目的:与Samter三联征(ST)相关的渗出性中耳炎(OME)是一种难以治疗的实体。研究的目的是调查ST患者中耳和鼻腔炎症介质(IM)的产生,并分析其与对照组之间的差异。
方法:前瞻性病例对照研究。19例OME患者(5例患有过敏性鼻炎,其中4人患有鼻咽淋巴增生,5例无明显鼻咽疾病,5例确诊为ST),15例健康参与者被纳入.IM白细胞介素-1β(IL-1β)的浓度,干扰素-α2(IFN-α2),干扰素-γ(IFN-γ),肿瘤坏死因子-α(TNF-α),单核细胞趋化蛋白-1(MCP-1),IL-6、IL-8、IL-10、IL-12p70、IL-17A、在鼻和中耳分泌物中测量IL-18、IL-23和IL-33。
结果:在ST亚组和其他OME患者之间,仅中耳液中的IL-1β水平存在接近统计学意义的差异(p=0.052)。此外,我们发现IL-23在这些亚组之间的鼻腔分泌物中存在显着差异(p=0.040),而鼻液IL-33的差异接近有统计学意义的水平(p=0.052)。鼻部IL-1β浓度存在显著差异,OME组和健康受试者之间的IFN-α2,MCP-1,IL-8,IL-18和IL-33(分别为p<0.001,p=0.005,p=0.008,p=0.011,p=0.011和p=0.011)。IL-1β浓度呈显著正相关,IFN-α2,IFN-γ,TNF-α,MCP-1,IL-17A,鼻和中耳分泌物中的IL-18和IL-33(分别为p<0.001,p<0.001,p=0.002,p=0.028,p<0.001,p<0.001,p<0.001和p<0.001)。
结论:本初步报告显示,与ST相关的OME患者和无OME患者的IM产生存在一些差异。我们的结果表明,鼻和中耳IM的产生均匀,并支持联合气道呼吸道疾病的概念。
OBJECTIVE: Otitis media with effusion (OME) associated with Samter\'s triad (ST) is a difficult entity to treat. The aim of study was an investigation of the middle ear and nasal production of inflammatory mediators (IM) in patients with ST and analysing differences between them and controls.
METHODS: Prospective case-control study. Nineteen patients with OME (five had allergic rhinitis, four had nasopharyngeal lymphoid hyperplasia, five had no evident sino-nasopharyngeal disease and five had confirmed ST) and 15 healthy participants were included. The concentrations of IM interleukin-1 beta (IL-1β), interferon-alpha 2 (IFN-α2), interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23 and IL-33 were measured in nasal and middle ear secretions.
RESULTS: There was a difference that was close to a level of statistical significance only for IL-1β levels in middle ear fluid (p = 0.052) between the ST subgroup and the other patients with OME. Also, we found a significant difference for IL-23 in nasal secretions between these subgroups (p = 0.040), whereas the difference in nasal fluid IL-33 was close to a level of statistical significance (p = 0.052). There was a significant difference in nasal concentrations of IL-1β, IFN-α2, MCP-1, IL-8, IL-18 and IL-33 (p < 0.001, p = 0.005, p = 0.008, p = 0.011, p = 0.011 and p = 0.011, respectively) between the OME group and the healthy subjects. There were significant positive correlations between concentrations of IL-1β, IFN-α2, IFN-γ, TNF-α, MCP-1, IL-17A, IL-18 and IL-33 (p < 0.001, p < 0.001, p = 0.002, p = 0.028, p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively) in nasal and middle ear secretions.
CONCLUSIONS: This preliminary report showed some differences in IM production between the patients with OME associated with ST and those without it. Our results suggest a uniformity of the production of nasal and middle ear IM and supported the concept of a united airway respiratory disease.