Cellular immune response in young children accounts for recurrent acute otitis media

Abstract

Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae (Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years, our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis prone(sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B and T cell responses and an immaturity in antigen-presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children.

Figure 1

MHC II expression levels in the peripheral blood of otitis-prone and non otitis-prone group of children were measured using flow cytometry. mDC (myeloid dendritic cells, pDC (plasmacytoid dendritic cells) and mono (monocytes)

Figure 2

Factors governing immune competence and poor antibody generation in otitis-prone (OP) group of children. DC (dendritic cells), pMHC (peptide-Major histocompatibility complex).