Viral RNA in middle ear mucosa and exudates in patients with chronic otitis media with effusion

Objective: To evaluate viral and cytokine signaling correlates of the persi stent inflammation associated with chronic otitis media with effusion (OME) . Design: Prospective study. Method: Reverse transcriptase-polymerase chain reaction targeting RNA virus es frequently associated with OME (respiratory syncytial virus and parainfl uenza virus type 3, the proinflammatory cytokines interleukin 8 and interle ukin 1 beta, and RANTES [regulated upon activation, normal T cell expressed and secreted]) was performed on mucosal biopsy samples and on samples of t he liquid and cellular compartments of inflammatory exudates obtained from 26 children (49 ears) with infected middle ears. Ribonucleic acid Extracted from rapidly frozen samples was reverse transcribed by Moloney murine leuk emia virus reverse transcriptase and amplified for 35 cycles using previous ly validated primers. Amplicons were evaluated by molecular size after agar ose gel electrophoresis with ethidium bromide. Results: Most children had evidence of the presence of an RNA virus in at l east one specimen. Respiratory syncytial virus was present in 40% and parai nfluenza virus type 3 in 8% of effusions. Interleukin 8 messenger RNA was p resent in 21% of inflammatory exudates but never in cells from the mucosal biopsy samples. Conclusions: Our data support a viral contribution to the cause of OME and suggest that the inflammatory cytokines observed derive more from cells in the inflammatory exudate than from those in the middle ear mucosa.