Serum and Middle Ear Immunoglobulins in Suppurative Otitis Media

Abstract

Background and Purpose: Despite the increasing occurrence of suppurative otitis media (SOM), the content of immunoglobulin fractions in the middle ear secretion (MES) has still not been determined. Method: The serum and MESwere analyzed for IgG and M using enzyme-linked immunoassay. Result: The subjects and controls were 30 males and 22 females, between 6 months and 9 years old, with a mean age of 6 years (SD = 3.26). The patient group included 20 chronic SOM (CSOM) and 17 acute SOM (ASOM) cases, and sera of 15 subjects made the control group. The mean serum IgG levels were for controls 1,051 mg/dl, ASOM 666.1 mg/dl and CSOM 1,321.1 mg/dl; the MES levels were for ASOM 203.4 mg/dl and CSOM 511.5 mg/dl. The mean serum IgM levels were for controls 35 mg/dl, ASOM 64.1 mg/dl and CSOM 40 mg/dl; the MES levels were for ASOM 22.59 mg/dl and CSOM 3.44 mg/dl. The mean MES:serum ratios for IgG and IgM were between 0.1 and 0.4 in ASOM and CSOM. The ratio of serum IgG levels of controls to ASOM cases was 0.66 while that of controls to CSOM was 1.3. The corresponding ratios of IgM were 1.6 and 0.88. Multivariate analysis revealed a significant correlation between serum IgG levels of ASOM and CSOM (p = 0.043) and MES IgG (p = 0.02) in ASOM and CSOM but no correlation between serum IgG levels in controls and ASOM (p = 0.25), serum IgM levels in controls and CSOM (p = 0.62) and serum IgM levels in controls and ASOM (p = 0.73), ASOM and CSOM (p = 0.064) and MES IgM levels of ASOM and CSOM (p = 0.06). Conclusions: Monitoring of the serum and MES IgG in ASOM may provide a useful index to assess the possibility of progression to chronicity. This forms a database for the immunological status of SOM patients.