Secretory otitis media (SOM) is characterized by persistence of fluid in the middle ear, often following an episode of acute otitis media. Our hypothesis is that failure to eliminate bacterial or viral pathogens may result in persistent low-grade inflammation. In this study, we analyzed inflammatory mediators in middle ear fluids from 67 children with SOM. This was combined with determinations of viable bacteria by culture along with detection of bacterial and viral genetic material by real-time polymerase chain reaction (PCR). The inflammatory mediators found at the highest concentrations (>30 ng/mL) were stem cell growth factor-β (median 110 ng/mL), CXCL1, IL-16, IL-8, migration inhibitory factor, CXCL10, and CXCL9. Among bacterial pathogens, Moraxella catarrhalis and Haemophilus influenzae dominated, regardless of detection methods, while rhinovirus dominated among viral pathogens. Middle ear fluid levels of interleukin (IL)-1α, IL-17, IL-1β, fibroblast growth factor basic, and tumor necrosis factor correlated strongly with presence of bacteria detected either by culture or PCR, while IL-1RA, IL-3, IL-6, IL-8, CCL3, CCL4, and granulocyte-colony stimulating factor correlated significantly with real-time PCR values. CXCL10, CXCL9, CCL2, and TRAIL correlated significantly with viral nucleic acid levels. To conclude, persistence of viral and bacterial pathogens may fuel persistent inflammation in SOM. Bacteria caused a broad inflammatory response, while viruses chiefly elicited the interferon-induced chemokines CXCL9 and CXCL10.

中文翻译：

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分泌性中耳炎中炎症介质与活细菌病原体以及细菌和病毒核酸的关系

分泌性中耳炎(SOM) 的特征是中耳内持续存在液体，通常发生在急性中耳炎发作之后。我们的假设是未能消除细菌或病毒病原体可能会导致持续的低度炎症。在这项研究中，我们分析了 67 名 SOM 儿童的中耳液中的炎症介质。这与通过培养确定活细菌以及通过实时聚合酶链反应 (PCR) 检测细菌和病毒遗传物质相结合。在最高浓度 (>30 ng/mL) 中发现的炎症介质是干细胞生长因子-β（中值 110 ng/mL）、CXCL1、IL-16、IL-8、迁移抑制因子、CXCL10 和 CXCL9。在细菌病原体中，卡他莫拉菌无论检测方法如何，流感嗜血杆菌和流感嗜血杆菌占主导地位，而鼻病毒在病毒病原体中占主导地位。中耳液中白细胞介素 (IL)-1α、IL-17、IL-1β、成纤维细胞生长因子碱性因子和肿瘤坏死因子的水平与通过培养或 PCR 检测到的细菌存在密切相关，而 IL-1RA、IL-3 、IL-6、IL-8、CCL3、CCL4 和粒细胞集落刺激因子与实时 PCR 值显着相关。CXCL10、CXCL9、CCL2 和 TRAIL 与病毒核酸水平显着相关。总而言之，病毒和细菌病原体的持续存在可能会加剧 SOM 中的持续炎症。细菌引起广泛的炎症反应，而病毒主要引起干扰素诱导的趋化因子 CXCL9 和 CXCL10。