transforming-growth-factor-alpha and Otitis-Media--Suppurative

Cholesteatoma in children is generally considered to be more aggressive and destructive than in adults. Each otologic surgeon has experienced widely extended cholesteatomas in children with large pneumatized mastoid processes. In this paper, we want to present clinical and experimental observations which imply that the destructive potential in children is similar to that in adults. Factors and observations that have led to the assumption that cholesteatoma in children is more aggressive will be discussed. Based on our experience and the literature, we tried to distill the current and leading thoughts concerning this intriguing entity.

Topics: Adolescent; Adult; Child; Child, Preschool; Cholesteatoma, Middle Ear; Chronic Disease; Ear Canal; Epidermal Growth Factor; Fibroblast Growth Factor 2; Humans; Immunohistochemistry; Infant; Ki-67 Antigen; Otitis Media, Suppurative; Skin; Transforming Growth Factor alpha

To characterize the existence and role of transforming growth factor-beta (TGF-beta) in otitis media with effusion (OME).. Retrospective.. The levels of two major TGF-beta isoforms, TGF-beta1 and TGF-beta2, in the middle ear effusions (MEEs) of 44 children were evaluated using enzyme-linked immunospecific assays (ELISAs). Forty-eight MEEs were separated into three clinically relevant groups (i.e., serous, mucoid, and purulent), and TGF-beta levels were correlated with clinical parameters of disease for these MEEs.. Both TGF-beta1 and TGF-beta2 were present in the samples. Mean levels of TGF-beta1 (920.36 +/- 437.75 pg/mg total protein) were generally 100-fold greater than those of TGF-beta2 (9.65 +/- 11.19 pg/mg total protein). TGF-beta1 levels were elevated in association with a history of previous tympanostomy tube placements (TTPs) (P = .029) and mucoid effusions (P = .042). TGF-beta2 levels were elevated in association with a history of previous TTPs (P = .100) and chronic (i.e., serous or mucoid) effusions (P = .003).. TGF-beta1 is present in the MEEs of children with OME. Furthermore, TGF-beta1 and TGF-beta2 levels were elevated differentially in the presence of chronic disease indicators in OME, suggesting that these isoforms may have differing roles in the inflammatory processes that characterize OME.

Topics: Child; Child, Preschool; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Exudates and Transudates; Female; Humans; Infant; Isomerism; Male; Middle Ear Ventilation; Otitis Media with Effusion; Otitis Media, Suppurative; Recurrence; Risk Factors; Transforming Growth Factor alpha; Transforming Growth Factor beta