The goals of this research are to define the etiologies and pathogeneses of otitis media with effusion. Our past studies have documented several pathogenic pathways whereby nasal inflammation provoked by allergy or viral infection are manifest as eustachian tube obstruction, a recognized cause of otitis media with effusion. The purpose of this ongoing research is to define the role and interaction of allergy and viral infection in promoting nasal congestion, tubal obstruction and middle ear pathophysiology. These relationships will be explored with an emphasis on amplification, modulation and prolongation of primary responses. Specifically, we will utilize human models for challenges with inflammatory mediators, allergens and viruses, and animal models of IgE hypersensitivity to: 1) define the role of inflammatory mediators in causing tubal obstruction and middle ear disease; 2) document the potential of allergen and viral priming and late allergic reactions to enhance and sustain the nasal and middle ear pathophysiologies; and 3) determine if allergic rhinitis subjects are hyperresponsive to upper respiratory virus infection. Age related response differences between children and adults will be further defined. Children who are indentified in prospective studies as """"""""otitis prone"""""""" will be evaluated for immune defects to explain their recurrent ear infections. Middle ear effusions (MEE) from children with acute and chronic OME will be assayed for histamine, prostaglandins, tryptase and eosinophil derived major basic protein and neurotoxin. Enhanced basophil histamine release and production of histamine releasing factors will be explored as possible predisposing factors in these children. This collaborative research effort by clinical immunologists, otolaryngologists, microbiologists, physiologists and biochemists will better define the role of allergy and viral infection in the pathogenesis of OME and should result in improved diagnosis and management of this most common pediatric disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI019262-11
Application #
2060892
Study Section
Hearing Research Study Section (HAR)
Project Start
1982-08-01
Project End
1996-12-31
Budget Start
1994-01-01
Budget End
1996-12-31
Support Year
11
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Children's Hosp Pittsburgh/Upmc Health Sys
Department
Type
DUNS #
044304145
City
Pittsburgh
State
PA
Country
United States
Zip Code
15224
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Gentile, Deborah A; Fireman, Philip; Skoner, David P (2003) Elevations of local leukotriene C4 levels during viral upper respiratory tract infections. Ann Allergy Asthma Immunol 91:270-4
Gentile, Deborah A; Doyle, William J; Zeevi, Adriana et al. (2003) Cytokine gene polymorphisms moderate responses to respiratory syncytial virus in adults. Hum Immunol 64:93-8
Gentile, Deborah A; Doyle, William J; Belenky, Sergei et al. (2002) Nasal and oral nitric oxide levels during experimental respiratory syncytial virus infection of adults. Acta Otolaryngol 122:61-6
Buchman, Craig A; Doyle, William J; Pilcher, Oltavio et al. (2002) Nasal and otologic effects of experimental respiratory syncytial virus infection in adults. Am J Otolaryngol 23:70-5
Skoner, David P (2002) Viral infection and allergy: lower airway. Allergy Asthma Proc 23:229-32
Gentile, D A; Doyle, W J; Fireman, P et al. (2001) Effect of experimental influenza A infection on systemic immune and inflammatory parameters in allergic and nonallergic adult subjects. Ann Allergy Asthma Immunol 87:496-500
Skoner, D P; Gentile, D A; Fireman, P et al. (2001) Urinary histamine metabolite elevations during experimental influenza infection. Ann Allergy Asthma Immunol 87:303-6
Fireman, P (2000) Rhinitis and asthma connection: management of coexisting upper airway allergic diseases and asthma. Allergy Asthma Proc 21:45-54
Doyle, W J; Seroky, J T; Angelini, B L et al. (2000) Abnormal middle ear pressures during experimental influenza A virus infection--role of Eustachian tube function. Auris Nasus Larynx 27:323-6

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