Expression of Pattern Recognition Receptor mRNA in Pediatric Patients with Otitis Media with Effusion

Abstract

Abstract Importance Otitis media with effusion (OME) in children often requires surgical treatment. Pattern recognition receptors (PRRs), which are involved in innate immunity in the middle ear, are believed to play an important role in relapse and chronicity of OME. Objective To investigated the expression of PPRs in children with OME. Participants Total 126 patients under 10 years of age who were diagnosed with OME and underwent unilateral or bilateral ventilation tube insertion (VTI). Main outcomes and measures Expression levels were compared in children with and without bacteria in the middle ear cavity, with and without concomitant diseases, by characteristics of middle ear fluid, and in children who were and were not otitis prone. Results Mean [SD] expression level of PRR mRNAs did not differ significantly in children with and without bacteria in the middle ear, with and without concomitant diseases, or by characteristics of middle ear fluid. However, mean [SD] expression level of TLR2 (0.037 [0.079] vs 0.093 [0.124]; MD, 0.056; 95% CI, 0.018 to 0.094), TLR4 (0.015 [0.054] vs 0.036 [0.047]; MD, 0.021; 95% CI, 0.003 to 0.039), TLR6 (0.038 [0.072] vs 0.107 [0.170]; MD, 0.069; 95% CI, 0.020 to 0.118), TLR9 (0.229 [0.256] vs 0.611 [0.840]; MD, 0.382; 95% CI, 0.146 to 0.618), NOD-1 (0.004 [0.002] vs 0.008 [0.014]; MD, 0.004; 95% CI, 0.001 to 0.008), and RIG-I (0.034 [0.086] vs 0.092 [0.191]; MD, 0.058; 95% CI, 0.002 to 0.114) mRNAs were lower in the otitis prone group than in the non-otitis prone group. Conclusions and relevance These findings suggest that PRRs are involved in the pathophysiology of OME. OME is frequent and chronic in children with low levels of TLR, NLR, and RIG-I mRNAs.