IgG4 Expression in Patients with Eosinophilic Otitis Media

Abstract

Objective: Eosinophilic otitis media (EOM) is an intractable middle ear disease recognized by an eosinophil enriched middle ear effusion and mucosa. Although precise pathogenesis of EOM remains unclear, it is characterized by type 2 inflammation. Since IgG4 is an IgG subclass induced by type 2 cytokines such as IL-4 and IL-13, we sought to characterize and compare local IgG4 expression in patients with and without EOM. Methods: Twelve patients with bilateral profound hearing loss, 9 of which underwent a cochlear implant surgery, were enrolled in this study (6 with EOM and 6 without EOM). The surgical specimens were harvested during surgery and were subjected to IgG4 immunostaining. Result: The middle ear mucosa showed the presence of a large number of IgG4-positive cells in patients with EOM, which was significantly higher than that in patients without EOM. Conclusion: Local IgG4 expression was observed in patients with EOM in comparison to those without EOM, suggesting that IgG4 contributes to EOM pathogenesis.

Manifestaciones otológicas de la enfermedad relacionada con IgG4

“…En cuanto a la relación entre otitis media eosinofílica y ER-IgG4, en un estudio se sugiere que la ER-IgG4 puede contribuir al desarrollo de esta, aunque solo en 2 de los 48 pacientes de nuestra revisión se les diagnosticó una OME 47 . Con lo cual parece más una presentación excepcional dentro de la ER-IgG4.…”

Proteomic Study of Middle Ear Effusion and Its Clinical Application for Otitis Media with Effusion

“…Previous studies have not provided analyses of the OME effusion proteome database or disease differential analyses. [4][5][6] With advancements in proteomic techniques, a more inclusive analysis is needed to realize the function of middle ear effusion. Moreover, previous studies have indicated that the pathogenesis of OME is associated with immune response, coagulation activities, and inflammatory disorders.…”

“…OME was defined as an infection-free disease in the past. 4 However, recent studies have challenged this definition by demonstrating bacterial colonization in the middle ear charge or mucosa of patients with OME. These findings have raised questions regarding the existing theories of the disease’s etiology.…”