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      An experimental study of inner ear injury in an animal model of eosinophilic otitis media

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          Abstract

          Conclusion:

          As the periods of intratympanic injection of ovalbumin (OVA) to the middle ear became longer, marked eosinophil infiltration in the perilymphatic space was observed. Moreover severe morphological damage of the organ of Corti was observed in the 28-day antigen-stimulation side. These results indicate that eosinophilic inflammation occurred in the inner ear and caused profound hearing loss.

          Objective:

          The purpose of the present study was to elucidate the inner ear damage in a new animal model of eosinophilic otitis media (EOM) which we recently constructed.

          Methods:

          We constructed the animal model of EOM by intraperitoneal and intratympanic injection of OVA. Infiltrating cells and the inner ear damage were examined by histological study.

          Results:

          In the inner ear, a few eosinophils were seen in the scala tympani of the organ of Corti and the dilation of capillaries of the stria vascularis was observed in the 7-day stimulation side. In the 14-day antigen stimulation side, some eosinophils and macrophages were seen in not only the scala tympani but also the scala vestibule. In the 28-day antigen-stimulation side, severe morphological damage of the organ of Corti and many eosinophils, red blood cells, and plasma cells infiltrating the perilymph were observed.

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          Most cited references20

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          Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease.

          Eosinophilic otitis media (EOM) is a newly recognized intractable middle ear disease, characterised by the accumulation of eosinophils in middle ear effusion and middle ear mucosa. Since EOM patients show gradual or sudden deterioration of hearing, it is important to properly diagnose EOM and to start adequate treatment for EOM. We aimed to investigate the clinical risk factors of EOM and to establish the diagnostic criteria of EOM. We reviewed 138 patients with EOM and 134 age-matched patients with the common type of otitis media with effusion or chronic otitis media as controls. We analyzed the incidence of the following clinical variables in both groups: bilaterality of otitis media, viscosity of middle ear effusion, formation of granulation tissue in the middle ear, response to the treatment for otitis media, deterioration of bone conduction hearing level, and association with other diseases such as bronchial asthma, chronic rhinosinusitis, nasal polyposis, and allergic rhinitis. A high odds ratio was obtained from an association with bronchial asthma (584.5), resistance to conventional treatment for otitis media (232.2), viscous middle ear effusion (201.6), association with nasal polyposis (42.17), association with chronic rhinosinusitis (26.49), bilaterality (12.93), and granulation tissue formation (12.62). The percentage of patients with EOM who were positive for two or more among the highest four items was 98.55%. A patient who shows otitis media with effusion or chronic otitis media with eosinophil-dominant effusion (major criterion) and with two or more among the highest four items (minor criteria), can be diagnosed as having EOM. Patients with ear symptoms should have the proper diagnosis of EOM using the proposed diagnostic criteria, and then can receive adequate treatment, resulting in prevention of deterioration of hearing and quality of life. Copyright © 2011. Published by Elsevier Ireland Ltd.
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            IL-5 and eotaxin levels in middle ear effusion and blood from asthmatics with otitis media with effusion.

            The purpose of this study was to evaluate eosinophil infiltration as well as IL-5 and eotaxin levels in middle ear effusion (MEE) and blood from otitis media with effusion (OME) patients with asthma and to compare the findings with those from OME patients without asthma (control group). Levels of IL-5 and eotaxin in MEE and blood were measured by means of enzyme-linked immunosorbent assay. 5 levels in MEE were significantly higher than those in blood in both groups of patients and in OME patients with asthma than in the control group. In addition, in OME patients with asthma, there was a significant correlation between the percentage of eosinophils and IL-5 levels in MEE. Eotaxin levels in blood were significantly higher than those in MEE in both groups of patients and in OME patients with asthma than in the control group. In addition, in OME patients with asthma, the percentage of eosinophils and eotaxin levels in blood tended to correlate, but did not reach statistical significance. These data suggest that, in OME patients with asthma, eosinophilia in MEE depends more on IL-5 than on eotaxin, and that eotaxin may play an important role in the mobilization of eosinophils from the bone marrow into the blood.
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              Eosinophil granule proteins and their role in disease.

              G Walsh (2001)
              The eosinophil has a potent armory of proinflammatory mediators with considerable potential to initiate and sustain an inflammatory response. These include cytotoxic granule proteins, cytokines, chemokines, and lipid mediators. Eosinophils are considered important in the immune response to infection with helminthic parasitic worms. Incrementally increasing evidence supports a critical role for their proinflammatory activities in diverse human conditions, most notably in allergic diseases such as asthma. In these conditions severe tissue damage is a consequence of an inappropriate accumulation of eosinophils and the subsequent release of their highly toxic granule proteins. In addition, release of granule-associated products such as chemokines and cytokines at the sites of inflammation is likely to have significant paracrine and autocrine relevance. This review will update recent developments in understanding the role that eosinophil granule proteins play in human disease, particularly those of the respiratory tract.
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                Author and article information

                Journal
                Acta Otolaryngol
                Acta Otolaryngol
                OTO
                Acta Oto-Laryngologica
                Informa Healthcare
                0001-6489
                1651-2251
                March 2014
                23 December 2013
                : 134
                : 3
                : 227-232
                Affiliations
                1Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine , 5 Zaifu-cho, Hirosaki 036-8562, Japan
                2Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine , 5 Zaifu-cho, Hirosaki 036-8562, Japan
                3Department of Otorhinolaryngology, Fukuoka University School of Medicine , Fukuoka, Japan
                Author notes
                Correspondence: Atsushi Matsubara, Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine , 5 Zaifu-cho, Hirosaki 036-8562, Japan. +81 172 39 5099. +81 172 39 5100. amatsu@ 123456cc.hirosaki-u.ac.jp
                Article
                10.3109/00016489.2013.859395
                3971771
                24359096
                43b6efe5-9119-48b3-a03b-1d9baeb9da9a
                © Informa Healthcare

                This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.

                History
                : 07 August 2013
                : 17 October 2013
                Categories
                Inner Ear

                Otolaryngology
                organ of corti,scala tympani,stria vascularis,round window membrane,ovalbumin
                Otolaryngology
                organ of corti, scala tympani, stria vascularis, round window membrane, ovalbumin

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