Otitis media with effusion (OME) is a condition that has significant impact on the quality of life of children. Although the etiology is multi-factorial, certain risk factors such as an allergic predisposition, daycare, and cigarette smoke exposure contribute to its pathogenesis.
Objective: (1) To determine whether there is a tendency for children with chronic or recurrent OME (cases) to have higher serum levels of the T-helper 2 cell (Th-2) allergenic-type cytokines, interleukin-4 (IL-4), and IL-5, or the T-helper 1(Th-1) infectious-type cytokines, interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha), compared to children without a history of recurrent OME (controls) and (2) to determine any possible correlations between the cytokine levels and risk factors associated with OME.
Methods: We analyzed serum levels of these four cytokines by enzyme-linked immunosorbent assays of 19 cases and 17 controls.
Results: Cases, independent of age, had increased levels of serum IL-5 compared to controls (p=0.014). While a significant difference in serum IL-4 levels did not exist between cases and controls, children exposed to cigarette smoke had significantly higher levels of serum IL-4 (p=0.003). While serum levels of IFN-gamma were statistically significantly higher in cases than controls with univariate analysis (p=0.011), when controlling for age and smoke exposure with multivariate analyses, the difference did not reach significance (p=0.086).
Conclusion: These results suggest that patients with chronic or recurrent OME and those exposed to cigarette smoke mount a Th-2 allergic-like response, as demonstrated by their serum cytokines.