In order to clarify the role of the microflora of the nasopharynx and adenoids as causative factors of otitis media with effusion (OME), bacteriologic species in middle ear effusions (MEEs), nasopharyngeal smears, and adenoid tissues of children with OME were cultured. The change in the microflora of the nasopharynx after adenoidectomy, and the degree of bacterial agreement between the microflora of the nasopharynx and adenoid tissue were investigated. Nasopharyngeal bacterial flora were investigated in 259 children with OME from November 1984 to November 1987. The patients were divided into two groups: group A (43 patients) underwent adenoidectomy, and group B (216 patients) had no adenoidectomy. Hemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis, and Staphylococcus aureus were cultured in 66.7% of nasopharyngeal smears from group B, and in 46.5% from group A. Adenoid specimens for bacteriologic investigation were obtained from 38 adenoidectomy patients at surgery. Of these, H influenzae were cultured from adenoid specimens taken from 16 of the 26 patients with OME (group C), while only three of the 12 adenoidectomy patients without OME (group D) were found to have H influenzae in their adenoid specimens. The findings of this study suggest that adenoid vegetation plays an important role in the etiology of OME.

Adenoidectomy↗

PubMedDate not supplied

Immunological potential of the tympanic membrane. Observation under normal and inflammatory conditions.

PURPOSE: The immunological potential of the murine tympanic membrane was studied under normal and inflammatory conditions. MATERIALS AND METHODS: Experimental otitis media was induced by injecting keyhole limpet hemocyanin into the tympanic cavity of systemically sensitized mice. The animals were killed from 1 day to 2 weeks after the injection, and the distribution of the immunocompetent cells in the tympanic membrane was compared with those in normal animals, by immunohistochemical and toluidine blue staining. RESULTS: Tympanic membranes under normal conditions showed few immunocompetent cells, except mast cells and la-positive dendritic cells (presumably Langerhans' cells) in the pars flaccida and in the annular and manubrial regions of the pars tensa. After the induction of otitis media, lymphocytes migrated into these regions, although the other regions of the pars tensa showed few of these cells. la-positive cells migrated into both pars tensa and pars flaccida. Mast cells did not show obvious changes between the normal and inflammatory conditions. CONCLUSION: The pars flaccida and the annular and manubrial regions of the pars tensa are considered to be the immunologically potential sites, responsible for the immune responses. The remaining greater part of the tympanic membrane can recognize antigens by the migrated Langerhans' cells.

Adjuvants, Immunologic↗

PubMedDate not supplied

Secretory IgA and serum type IgA in nasal secretion and antibody activity against the M protein.

We studied IgA immunoglobulins in nasal secretions in order to clarify mucosal immunity of the nasal cavity and paranasal sinuses during chronic nasal infection. Secretory IgA and serum type IgA of 165 samples of nasal secretions were analyzed quantitatively by use of electroimmunodiffusion techniques, and the specific antibody activity of secretory IgA against the M protein of Streptococcus pyogenes was investigated by use of enzyme-linked immunosorbent assay. Results show that although the secretory IgA content in nasal secretions was elevated in chronic sinusitis, its specific antibody activity against the M protein was lower than that in normal subjects. This evidence suggests that nonspecific secretory IgA antibodies are predominantly produced in chronic sinusitis, and that mucosal immunity preventing the adherence of bacteria is impaired in the diseased mucosa.

Adolescent↗