Immunology and Microbiology in Acute Otitis Media
Immunology and Microbiology in Acute Otitis Media
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急性中耳炎的免疫学和微生物学
DOI：
10.1177/00034894760850s224
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发表时间：
1976
期刊：
影响因子：
--
通讯作者：
V. Howie
中科院分区：
文献类型：
--
作者：
J. Sloyer;J. H. Ploussard;V. Howie
对肺炎链球菌或流感嗜血杆菌引起的急性中耳炎患儿的血清、中耳液（MEF）、外周血淋巴细胞和MEF的各种免疫学参数进行了测定。通过间接荧光抗体（IFA）技术检测，131例患者中约有一半具有针对感染细菌的IgE特异性抗体。71%的IgE阳性患者在MEF中有IgE特异性抗体。与同期抽取的血清相比，MEF中总IgE浓度平均高出1.5 ~ 3.0倍。此外，在MEF中通过放射免疫测定证实了对肺炎球菌荚膜多糖和肺炎球菌c -碳水化合物的抗体。MEF特异性抗体与血清抗体比较，MEF中c -碳水化合物抗体更为集中。IFA提示该抗体属于IgE类，但未得到最终证实。有证据表明，增强IgE合成的条件与t细胞活性的降低密切相关。经玫瑰花结形成和植物血凝素（PHA）刺激测定，MEF衍生淋巴细胞的t细胞功能约为外周血淋巴细胞的十分之一。然而，t细胞可能参与了对多糖的免疫应答，这是由观察到多糖刺激的婴儿外周血淋巴细胞的蛋白质合成是PHA刺激细胞的两到三倍。这一发现的临床意义以及负责增加蛋白质合成的细胞的性质仍有待确定。据推测，急性中耳炎是由局部合成细菌特异性IgE抗体引起的，这种抗体由于局部t细胞活性的缺乏而增强。
Various immunological parameters were measured in serum, middle ear fluid (MEF), and lymphocytes from peripheral blood and MEF of infants with acute otitis media due to S. pneumoniae or H. influenzae. Approximately half of 131 patients had IgE specific antibody to the infecting bacterium as determined by the indirect fluorescent antibody (IFA) technique. Seventy-one percent of these IgE positive patients had IgE specific antibody in the MEF. Total IgE concentration was found to be from an average of 1.5 to 3.0 times higher in the MEF when compared to the simultaneously drawn serum. In addition, antibody to pneumococcal capsular polysaccharides and to pneumococcal C-carbohydrate was demonstrated in the MEF by radioimmunoassay. When MEF specific antibody was compared to serum antibody it appeared that antibody to C-carbohydrate was more concentrated in the MEF. That this antibody was of the IgE class was suggested by IFA but not conclusively proven. Evidence exists that conditions for enhanced IgE synthesis is concomitantly associated with a decrease in T-cell activity. T-cell function in MEF derived lymphocytes as determined by rosette formation and by phytohemagglutinin (PHA) stimulation was approximately one-tenth that of the peripheral blood lymphocytes. However, that T-cells may participate in the immune response to polysaccharides was suggested by the observation that polysaccharide stimulated peripheral blood lymphocytes from infants immunized with octavalent pneumococcal capsular vaccine underwent protein synthesis two to three times that of the PHA stimulated cells. The clinical significance of this finding as well as the nature of the cell responsible for the increased protein synthesis remains to be established. It is hypothesized that acute otitis media results from local synthesis of bacteria specific IgE antibody which is enhanced by a paucity of local T-cell activity.