Otitis media (OM) is one of the most common of childhood diseases and a major public health problem. The disease can lead to middle ear and inner ear pathology and hearing loss. There are fundamental gaps in our understanding of how bacterial pathogens in OM cause the inflammatory response in the middle ear, the mechanism of middle and inner ear interaction, inner ear pathology, and hearing loss. This prompted us to develop a cogent investigation of the molecular processes underlying migration of infectious agents from the middle to the inner ear and the effects of such migration on the ear pathology. Widespread use of antibiotics has resulted in an increase of antibiotic-resistant Streptococcus pneumoniae and an increased potential for chronic OM development and its complications. Although polysaccharide vaccines have been developed, there are more than 90 distinct serotypes for S. pneumoniae, and antibodies against one serotype generally do not protect against another. The current 7-valent pneumococcal conjugate vaccine PCV7 is 100% efficacious against invasive pneumococcal disease of vaccine serotypes in children <2-years old, but only 34% against acute OM. A protein-based vaccine may overcome this limitation by including antigens conserved among different pneumococcal serotypes. Our long-term goal is to develop novel approaches for prevention and treatment of OM and its complications. In this application, we propose a new strategy for prevention of OM and its complications that relies on a combination of PspA and other pneumococcal proteins. We will utilize different mutant bacterial strains and immunization of animals against these proteins. Our objective is to understand the role of bacterial virulence factors in bacterial invasion, colonization, and pathogenesis in the middle and inner ears for therapeutic targeting and to develop a vaccine composition that optimally neutralizes the most critical protein virulence factors. Our central hypothesis is that PspA and other bacterial proteins affect the pathology of the middle and inner ears. Bacterial components and inflammatory mediators produced in the middle ear pass through the round window membrane into the inner ear, damage cochlear structures, resulting in hearing loss. Our rationale is that knowing how bacterial components affect the pathology of the middle and inner ears will make it possible to design new approaches for the prevention and treatment of OM. These considerations have led to the formulation of our Specific Aims: 1) To identify the role of pneumococcal PspA protein and its combination with other potential pneumococcal vaccine proteins on the middle and inner ear and strategies for prevention of OM;2) To identify mechanisms of inner ear damage and auditory dysfunction caused by live S. pneumoniae. The results gained from these studies will provide new insights into the roles of S. pneumoniae virulence factors in the development of OM and inner ear complications. To achieve our goal we have assembled a group of PIs who have collaborated in recent years, and who are uniquely qualified to address this challenge with their combined expertise.

Public Health Relevance

These studies will use innovative approaches to determine the effects of important pneumococcal virulence proteins and their combination on the middle and inner ears. Understanding the role of bacterial virulence factors and host defense using mutant strains and immunization experiments may have an important positive impact to facilitate the development of new strategies for prevention and treatment of otitis media and its complications, especially significant in the era of multi-drug resistant bacteria, by selection of bacterial proteins for future vaccine design against pneumococcal otitis media, such as protein- based or conjugate polysaccharide vaccine with pneumococcal proteins as carriers.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
Project #
Application #
Study Section
Clinical Research and Field Studies of Infectious Diseases Study Section (CRFS)
Program Officer
Watson, Bracie
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Minnesota Twin Cities
Schools of Medicine
United States
Zip Code
Shirai, Kyoko; Schachern, Patricia A; Schachern, Monika G et al. (2015) Volume of the epitympanum and blockage of the tympanic isthmus in chronic otitis media: a human temporal bone study. Otol Neurotol 36:254-9
Vianna, Melissa; Adams, Meredith; Schachern, Patricia et al. (2014) Differences in the diameter of facial nerve and facial canal in bell's palsy--a 3-dimensional temporal bone study. Otol Neurotol 35:514-8
Schachern, Patricia A; Tsuprun, Vladimir; Ferrieri, Patricia et al. (2014) Pneumococcal PspA and PspC proteins: potential vaccine candidates for experimental otitis media. Int J Pediatr Otorhinolaryngol 78:1517-21
Yildirim-Baylan, Muzeyyen; Schachern, Patricia; Tsuprun, Vladimir et al. (2014) The pathology of silent otitis media: a predecessor to tympanogenic meningitis in infants. Int J Pediatr Otorhinolaryngol 78:451-4
Croney, Christina M; Nahm, Moon H; Juhn, Steven K et al. (2013) Invasive and noninvasive Streptococcus pneumoniae capsule and surface protein diversity following the use of a conjugate vaccine. Clin Vaccine Immunol 20:1711-8
Schachern, Patricia A; Tsuprun, Vladimir; Goetz, Sarah et al. (2013) Viability and virulence of pneumolysin, pneumococcal surface protein A, and pneumolysin/pneumococcal surface protein A mutants in the ear. JAMA Otolaryngol Head Neck Surg 139:937-43
Genschmer, Kristopher R; Accavitti-Loper, Mary Ann; Briles, David E (2013) A modified surface killing assay (MSKA) as a functional in vitro assay for identifying protective antibodies against pneumococcal surface protein A (PspA). Vaccine 32:39-47
Li, Jian-Dong; Hermansson, Ann; Ryan, Allen F et al. (2013) Panel 4: Recent advances in otitis media in molecular biology, biochemistry, genetics, and animal models. Otolaryngol Head Neck Surg 148:E52-63
Lee, Yun-Woo; Chung, Yunju; Juhn, Steven K et al. (2011) Activation of the transforming growth factor beta pathway in bacterial otitis media. Ann Otol Rhinol Laryngol 120:204-13
Yoda, Shigetoshi; Cureoglu, Sebahattin; Shimizu, Shigetaka et al. (2011) Round window membrane in Meniere's disease: a human temporal bone study. Otol Neurotol 32:147-51

Showing the most recent 10 out of 21 publications