Systemic inflammatory response in children of the first months of life with acute otits media
Belarusian State Medical University, Belarus
: J Otol Rhinol
Introduction: Specific characteristics of the immune response in children of the first months of life affect both manifestations and the course of the inflammatory response. Changes in peripheral blood parameters, typical for acute otitis mediain older children, are not often found in children of the first months of life. Cytokines IL-8 and soluble TNF-α receptor p55 plays an important role in the inflammatory process. Materials & Methods: We have examined 200 children- 3 months of age infants with acute otitis media. Blood and urine sampling was performed at the 4-5 days of the disease. Determination of the concentration of IL-8 and soluble TNF-α receptor p55 was performed applying a sandwich method of enzyme immunoassay using monoclonal antibodies. Results: The content of the soluble p55 TNF receptor in the blood ranged from 0.34 to 3.79 g/ml (the mean value was 1.13 g/ml) and in urine it was in the range of 0.18-6.41 g/ml (mean 1.45 g/ml). The content of the IL 8 ranged from 0.02 to 0.08 g/ml (mean -0.03 g/ ml) in the blood and from 0.02 to 0.21 g/ml (mean -0.036 g/ml) in urine. No significant differences between the content of this pro inflammatory cytokines in blood and urine were detected (p>0.05). The levels of the soluble p55 TNF receptor and IL 8 correspond to their levels in the serum of healthy children. Conclusions: An increase in the synthesis of pro-inflammatory cytokines TNF-α p55 and IL-8 is not typical for children 0-3 months of age with acute otitis media. Assessment of the cytokine levels in infants with acute otitis media may be usefulonly in case of high risk of infection generalization in order to exclude the septic process. The absence of significant differences in TNF-α p55 and IL-8 content in blood and urine suggest that the non-invasive method of studying urine samples is more preferable for the benefit of the patient.
Alena Merkulava is a Professor of an Ear, Nose and Throat Diseases of Belarusian Medical Academy of Postgraduate Education (Belarus). She is an ENT Doctor in the Department of Neck and Head Tumors at the Scientific Research Institute of Oncology and Medical Radiology of the Health Ministry of the Republic of Belarus. She is an Associate Professor in the Department of ENT Diseases at the Belarusian State Medical University. She is a Member of: Otolaryngology Society of the Republic of Belarus; Otolaryngology Society of Germany; European Otolaryngology Society etc.