Immunologic aspects of otitis media

Bernstein, Joel

doi:10.1007/s11882-002-0056-4

Cited by 18 publications

(12 citation statements)

References 28 publications

(24 reference statements)

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“…The development of otitis media and allergy in children is strongly associated with allergic rhinitis 29. This has primarily been attributed to malfunction of the Eustachian tube induced by allergic reactions or depressed mucociliary clearance.…”

Section: Discussionmentioning

confidence: 99%

Differences in the antibody response to a mucosal bacterial antigen between allergic and non-allergic subjectsSmoke-free legislation reduces exposure in children

Hales

Pearce

Kusel

et al. 2008

Thorax

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Background: The immune response to bacterial antigens on mucosal surfaces may be modified in individuals allergic to aeroallergens due to a maturational or genetic difference or from the interaction between inhaled allergens and bacteria at the mucosa. Methods: Plasma from children and adults allergic (n = 97) and non-allergic (n = 54) to aeroallergens were initially tested for IgG1 (Th1) and IgG4 (Th2) reactivity to P6, a conserved outer membrane protein of Haemophilus influenzae. IgE binding was measured for some allergic donors. The development of the antibody responses to P6 was subsequently examined in the plasma from 35 children aged 1, 2 and 5 years taken from a prospective birth cohort. Results: IgG4 antibodies to P6 were more readily detected in allergic subjects than in non-allergic subjects (p,0.001), with a strong bias to the male gender. Some allergic subjects (35%) also had IgE antibody (1-10 ng/ ml) that was not associated with IgG4 or gender. In the cohort study of infants, subjects who developed skin prick test positivity to mite allergens by 5 years of age had an 85% reduction in the IgG1 anti-P6 antibody at year 2 (p,0.05) and, unlike skin test negative infants, this group had IgG4 anti-P6 antibodies at 5 years of age. Conclusions: The antibodies of subjects allergic to a bacterial antigen included IgE and IgG4 (particularly for males) compared with the almost exclusive IgG1 response of non-allergic subjects. The IgG1 responses of 2-year-old children who became skin test positive was markedly reduced and P6-specific IgG4 became detectable at 5 years of age.The T cell responses of children who develop allergic sensitisation have been shown to mature slowly. The late maturation has been demonstrated in T cell precursor analyses, 1 responses to mitogens 2 3 and in the production of Th1 and Th2 cytokines induced by allergens.4 5 Both Th1 and Th2 responses are lower in allergic infants, 4 but the Th1 cytokine production has been a centre of focus because interferon-c (IFNc) responses are very slow to mature in children, 6 leaving the possibility that Th2 imprinting in the neonatal period can persist into infancy. Most of the studies of cytokine regulation of allergic sensitisation have examined the response to allergens. An effect on responses to other antigens could also be expected. This could result from a genetic or environmentally-induced predisposition to producing Th2 responses in general, or be mediated via bystander interactions with the responses to allergens. The latter possibility has been demonstrated by experiments with viral and bacterial infections of sensitised mice.7-9 A greater involvement of the Th2 component of the response of children with aeroallergies to childhood vaccines has been observed. [10][11][12] The responses to mucosal antigens where co-presentation could occur with allergens would therefore be of interest.To study immune responses to an antigen presented at the respiratory mucosa, the IgE and IgG subclass antibodies induced by a conserved outer membrane p...

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Section: Discussionmentioning

confidence: 99%

Differences in the antibody response to a mucosal bacterial antigen between allergic and non-allergic subjectsSmoke-free legislation reduces exposure in children

Hales

Pearce

Kusel

et al. 2008

Thorax

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“…The mechanism by which this occurs is unknown and again it could possibly be due to the virus-mediated immunosuppression, which allows opportunistic secondary infections in the middle ear by decreasing levels of IgG and IgM within this compartment. However, whether this occurs directly or indirectly is unclear [98]. Pathological changes have been reported in four individuals with severe necrotizing otitis media who died due to secondary bronchopneumonia, indicating that the virus may directly infect the middle ear [99].…”

Section: Hearing Loss and Measles Infectionmentioning

confidence: 99%

Morbilliviruses and human disease

Rima

Duprex

2005

The Journal of Pathology

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Morbilliviruses are a group of viruses that belong to the family Paramyxoviridae. The most instantly recognizable member is measles virus (MV) and individuals acutely infected with the virus exhibit a wide range of clinical symptoms ranging from a characteristic mild selflimiting infection to death. Canine distemper virus (CDV) and rinderpest virus (RPV) cause a similar but distinctive pathology in dogs and cattle, respectively, and these, alongside experimental MV infection of primates, have been useful models for MV pathogenesis. Traditionally, viruses were identified because a distinctive disease was observed in man or animals; an infectious agent was subsequently isolated, cultured, and this could be used to recapitulate the disease in an experimentally infected host. Thus, satisfying Koch's postulates has been the norm. More recently, particularly due to the advent of exceedingly sensitive molecular biological assays, many researchers have looked for infectious agents in disease conditions for which a viral aetiology has not been previously established. For these cases, the modified Koch's postulates of Bradford Hill have been developed as criteria to link a virus to a specific disease. Only in a few cases have these conditions been fulfilled. Therefore, many viruses have over the years been definitely and tentatively linked to human diseases and in this respect the morbilliviruses are no different. In this review, human diseases associated with morbillivirus infection have been grouped into three broad categories: (1) those which are definitely caused by the infection; (2) those which may be exacerbated or facilitated by an infection; and (3) those which currently have limited, weak, unsubstantiated or no credible scientific evidence to support any link to a morbillivirus. Thus, an attempt has been made to clarify the published data and separate human diseases actually linked to morbilliviruses from those that are merely anecdotally associated.

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“…Eustachian tube (ET) dysfunction and the inflammatory response to viruses and bacteria that enter the middle ear are considered to be core elements in the development of OME [15][16][17]. Some birth characteristics are likely to impair the immune system, or ET function, or both, and thus contribute to a higher risk of developing OME.…”

Section: Introductionmentioning

confidence: 99%