IMMUNE MECHANISMS OF MIDDLE EAR DISEASE

这项研究的目的是确定这些免疫机制 包括已被建议但尚未确定为 在渗出性中耳炎(OME)的发病机制中起重要作用。OMe是 一种多因素综合征，感染和咽鼓管 梗阻(ETO)是最有文献记载的致病机制。一个 刺激性鼻腔抗原(花粉)激发诱导ETO 患有过敏性鼻炎的成年人被证明是可复制的， 与抗原剂量相关的可逆免疫反应 IgE抗体。这项研究计划将研究免疫和非免疫因素。 这可能会维持和延长ETO并探索潜在的关系 抗原诱导的ETO和上呼吸道感染。由于OME是一家 主要是儿童疾病，这项研究计划将开始扩大 这些观察从成人到儿童过敏性鼻炎和OME。 免疫反应，包括过敏，释放和产生介质 炎症的组织和分泌物。这项研究将研究 鼻腔内挑衅这些介体，包括组胺， 前列腺素和白三烯以及乙酰甲胆碱可诱导ETO。 新技术包括测量ETO的声学方法以及 兼具两种功能的计算机辅助鼻压计 将使用主动和被动、前鼻测量和后鼻测量。在……里面 此外，这些介质的存在将在中耳进行研究。 OME和变应性鼻炎患者的体液和鼻分泌物 与Ig亚型、细菌培养和临床的相关性 当然了。鉴于与ETO和OME发展有关的若干问题 需要有侵入性的技术，不适合人类这种猴子动物 建立了抗原诱导的ETO模型。鼻腔注射组胺 挑战也诱导了猴子的ETO，特别是在较年轻的动物身上 组胺、乙酰甲胆碱、前列腺素和白三烯在 在这个模型中，我们将研究ETO和OME的发病机制。年龄 相关的差异将在实验的每个方面进行探索 设计。通过了解免疫反应的作用，特别是过敏， 在ETO和OME的发病机制上，本研究应提供依据 对于未来的研究，以建立更好的诊断和治疗这种 常见的儿科疾病。

The objectives of this research are to define those immune mechanisms including allergy which have been suggested but not established as important in the pathogenesis of otitis media with effusion (OME). OME is a multifactorial syndrome in which infection and eustachian tube obstruction (ETO) are the best documented pathogenetic mechanisms. A provocative intranasal antigen (pollen) challenge which induces ETO in adults with allergic rhinitis has been shown to be a reproducible, reversible immune response which is antigen dose dependent and related to IgE antibody. This research plan will study immune and non-immune factors which may sustain and prolong ETO and explore potential relationships for antigen induced ETO and upper respiratory infections. Since OME is a disease primarily of children, this research plan will begin to extend these observations from adults to children with allergic rhinitis and OME. Immune reactions, including allergy, release and generate mediators in tissues and secretions of inflammation. This research will study whether intranasal provocative challenge with these mediators including histamine, prostaglandins and leukotrienes as well as methacholine will induce ETO. New technology including a sonometric method of measuring ETO along with a computer assisted rhinomanometer with capabilities of performing both active and passive, anterior and posterior rhinometry will be utilized. In addition, the presence of these mediators will be studied in middle ear fluids, and nasal secretions of patients with OME and allergic rhinitis and correlated with presence of Ig isotypes, bacteria cultures and clinical course. Since certain questions concerning the development of ETO and OME require invasive techniques and are not suitable in man, a monkey animal model of antigen induced ETO has been developed. Histamine intranasal challenge has also induced ETO in the monkey, especially in younger animals and the role of histamine, methacholine, prostaglandins and leukotrienes in the pathogenesis of ETO and OME will be examined in this model. Age related differences will be explored at each aspect of the experimental design. By understanding the role of immune reactions, especially allergy, in the pathogenesis of ETO and OME, this research should provide the basis for future studies to establish better diagnosis and therapy of this most common pediatric illness.