Increased expression of major basic protein (MBP) and interleukin-5 (IL-5)in middle ear biopsy specimens from atopic patients with persistent otitismedia with effusion

BACKGROUND: Molecular biologic evidence to support an etiologic role for al lergy in the pathogenesis of persistent otitis media with effusion (OME) is lacking. OBJECTIVE: The goal of this article was to document expression of allergy-a ssociated Th-2-type cytokines and inflammatory cells in the middle ear muco sa of children with persistent OME, METHODS: With immunocytochemistry (CD3, major basic protein) and in situ hy bridization (interleukin-5 mRNA), middle ear biopsy specimens from 7 childr en with persistent OME were stained. Nonatopic stapedectomy patients with n o history of otitis media served as controls (n = 7). RESULTS: There was a statistically significant (P < 0.05) difference in exp ression of CD3, major basic protein, and interleukin-5 between experimental and control subjects. All 8 OME patients proved to be atopic by ELISA test ing. CONCLUSIONS: Type I allergy involving a Th-2-type cytokine and cellular pro file may be a contributing factor in the persistence of OME in atopic child ren. SIGNIFICANCE: The middle ear may serve as a target organ for allergic infla mmation, suggesting that appropriate allergy management may be a useful adj unct to the management of OME.