The role of vascular endothelial growth factor in pediatric otitis media with effusion.
The role of vascular endothelial growth factor in pediatric otitis media with effusion.
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DOI：
10.1016/j.anl.2010.10.008
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发表时间：
2011-06
期刊：
影响因子：
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通讯作者：
Kohsuke Sekiyama;J. Ohori;S. Matsune;Y. Kurono
中科院分区：
文献类型：
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作者：
Kohsuke Sekiyama;J. Ohori;S. Matsune;Y. Kurono
目的血管内皮细胞生长因子(VEGF)是血管生成和血管通透性的重要诱导剂，与缺氧和炎性细胞因子一起在炎症事件中发挥重要作用。在实验性渗出性中耳炎(OME)动物模型和渗出性中耳炎患者的中耳中，表达了血管内皮生长因子信使核糖核酸(MRNA)。然而，中耳积液中血管内皮生长因子的蛋白水平尚不清楚，其在中耳积液发病机制中的作用也不清楚。本研究的目的是通过与白介素8(IL-8)、内毒素和白蛋白水平的比较，来检测MEE中的血管内皮生长因子(VEGF)水平，并探讨其在MEES产生中的作用。受试者的平均年龄为6.3岁(1-12岁)。患者接受鼓膜切开和/或插入通气管治疗OME。鼓膜切开术后，用Juhn Tym-Tap收集MEE。根据肉眼观察，标本分为浆液型和粘液型。在测量了MEE的重量后，用磷酸盐缓冲盐水稀释样品并冷冻直到使用。采用双抗体夹心酶联免疫吸附试验检测MEE中血管内皮生长因子(VEGF)、白蛋白-8(IL-8)的浓度，用免疫比浊法测定内毒素水平，用免疫比浊法测定白蛋白。黏液性MEE患者血清中的血管内皮生长因子、内毒素和IL-8水平显著高于浆液性MEES患者(p<；0.01)，而白蛋白浓度在粘液性和浆液性MEES患者之间无显著差异。在浆液性MES中，VEGF水平与内毒素(R2=0.17，p<；0.05)和白蛋白(R2=0.65，p<；0.01)呈正相关，而在浆液性MEE中则不相关。结论VEGF是对中耳腔内毒素等细菌成分的应答而产生的，并通过增加血清渗出和粘膜分泌而与粘液性Mees的产生有关。
OBJECTIVESVascular endothelial growth factor (VEGF) is a potent and critical inducer of angiogenesis and vascular permeability, and has been shown to play an important role in inflammatory events, together with hypoxia and inflammatory cytokines. VEGF messenger ribonucleic acid (mRNA) is expressed in the middle ear in an experimental animal model of otitis media with effusion (OME) and in patients with OME. However, the protein levels of VEGF in middle ear effusions (MEEs) are unknown and the role of VEGF in the pathogenesis of OME is unclear. The goals of this study were to determine the VEGF levels in MEEs and to investigate the role of VEGF in production of MEEs by comparing these levels with those of interleukin-8 (IL-8), endotoxin, and albumin.METHODSForty-six MEEs obtained from 33 children (24 boys, 9 girls) were used in the study. The mean age of the subjects was 6.3 years old (range, 1–12 years old). The patients underwent myringotomy and/or insertion of a ventilation tube for treatment of OME. After myringotomy, MEEs were collected with a Juhn Tym-Tap. The samples were divided into serous and mucoid types based on observation by the naked eye. After measuring the weight of the MEE, the sample was diluted with phosphate-buffered saline and frozen until use. The concentrations of VEGF and IL-8 in the MEEs were determined by enzyme-linked immunosorbent assays, endotoxin concentrations were measured by the Limulus Amebocyte Lysate test, and albumin levels were determined using an immunoturbidimetric assay.RESULTSVEGF, endotoxin, IL-8, and albumin were detected in 100%, 89%, 98%, and 100% of the 46 MEEs, respectively. The concentrations of VEGF, endotoxin, and IL-8 were significantly higher in mucoid MEEs than in serous MEEs (p<0.01), whereas there was no significant difference in the albumin concentration between mucoid and serous MEEs. The VEGF levels were positively correlated with those of endotoxin (R2=0.17, p<0.05) and albumin (R2=0.65, p<0.01) in mucoid MEEs, but not in serous MEEs.CONCLUSIONSOur results suggest that VEGF is produced in response to bacterial components such as endotoxin in the middle ear cavity and is associated with production of mucoid MEEs by increasing serum exudation and mucosal secretion.