Eosinophils are activated in middle ear mucosa and middle ear effusion of patients with intractable otitis media associated with bronchial asthma
Eosinophils are activated in middle ear mucosa and middle ear effusion of patients with intractable otitis media associated with bronchial asthma
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DOI：
10.1046/j.1365-2222.2001.01134.x
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发表时间：
2001-07-01
影响因子：
6.1
通讯作者：
Matsutani, S
中科院分区：
文献类型：
--
作者：
Iino, Y;Nagamine, H;Matsutani, S
背景虽然支气管哮喘合并顽固性中耳炎患者的中耳黏膜和中耳积液中存在广泛的嗜酸性粒细胞聚集，但尚未进行系统的组织学和免疫组化研究。方法应用抗EG 1、EG 2、肥大细胞类胰蛋白酶、伊加和IgE的单克隆抗体，对8例成人中耳炎患者和17例正常人的中耳标本进行免疫组化染色。结果哮喘患者中耳积液中嗜酸性粒细胞阳离子蛋白（ECP）的含量明显高于正常对照组（P < 0. 05），且大多数EG 1阳性细胞同时为EG 2阳性。在对照组患者中，粘膜显示纤维化改变，伴有少量炎性细胞，EG 1或EG 2阳性细胞相当少。哮喘患者肥大细胞表面及浆细胞内均有IgE表达，且IgE阳性细胞数约为肥大细胞的2倍。结论哮喘患者中耳粘膜及中耳积液中嗜酸性粒细胞大多被激活，导致ECP脱颗粒释放，并在中耳粘膜局部产生IgE，表明难治性炎症与IgE介导的晚期反应和嗜酸性粒细胞聚集密切相关。
Background Although patients with intractable otitis media associated with bronchial asthma have extensive accumulation of eosinophils in the middle ear mucosa and middle ear effusion, systematic histological and immunohistochemical studies have not been performed.Objectives To clarify the pathogenesis of middle ear diseases. we carried out immunohistochemical studies on middle ear specimens, particularly focusing on the characteristics of accumulated eosinophils.Methods Middle ear specimens obtained from eight adult patients and from 17 controls were immunohistochemically stained using monoclonal antibodies against EG1, EG2, mast cell tryptase, IgA and IgE. The concentration of eosinophil cationic protein (ECP) in middle ear effusion samples was also measured.Results In the asthmatic patients, severe round-cell infiltration was observed in the submucosa and most of the EG1-positive cells were also EG2-positive. In the control patients, the mucosa showed a fibrotic change with a few inflammatory cells, and EG1- or EG2-positive cells were quite few. The expression of IgE was found not only on the surface of mast cells but also within the plasma cells in the asthmatic patients, and the number of IgE-positive cells was about twice as high as that of mast cells. A significantly higher concentration of ECP was noted in middle ear effusion obtained from the asthmatic patients than that from the control patients.Conclusion Most of the eosinophils in the middle ear mucosa and middle ear effusion were activated, resulting in degranulation and release of ECP, and local IgE production occurs in the middle ear mucosa, indicating that the intractable inflammation is closely associated with IgE-mediated late phase response with eosinophil accumulation.