The effect of endotoxin was investigated on air-exposed cultured human midd
le ear epithelium. Concentrations of 0, 1 and 100 ng/ml endotoxin were used
, Complete differentiation of the cells was not reached at 12 days. After 2
1 days, endotoxin had induced an increased proliferation of the epithelial
layer, Furthermore, an increase in the number of secretory cells and in the
amount and length of microvilli was observed at this time. There were no s
ignificant morphological differences between the high and the low endotoxin
concentrations, which supports our hypothesis that endotoxin induces an al
l-or-nothing reaction. These findings are in agreement with our previous re
sults on serially submerged cultured rat middle ear epithelium. From these
results we conclude that endotoxin is an important factor in the disturbanc
e of the morphology of the middle ear epithelium, which may lead to chronic
otitis media with effusion. In addition, our tissue culture method proved
to be a good model for further studies on human middle ear mucosa.