Abstract
Defective or immature antibody responses to pathogens in children may explain the increased susceptibility to acute otitis media (AOM) in otitis-prone children. In literature, data on immunology have been based on studies of small groups of severely otitis-prone children and have not been consistent. Humoral immune status was assessed in 365 children, 1–7 years old, with two or more documented episodes of AOM in the previous year. Children with 4 or more episodes in the preceding year were defined as otitis-prone. Serum immunoglobulin levels were determined by radial immunodiffusion. Immunoglobulin levels of otitis-prone children were compared with those of children who had experienced 2-3 AOM episodes per year. Children with recurrent episodes of AOM were found to have normal or increased serum IgA, IgM, IgG, and IgG1 levels compared with normal values for age, whereas the serum IgG2 levels were mostly in the lower normal range. Twenty-two percent of all children showed IgG2 levels lower than 2 SD below the age-specific mean. Interestingly, the otitis-prone group of children showed significantly lower median and mean levels for all immunoglobulins compared with those children with only 2-3 previous AOM episodes. Lower immunoglobulin levels in otitis-prone children suggest a generalized decreased antibody response in otitis-prone children.
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Abbreviations
- AOM:
-
acute otitis media
- NTHI:
-
nontypeable Haemophilus influenzae
References
Howie VM, Plouss JH, Sloyer J 1975 The “otitis-prone” condition. Am J Dis Child 129: 67–68
Dowell SF, Marcy MS, Philips WR, Gerber MA, Schwartz B 1998 Otitis media-principles of judicious use of antimicrobial agents. Pediatrics 101: 165–171
Alho OP, Koivu M, Sorri M 1991 What is an ‘otitis-prone' child?. Int J Pediatr Otorhinolaryngol 21: 201–209
Berman S, Lee B, Nuss R, Roark R, Giclas PC 1992 Immunoglobulin G, total and subclass, in children with or without recurrent otitis media. J Pediatr 121: 249–251
Sørensen CH, Nielsen LK 1988 Plasma IgG, IgG subclasses and acute-phase proteins in children with recurrent acute otitis media. APMIS 96: 676–680
Freijd A, Oxelius VA, Rynnel-Dagoo B 1985 A prospective study demonstrating an association between plasma IgG2 concentrations and susceptibility to otitis media in children. Scand J Infect Dis 17: 115–120
Jørgensen F, Andersson B, Hanson LA 1990 Gamma-globulin treatment of recurrent acute otitis media in children. Pediatr Infect Dis J 9: 389–394
Prellner K, Kalm O, Karup Pedersen F 1986 Pneumococcal antibodies and complement during and after periods of recurrent otitis. Acta Otolaryngol 101: 467–474
Gross S, Blaiss MS, Herrod HG 1992 Role of immunoglobulin subclasses and specific antibody determinations in the evaluation of recurrent infection in children. J Pediatr 121: 516–522
Sanders EAM, Rijkers GT, Tenbergen-Meekes AM, Voorhorst-Ogink MM, Zegers BJ 1995 Immunoglobulin isotype specific antibody responses to pneumococcal polysaccharide vaccine in patients with recurrent respiratory tract infections. Pediatr Res 37: 812–817
Hotomi M, Yamanaka N, Saito T, Shimada J, Suzumoto M, Suetake M, Faden H 1999 Antibody responses to the outer membrane protein P6 of nontypeable Haemophilus influenzae and pneumococcal capsular polysaccharides in otitis-prone children. Acta Otolaryngol 119: 703–707
Herrod HG, Gross S, Insel R 1989 Selective antibody deficiency to Haemophilus influenzae type B capsular polysaccharide vaccination in children with recurrent respiratory tract infection. J Clin Immunol 9: 429–434
Prellner K, Harsten G, Lofgren B, Christenson B, Heldrup J 1990 Responses to rubella, tetanus, and diphtheria vaccines in otitis-prone and non-otitis-prone children. Ann Otol Rhinol Laryngol 99: 628–632
Yamanaka N, Hotomi M, Shimada J, Togawa A 1997 Immunological deficiency in “otitis-prone” children. Ann N Y Acad Sci 830: 70–81
Van der Giessen M, Rossouw E, van Veen TA, van Loghum E, Zegers BJ, Sander PC 1975 Quantification of IgG subclasses in sera of normal adults and healthy children between 4 and 12 years of age. Clin Exp Immunol 21: 501–509
Vlug A, Nieuwenhuys EJ, van Eijk RV, Geertzen HG, van Houte AJ 1994 Nephelometric measurements of human IgG subclasses and their reference ranges. Ann Biol Clin (Paris) 52: 561–567
Freijd A, Hämmarström L, Persson MAA, Smith CI 1984 Plasma anti-pneumococcal antibody activity of the IgG class and subclasses in otitis prone children. Clin Exp Immunol 56: 233–238
Lortan JE, Kaniuk AS, Monteil MA 1993 Relationship of in vitro phagocytosis of serotype 14 Streptococcus pneumoniae to specific class and IgG subclass antibody levels in healthy adults. Clin Exp Immunol 91: 54–57
Rodriguez ME, Pol van de WL, Sanders EAM, Winkel van de JGJ 1999 Crucial role of FcγRIIa (CD32) in assessment of functional anti-S pneumoniae antibody activity in human sera. J Infect Dis 179: 423–433
Jansen WT, Breukels MA, Snippe H, Sanders EAM, Verheul AF, Rijkers GT 1999 Fcγreceptor polymorphisms determine the magnitude of vitro phagocytosis of Streptococcus pneumoniae mediated by pneumococcal conjugate sera. J Infect Dis 180: 888–891
Sanders EAM, Van de Winkel JG, Rijkers GT, Voorhorst-Ogink MM, de Haas M, Capel PJ, Zegers BJ 1994 Fcγreceptor IIa (CD32) heterogeneity in patients with recurrent bacterial respiratory tract infections. J Infect Dis 170: 854–861
Yee AM, Phan HM, Zuniga R, Salmon JE, Musher DM 2000 Association between FcγRIIa-R131 allotype and bacteremic pneumococcal pneumonia. Clin Infect Dis 30: 25–28
Waage A, Halstensen A, Shalaby R, Brandtzaeg P, Kierulf P, Espevik T 1989 Local production of tumor necrosis factor alfa, interleukin 1, and interleukin 6 in meningococcal meningitis. Relation to the inflammatory response. J Exp Med 170: 1859–1867
Lindberg K, Rynnel-Dagöö B, Sundqvist KG 1994 Cytokines in nasopharyngeal secretions; evidence for defective IL-1beta production in children with recurrent episodes of acute otitis media. Clin Exp Immunol 97: 396–402
Rynnel-Dagöö B, Ågren 2001 The nasopharynx and the middle ear. Inflammatory reactions in middle ear disease. Vaccine 19: S26–31
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This study is supported by grants from Zon Mw, the Netherlands Organization for Health, Research and Development, and the Health Insurance Company Zilveren Kruis–Achmea.
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Veenhoven, R., Rijkers, G., Schilder, A. et al. Immunoglobulins in Otitis-Prone Children. Pediatr Res 55, 159–162 (2004). https://doi.org/10.1203/01.PDR.0000099776.66136.39
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DOI: https://doi.org/10.1203/01.PDR.0000099776.66136.39
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