Acute Otitis Media (AOM) is a multifactorial disease occurring mostly in young children who are immunologically naïve to AOM pathogens. This review focuses on work from Rochester NY, USA over the past 12 years among young children who had AOM infections microbiologically-confirmed by tympanocentesis, so called "stringently-defined". Among stringently-defined otitis prone children deficiencies in fundamental immune defense mechanisms have been identified that contribute to the propensity of young children to experience recurrent AOM. Dysfunction in innate immune responses that cause an immunopathological impact in the nasopharynx have been discovered including inadequate proinflammatory cytokine response and poor epithelial cell repair. Adaptive immunity defects in B cell function and immunologic memory resulting in low levels of antibody to otopathogen-specific antigens allows repeated infections. CD4+ and CD8+ T cell function and memory defects significantly contribute. The immune profile of an otitis prone child resembles that of a neonate through the first year of life. Immunologic deficits in otitis prone children cause them to be unusually vulnerable to viral upper respiratory infections and respond inadequately to routine pediatric vaccines.

中文翻译：

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免疫功能障碍可导致中耳炎。

急性中耳炎（AOM）是一种多因素疾病，主要发生在对AOM病原体免疫方面尚不成熟的幼儿中。这篇综述的重点是过去12年中美国罗彻斯特（Rochester）的工作，这些孩子中有通过鼓室穿刺术经微生物学确诊的AOM感染，即所谓的“严格定义”。在严格定义的易患中耳炎的儿童中，已发现基本的免疫防御机制缺乏，这有助于幼儿发生复发性AOM的倾向。已经发现先天免疫反应功能异常会在鼻咽中引起免疫病理学影响，包括促炎性细胞因子反应不足和上皮细胞修复不良。B细胞功能和免疫记忆的适应性免疫缺陷会导致针对耳病原体特异性抗原的抗体水平降低，从而导致反复感染。CD4 +和CD8 + T细胞的功能和记忆缺陷显着。易患中耳炎的儿童的免疫状况类似于婴儿在出生后第一年的免疫状况。易患中耳炎的儿童的免疫学缺陷导致他们异常易感染病毒性上呼吸道感染，并对常规的儿科疫苗反应不足。