2016; 39:451-4. [PMID: 26887920 DOI: 10.3109/01480545.2016.1143482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Heparin-binding epidermal growth factor like growth factor (HB-EGF) is an emerging therapeutic for the regeneration of the tympanic membrane (TM). OBJECTIVE Our aim was to determine whether the doses of HB-EGF delivered in a sustained release hydrogel into a middle ear mouse model, would be measurable in the systemic circulation. We also aimed to observe, in the scenario that the intended dose was absorbed directly into the circulation, whether these levels could be measured above the background levels of HB-EGF in the circulation. METHODS A total of 12 mice had transtympanic injections of 5 μg/ml of HB-EGF contained within a previously described novel hydrogel vehicle, while another 12 mice had intravenous delivery of 10 μg/kg of HB-EGF. Intravenous blood samples were collected at 0-, 3-, 24-, 168-, 288- and 720-h post-injection. A double-antibody sandwich one-step process enzyme-linked immunosorbent assay (ELISA) was used to determine the level of HB-EGF in the serum. RESULTS No mice in the transtympanic administration group and no mice in the intravenous administration group were found to have blood level measured above that in the controls. DISCUSSION The inability of the positive control to measure levels above background, suggest the total dose used in our studies, even if 100% absorbed into the system circulation is insignificant. CONCLUSIONS HB-EGF at the doses and delivery method proposed for treatment of chronic TM perforation in a mouse model are likely to have no measurable systemic effect.
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Affiliation(s)
- Peter Luke Santa Maria
- a Department of Otolaryngology , Head and Neck Surgery, Stanford University , Stanford , CA , USA
| | - Sungwoo Kim
- b Department of Orthopedic Surgery , Stanford University , Stanford , CA , USA
| | - Yunzhi Peter Yang
- b Department of Orthopedic Surgery , Stanford University , Stanford , CA , USA .,c Department of Materials Science and Engineering , Stanford University , Stanford , CA , USA , and.,d Department of Bioengineering , Stanford University , Stanford , CA , USA
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16
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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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17
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Hernandez M, Leichtle A, Pak K, Webster NJ, Wasserman SI, Ryan AF. The transcriptome of a complete episode of acute otitis media. BMC Genomics 2015; 16:259. [PMID: 25888408 PMCID: PMC4394589 DOI: 10.1186/s12864-015-1475-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/20/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Otitis media is the most common disease of childhood, and represents an important health challenge to the 10-15% of children who experience chronic/recurrent middle ear infections. The middle ear undergoes extensive modifications during otitis media, potentially involving changes in the expression of many genes. Expression profiling offers an opportunity to discover novel genes and pathways involved in this common childhood disease. The middle ears of 320 WBxB6 F1 hybrid mice were inoculated with non-typeable Haemophilus influenzae (NTHi) or PBS (sham control). Two independent samples were generated for each time point and condition, from initiation of infection to resolution. RNA was profiled on Affymetrix mouse 430 2.0 whole-genome microarrays. RESULTS Approximately 8% of the sampled transcripts defined the signature of acute NTHi-induced otitis media across time. Hierarchical clustering of signal intensities revealed several temporal gene clusters. Network and pathway enrichment analysis of these clusters identified sets of genes involved in activation of the innate immune response, negative regulation of immune response, changes in epithelial and stromal cell markers, and the recruitment/function of neutrophils and macrophages. We also identified key transcriptional regulators related to events in otitis media, which likely determine the expression of these gene clusters. A list of otitis media susceptibility genes, derived from genome-wide association and candidate gene studies, was significantly enriched during the early induction phase and the middle re-modeling phase of otitis but not in the resolution phase. Our results further indicate that positive versus negative regulation of inflammatory processes occur with highly similar kinetics during otitis media, underscoring the importance of anti-inflammatory responses in controlling pathogenesis. CONCLUSIONS The results characterize the global gene response during otitis media and identify key signaling and transcription factor networks that control the defense of the middle ear against infection. These networks deserve further attention, as dysregulated immune defense and inflammatory responses may contribute to recurrent or chronic otitis in children.
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Affiliation(s)
- Michelle Hernandez
- Divisions of Surgery / Otolaryngology, University of California, San Diego, La Jolla, CA, USA. .,Department of Pediatrics, Division of Allergy, Immunology, Rheumatology, and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
| | - Anke Leichtle
- Divisions of Surgery / Otolaryngology, University of California, San Diego, La Jolla, CA, USA. .,Department of Otolaryngology, University of Lübeck, Lübeck, Germany.
| | - Kwang Pak
- Divisions of Surgery / Otolaryngology, University of California, San Diego, La Jolla, CA, USA. .,VA San Diego Healthcare System, San Diego, CA, USA.
| | - Nicholas J Webster
- Medicine / Endocrinology, University of California, San Diego, La Jolla, CA, USA. .,VA San Diego Healthcare System, San Diego, CA, USA.
| | - Stephen I Wasserman
- Rheumatology, Allergy and Immunology, University of California, San Diego, La Jolla, CA, USA.
| | - Allen F Ryan
- Divisions of Surgery / Otolaryngology, University of California, San Diego, La Jolla, CA, USA. .,VA San Diego Healthcare System, San Diego, CA, USA.
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