RESUMEN
OBJECTIVE: To explore the shift of Th2/Th1 type cytokine profiles in middle ear and peripheral blood of chronic otitis media with effusion (COME) patients. METHODS: Middle ear effusions (MEEs) and peripheral bloods were collected from 30 COME patients between April 2011 and July 2012 at Department of Otolaryngology, Beijing Tongren Hospital, Capital Medical University. Peripheral blood samples were collected from 20 healthy controls. The expressions of IFN-γ (Th1 cytokine) and IL-4 (Th2 cytokine) in peripheral blood and middle ear fluid were assessed by flow cytometry and cytometric bead array. The expression levels of cytokines in peripheral blood were compared between patient and control groups. Moreover, the levels of cytokines in the Middle ear fluid and the supernatant of COME patients were also compared. RESULTS: Compared to the control group, the level of IL-4 in peripheral blood of COME patients significantly increased (0.7% ± 0.8% vs 2.4% ± 4.5%, P < 0.05) . The ratio of IFN-γ positive cells/IL-4 positive cells was significantly lower in peripheral blood of COME patients than that of control group (17 ± 13 vs 35 ± 19, P < 0.05) . However, the level of IFN-γ showed no significant difference between two groups (12% ± 8% vs 13% ± 8%, P > 0.05) . The levels of IL-4 and IFN-γ in middle ear fluid and the supernatant of the case group showed no significant difference. CONCLUSIONS: COME may be a Th2 predominant disease. Th1/Th2 imbalance is probably involved in the pathogenesis of COME. The role of the allergic reaction in middle ear microenvironment remains uncertain.