Demonstration of RANTES and eosinophilic cataionic protein in otitis media with effusion with allergy

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Abstract

Regulated upon activation, normal T cell-expressed and -secreted (RANTES) is a chemokine which is an effective eosinophil and memory T cell chemoattractant and activator, and eosinophil is an important effector cell in allergic disease. It may contribute to the pathogenesis of otitis media with effusion (OME). Eosinophil cataionic protein (ECP), one of the major components of basic granules of eosinophils which is identified in middle ear effusion (MEE). We measured RANTES and ECP in MEEs of OME to determine whether RANTES is increased in the MEEs of OME with allergy. We also evaluated the correlation between RANTES and ECP to determine the role of RANTES as an eosinophil activator in the pathogenesis in OME with allergy. Both RANTES and ECP in MEE of OME with allergy were significantly higher than controls. There was a significant correlation between the contents of RANTES and ECP. Our results suggest the allergic role of chemokine in the pathogenesis of OME.

Introduction

Otitis media with effusion (OME) is defined as an inflammation of the middle ear accompanied by fluid collection in the middle ear cleft without signs and symptoms of acute infection. The allergic response may, at least, predispose the patient to middle ear effusion (MEE) by congesting and obstructing the Eustachian tube. There are some studies of a role for allergy in OME etiology [1], [2], [3], [4]. Recently, Wright et al. [5] have demonstrated elevated levels of eosinophil cationic protein (ECP) in both MEEs of patients with OME and middle ear mucosal biopsy specimens from these patients. And Nagamine et al. [6] observed the accumulation of eosinophils in MEE, middle ear mucosa and nasal polyps, and the eosinophils were highly activated with degranulation. High level of ECP was also recovered from MEE.

Regulated upon activation, normal T cell-expressed and -secreted (RANTES) is a chemokine which is an effective eosinophil and memory T cell chemoattractant and activator, and eosinophil is an important effector cell in allergic disease. The purpose of this study was to determine whether RANTES is increased in the effusions of OME with allergy. We also evaluated the correlation between RANTES and ECP to determine the role of RANTES as an eosinophil activator in the pathogenesis in OME with allergy.

Section snippets

Patients

The MEE samples were collected from 25 patients with allergy and 20 patients without allergy. The patients aged 5–11 years (mean 6) were selected for myringotomy with ventilation tube insertion based on standard criteria including persistent MEE for 3 months. Patients were excluded if they had a history of acute otitis media in the preceding 3 months or a history of multiple placements of tympanostomy tubes. None had immunodeficiency or congenital malformations. All had documented mild to

Results

RANTES in MEE was significantly higher in OME with allergy than OME without allergy (0.99±0.14 vs. 0.34±0.03 ng/ml; P<0.01, Table 1). The level of ECP in MEE was significantly higher in OME with allergy than OME without allergy (24.1±4.5 vs. 8.91±3.5 μg/ml; P<0.05, Table 1). The concentrations of RANTES were positively correlated with ECP concentrations in the MEE of OME with allergy (r=0.63, P<0.01).

Discussion

In this study, we measured RANTES and ECP levels in the MEE. RANTES is an 8 kDa chemokine which is considered to be involved in the pathophysiology of allergic inflammation because of their ability to drive eosinophils through their binding sites, chemokine receptors, expressed on eosinophils [7], [8]. Recently, Schousboe et al. [9] measured the amount of RANTES in MEE with respect to monocyte-chemotactic properties and found that RANTES might explain the recruitment of monocytes in OME.

Acknowledgements

This work was supported by grant No. (R05-2001-000-00395-0) from the Basic Research Program of the Korea Science and Engineering Foundation.

References (13)

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