Abstract
Acute otitis media (AOM) can persist or lead to various complications in individuals in which the innate immune system is impaired. In this context, impaired expression of nucleotide-binding oligomerization domain (NOD)-like receptor (NLR), an intracellular pathogen-recognition receptor (PRR), is involved in the etiology of OM in humans and animals, affecting its development, severity, chronicity, recurrence, and associated complications. To assess this relationship, we reviewed literature reports relating NLR expression patterns with the pathophysiology and clinical features of OM in the larger context of impaired innate immunity. We summarized the results of published studies on the expression of NLRs in animals and humans in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. NLRs were expressed mainly in association with bacterial infection in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. In addition, expression of NLRs was affected by the presence or absence of bacteria, fluid characteristics, disease recurrence, tissue type, and repeated surgery. Various factors of the innate immune system are involved in the pathogenesis of OM in the middle ear. NLRs are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. Impaired NLR expression induced the development, chronicity and recurrence of OM and exacerbated associated complications, indicating that NLRs have important roles in the pathogenesis of OM.
Highlights
On the basis of their findings, the authors of this study suggested that activation of the NLRP3 inflammasome contributes to the pathogenesis of otitis media (OM) through regulation of the activity of IL-1β, concluding that IL-1β plays a central role in the inflammatory process of OM [53]
Cells, and complement contribute to the pathogenesis of OM
NOD-like Receptors (NLRs) are expressed in the fluid and middle ear mucosa of Acute otitis media (AOM), the effusion of otitis media with effusion (OME), and the middle ear mucosa and inflamed tissue of chronic otitis media (COM)
Summary
Among thepathologies pathologiesininthe the field of otolaryngology notbeen yet completely been comresolvedresolved is otitis media (OM), an (OM), otologic of infants children. Various enzymes, including collagenase, acid phosphatase, and acid protease, secreted rate in bacterial culture tests for OME is 40–60% The causes of this high negative detection from granulation tissue produced by the inflammatory reaction as well as the pressure rate include slow or poorly growing bacteria, intracellular substances derived from viruses effect of the cholesteatoma itself are involved in bone destruction. It was recently shown or anaerobes, and biofilms. COM without cholesteatoma causes changes in mucous membranes, submucosal tissue, and surrounding bone tissue as a result of a persistent inflammatory response in the middle ear cavity or mastoid air cells. This requires a better understanding of the development of otitis media and the defense mechanisms provided by the immune system in the middle ear cavity [14]
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