Spontaneous Resolution of Cholesteatoma in a Patient on Long-Term Infliximab

Chao, Janet Ren; Dewyer, Nicholas A.; McKenna, Michael J.

doi:10.1177/0003489418823790

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…These findings are promising for cholesteatoma treatment options. In a case report, Chao et al [17] reported that the patient completely recovered from cholesteatoma after long-term anti-TNFa antibody (infliximab) treatment. Our study found high periostin and fibronectin levels in cholesteatoma tissue This suggests that periostin and fibronectin may play a role in the mechanism of cholesteatoma formation and that agents targeting periostin and fibronectin may be used in the treatment of cholesteatoma in the future.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of periostin, fibronectin and tenascin-C in patients chronic otitis media with cholesteatoma

Birinci

Terzi

Demir

et al. 2022

Egypt J Otolaryngol

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Background Although many studies have investigated the mechanisms of cholesteatoma formation, its pathogenesis remains unclear. The aim of this study was to evaluate the levels of periostin, fibronectin and tenascin-C, which are involved in many mechanisms, such as cell adhesion, cell differentiation, inflammation, fibrosis, angiogenesis and cell proliferation, in patients with chronic otitis media (COM). A total of 80 participants, 65 COM patients undergoing surgery and 15 healthcare personnel volunteers serving as controls, were included in this study. The participants were divided into four groups: cholesteatoma, granulation, avivation and control group. The serum periostin, fibronectin and tenascin-C levels of all participants were determined biochemically. Histopathological evaluation of tissue samples and 20 skin samples used as controls was performed by immunohistochemistry. Results Of the 65 patients, 22 presented with cholesteatoma, 15 with granulation tissue and 28 with the edge of the tympanic membrane perforation freshening tissue. There were no significant differences in serum periostin, fibronectin and tenascin-C levels between the groups. In the immunohistochemical evaluation, fibronectin and periostin staining was significantly more intense in the cholesteatoma group than in the other groups (p = 0.001). Epithelial tenascin-C staining was significantly more intense in the avivation group than in the other groups (p = 0.041). Conclusion The levels of periostin and fibronectin were higher in cholesteatoma tissue than in other forms of chronic otitis and skin tissue. This suggests that they may be involved in the mechanism of cholesteatoma formation. These proteins could be used as biomarkers in the diagnosis and treatment of cholesteatoma.

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Section: Discussionmentioning

confidence: 99%

Evaluation of periostin, fibronectin and tenascin-C in patients chronic otitis media with cholesteatoma

Birinci

Terzi

Demir

et al. 2022

Egypt J Otolaryngol

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“…Based on the findings of the present study, it is tempting to speculate about a similar potential therapeutic application for infliximab in human acquired cholesteatoma. Interestingly, the only known case report of spontaneous remission of human acquired cholesteatoma in the literature has described complete clinical and radiological disease resolution in a patient under long-term immunosuppression with infliximab [ 65 ]. Thus, we hypothesize that a shift from the destructive M1 pathway toward the homeostatic M2 pathway through TNFα inhibition may represent a biological approach to the management of cholesteatoma.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between the M1/M2 Macrophage Polarization and the Degree of Ossicular Erosion in Human Acquired Cholesteatoma: An Immunohistochemical Study

Bassiouni

Arens

Zabaneh

et al. 2022

JCM

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The differential involvement of the macrophage activation phenotypes (M1 vs. M2) has been linked to disease severity in various chronic inflammatory disorders. Pharmacologic manipulation of the M1/M2 macrophage polarization has shown therapeutic potential. Cholesteatoma is a destructive chronic middle ear disease with potentially life-threatening complications. The distribution of macrophage polarization phenotypes in middle ear cholesteatoma has not been described. In the present study, human cholesteatoma specimens acquired during tympanomastoidectomy were retrospectively retrieved and immunohistochemically characterized using a combination of antibodies labeling M1 macrophages (CD80), M2 macrophages (CD163), and total macrophages (CD68). The correlations between the immunohistochemical findings and clinical presentation were assessed. The findings revealed that cholesteatomas with more extensive ossicular erosion demonstrated a significantly higher number of M1 (CD80+) cells and a higher M1/M2 ratio than less invasive cholesteatomas (Wilcoxon test, p < 0.05). The extent of ossicular erosion correlated significantly with the M1/M2 ratio (Spearman correlation coefficient ρ = 0.4, p < 0.05). Thus, the degree of ossicular erosion in human acquired cholesteatoma appears to be related to the M1/M2 macrophage polarization. The investigation of macrophage polarization and functions in various clinical presentations of middle ear cholesteatoma is of great interest since it may contribute to the development of pharmaceutical treatment approaches.

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“…The etiological mechanisms underlying cholesteatomas can be briefly explained as inflammation and hyperplasia in connective tissues (17).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Oral Montelukast Administration in Cholesteatoma Development and Inflammation: An Experimental Animal Model

Öcal

Kaytez

Yumuşak

et al. 2021

Otology &Amp; Neurotology

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Hypothesis: We hypothesized that oral montelukast treatment could inhibit cholesteatoma formation in an experimental animal model. Background: Inflammation and excessive proliferation have been described in the histopathology of cholesteatoma. The aim of this study was to determine the effect of oral montelukast on cholesteatoma development. Methods: Eighteen healthy female Wistar albino rats weighing 250 g were chosen for the study. The animals were divided into two groups: group 1 received montelukast and group 2 was the control group. Intratympanic propylene glycol injection was administered into the left ears and physiologic serum was instilled into the right ears of the animals on the first, eighth, and fifteenth days. The effects of montelukast adminis-tration were evaluated by histological examination of the tympanic membrane and middle ear. Results: Group 1 (montelukast group) showed significant differences in terms of cholesteatoma formation, granulation, epithelial invagination, and inflammation. Cholesteatoma formation in the left ear was observed in 2 (22%) and 8 (89%) rats in groups 1 and 2, respectively ( p ¼ 0.015). Conclusion: Development of cholesteatoma and inflammation was significantly lower in the montelukast-administered group. Thus, oral montelukast was found effective in preventing cholesteatoma formation.

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Spontaneous Resolution of Cholesteatoma in a Patient on Long-Term Infliximab

Cited by 6 publications

References 15 publications

Evaluation of periostin, fibronectin and tenascin-C in patients chronic otitis media with cholesteatoma

Evaluation of periostin, fibronectin and tenascin-C in patients chronic otitis media with cholesteatoma

The Relationship between the M1/M2 Macrophage Polarization and the Degree of Ossicular Erosion in Human Acquired Cholesteatoma: An Immunohistochemical Study

The Effect of Oral Montelukast Administration in Cholesteatoma Development and Inflammation: An Experimental Animal Model

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