Immune Response to Acute Otitis Media in Children I. Serotypes Isolated and Serum and Middle Ear Fluid Antibody in Pneumococcal Otitis Media

Abstract

Seventy percent of pneumococci isolated from the middle-ear cavity of infants and children with acute otitis media were of one of the seven serotypes 1, 3, 6, 14, 18, 19, or 23. The immunological response in the serum and middle-ear fluid from otitis media caused by one of these serotypes was studied in 61 children by using either indirect hemagglutination or indirect fluorescent antibody tests, or both. Twenty-six of the patients had pneumococcal antibody present in the acute serum and 28 had it in the convalescent serum by at least one method. Thirteen of the 49 middle-ear fluids examined had antibody by the indirect fluorescent antibody technique. Serum pneumococcal antibody was found to reside predominantly in the immunoglobulin G or immunoglobulin M classes, whereas pneumococcal antibody with middle-ear fluid was found to be distributed equally among all three classes. Approximately 25% of the patients (16 of 61) had a positive immune response to their infection as evidenced by increased levels of pneumococcal antibody in the convalescent serum. The percentage of patients responding immunologically increased with age: 12% of infants less than 12 months showed a significant response, whereas 48% of children over 24 months responded.

Immune response to outer membrane antigens of Moraxella catarrhalis in children with otitis media

“…An immune response to a pathogen traditionally follows infection. In the case of otitis media, nontypeable H. influenzae and S. pneumoniae are often associated with a rise in antibody level during convalescence (12,18,21,22,37,38).…”

Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged-matched cohorts of children with and without otitis media with effusion

“…Most cases resolve spontaneously and the appropriate antibody responses are required for resolution of acute otitis media. 16 IgG immunoglobulins have four subclasses and have been studied more extensively. IgG 2 provides the dominant response to polysaccharide antigens in the circulation and probably the tissues.…”

C1 Subcomponents in Acute Pneumococcal Otitis Media in Children

“…A possibility that should be borne in mind is that specific antibodies may not produce sufficient opsonization of the pneumococcus (Fc-opsonization) . Shyer et al (26) showed that the presence of type specific antibodies 14 in the middle ear fluid did not prevent development of acute pneumococcal otitis media. We did not study the antibodies in such fluid, but despite type specific antibodies in serum acute pneumococcal otitis media relapsed.…”

“…Titers of specific pneumococcal polysaccharide antibodies were determined with the indirect immunofluorescens technique with the use of F I T C labelled anti-human IgG and anti-human IgM antisera (BBL, Division of Becton, Dickinson and Company, USA) as described by Sloyer et al (26).…”

“…Several studies of the immunological response to pneumococcal infections of the middle ear have been reported, Sloyer et al (26) demonstrated specific pneumococcal antibodies in patients with acute otitis media. They concluded that the presence of anti-10 bodies in the middle ear fluid does not prevent the development of otitis media.…”