Presence of otitis media with effusion and its risk factors affect serum cytokine profile in children

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-γ (IFN-γ), and tumor necrosis factor-α (TNF-α), 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-γ 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.