LOCALIZATION OF CYTOKINES IN CHOLESTEATOMA TISSUE

Acquired cholesteatoma is associated with an intense inflammatory reac tion with resultant tissue and bone destruction, Cytokines are molecul es released by inflammatory cells at the site of infection and are pot ent mediators of inflammation and the immune response. Five cytokines, tumor necrosis factor-alpha, transforming growth factor-beta 1 and 2, and interleukin-1 and 6, were immunolocalized in human cholesteatoma epithelium and subepithelial stroma, with greater intensity of stainin g compared with noninflamed external auditory canal skin, Increased in terleukin-6 activity in cholesteatoma epithelium and stroma correlated significantly with the presence of ossicular and bony erosion and gra nulation tissue noted intraoperatively. Transforming growth factor-bet a 2 activity in cholesteatoma epithelium correlated significantly with bony erosion at surgery. Additionally, transforming growth factor-bet a 1 activity in cholesteatoma epithelium correlated significantly with increased length of disease, Tumor necrosis factor-alpha, interleukin -1, and interleukin-6 appear to be involved in the inflammation and re sultant remodeling associated with cholesteatoma. We hypothesized a pr otective function of transforming growth factor-beta 1 and 2 in the pr esence of cholesteatoma, The antiinflammatory and osteoclast and kerat inocyte inhibitory actions of the transforming growth factor-beta s co uld potentially slow the proliferation and resultant tissue destructiv eness associated with cholesteatoma.