Otitis media (OM) is a common disease in infants and children. While each year between 3 and 5 billion dollars are spent in the United States on the management of this disease, few treatments are recognized as effective. The well-supported immediate cause of OM is a preceding or concurrent viral upper respiratory tract infection (vURI) and it has been suggested that most episodes of OM could be prevented by preventing vURIs or by early treatment of those infections prior. In recent years, effective vaccines and antivirals have been marketed that prevent or treat infection with some of the viruses that cause OM, and others are in development. However, the judicious introduction of these possible interventions for OM depends on a number of factors not known at present. These include, for each virus that can cause vURIs: the natural history of OM, the temporal pattern relating vURIs and OM presentations, the co-incidence of OM and vURI and the percent of vURI and OM episodes that are symptomatic, among others. Also, to avoid over-treatment of patients at little risk for OM, a definition of patient characteristics that predispose to OM is important. In the proposed study, we will acquire this information. Specifically, we will study young children in their home environment throughout the typical cold-flu months by daily symptom recording and assessment of middle ear status, weekly ear and nose examinations and monthly bacterial and virus assays; and, if they develop signs and symptoms of either a cold-like illness or OM, we will re-evaluate these children in the clinic for confirmatory diagnosis of OM, vURI and etiological virus. For all enrolled children, we will determine their genotype for the production of certain cytokines that were suggested to influence disease expression during a vURI and/or the development of OM. During vURIs, we will also determine the types of cytokines that are produced in the nose, and relate these to OM incidence. From this close follow up of children for OM and vURI, we will estimate the parameters needed to define the expected efficacy and efficiency of different strategies to prevent OM caused by vURI. The role of cytokine genotype and expression pattern in predisposing to the development of OM as a complication of vURI may delineate possible """"""""at risk"""""""" groups for targeted intervention. These results will be used in the design of future studies that prevent OM by moderating vURI pathogenesis. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC005832-03
Application #
6799673
Study Section
Special Emphasis Panel (ZDC1-SRB-A (36))
Program Officer
Watson, Bracie
Project Start
2002-09-27
Project End
2007-08-31
Budget Start
2004-09-01
Budget End
2005-08-31
Support Year
3
Fiscal Year
2004
Total Cost
$543,393
Indirect Cost
Name
Children's Hosp Pittsburgh/Upmc Health Sys
Department
Type
DUNS #
044304145
City
Pittsburgh
State
PA
Country
United States
Zip Code
15224
Swarts, J Douglas; Foley, Sean; Alper, Cuneyt M et al. (2012) Mastoid geometry in a cross-section of humans from infancy through early adulthood with a confirmed history of otitis media. Int J Pediatr Otorhinolaryngol 76:137-41
Alper, Cuneyt M; Losee, Joseph E; Mandel, Ellen M et al. (2012) Postpalatoplasty Eustachian tube function in young children with cleft palate. Cleft Palate Craniofac J 49:504-7
Alper, Cuneyt M; Losee, Joseph E; Mandel, Ellen M et al. (2012) Pre- and post-palatoplasty Eustachian tube function in infants with cleft palate. Int J Pediatr Otorhinolaryngol 76:388-91
Casselbrant, Margaretha L; Mandel, Ellen M; Seroky, James T et al. (2011) A pilot study of the ability of the forced response test to discriminate between 3-year-old children with chronic otitis media with effusion or with recurrent acute otitis media. Acta Otolaryngol 131:1150-4
Alper, Cuneyt M; Li-Korotky, Ha-Sheng; Lo, Chia-Yee et al. (2010) Nasal secretion concentrations of IL-5, IL-6, and IL-10 in children with and without upper respiratory tract viruses. Arch Otolaryngol Head Neck Surg 136:281-6
Alper, Cuneyt M; Winther, Birgit; Hendley, J Owen et al. (2009) Cytokine polymorphisms predict the frequency of otitis media as a complication of rhinovirus and RSV infections in children. Eur Arch Otorhinolaryngol 266:199-205
Alper, Cuneyt M; Winther, Birgit; Mandel, Ellen M et al. (2009) Rate of concurrent otitis media in upper respiratory tract infections with specific viruses. Arch Otolaryngol Head Neck Surg 135:17-21
Doyle, William J; Winther, Birgit; Alper, Cuneyt (2009) Daily tympanometry as a functional measure of middle ear status and Eustachian tube function. Auris Nasus Larynx 36:20-5
Mandel, Ellen M; Doyle, William J; Winther, Birgit et al. (2008) The incidence, prevalence and burden of OM in unselected children aged 1-8 years followed by weekly otoscopy through the ""common cold"" season. Int J Pediatr Otorhinolaryngol 72:491-9
Doyle, William J; Winther, Birgit; Alper, Cuneyt M (2008) Daily tympanometry for high-resolution measurement of the time between onset of cold-like illness and middle ear effusion. Laryngoscope 118:1066-71

Showing the most recent 10 out of 14 publications