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Elling CL, Ryan AF, Yarza TKL, Ghaffar A, Llanes EGDV, Kofonow JM, Reyes-Quintos MRT, Riazuddin S, Robertson CE, Tantoco MLC, Ahmed ZM, Chan AL, Frank DN, Chiong CM, Santos-Cortez RLP. A Novel SLPI Splice Variant Confers Susceptibility to Otitis Media in Humans. Int J Mol Sci 2025; 26:1411. [PMID: 40003878 PMCID: PMC11855725 DOI: 10.3390/ijms26041411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2024] [Revised: 01/30/2025] [Accepted: 02/03/2025] [Indexed: 02/27/2025] Open
Abstract
Otitis media is the most frequently diagnosed disease and a leading cause of hearing loss in young children. However, genetic contributors to susceptibility and pathogen-host-environment interactions in otitis media remain to be identified. Such knowledge would help identify at-risk individuals and effectively monitor, diagnose, and treat patients with otitis media. Through exome and Sanger sequencing, we identified a rare, deleterious splice variant SLPI c.394+1G>T co-segregating with otitis media in a large pedigree, with a genome-wide significant maximum LOD score of 4.59. Alternative splicing of SLPI was observed in saliva RNA of variant carriers. In bulk mRNA-seq data from an independent cohort of children with otitis media, SLPI was co-expressed with genes involved in infection, immune response, inflammation, and epithelial cell organization. After inoculation of non-typeable Haemophilus influenzae, Slpi was upregulated in polymorphonuclear leukocytes and epithelial cells of mouse middle ears. Furthermore, in the human middle ear, Haemophilus was significantly enriched in non-carriers, whereas Family-XI-Incertae-Sedis and Dialister were significantly enriched in variant carriers. Given the role of SLPI in immune modulation and host defense in mucosal epithelia, our findings support the SLPI variant as modulating susceptibility to otitis media.
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Affiliation(s)
- Christina L. Elling
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Allen F. Ryan
- Department of Otolaryngology, School of Medicine and Veterans Affairs Medical Center, University of California San Diego, La Jolla, CA 92093, USA;
| | - Talitha Karisse L. Yarza
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
| | - Amama Ghaffar
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.G.); (S.R.); (Z.M.A.)
| | - Erasmo Gonzalo d. V. Llanes
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines College of Medicine—Philippine General Hospital, Manila 1000, Philippines
| | - Jennifer M. Kofonow
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (J.M.K.); (C.E.R.); (D.N.F.)
| | - Maria Rina T. Reyes-Quintos
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines College of Medicine—Philippine General Hospital, Manila 1000, Philippines
| | - Saima Riazuddin
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.G.); (S.R.); (Z.M.A.)
| | - Charles E. Robertson
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (J.M.K.); (C.E.R.); (D.N.F.)
| | - Ma. Leah C. Tantoco
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines College of Medicine—Philippine General Hospital, Manila 1000, Philippines
| | - Zubair M. Ahmed
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.G.); (S.R.); (Z.M.A.)
| | - Abner L. Chan
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines College of Medicine—Philippine General Hospital, Manila 1000, Philippines
| | - Daniel N. Frank
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (J.M.K.); (C.E.R.); (D.N.F.)
| | - Charlotte M. Chiong
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (T.K.L.Y.); (E.G.d.V.L.); (M.R.T.R.-Q.); (M.L.C.T.); (A.L.C.); (C.M.C.)
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines College of Medicine—Philippine General Hospital, Manila 1000, Philippines
| | - Regie Lyn P. Santos-Cortez
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
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Kulasek M, Mercier E, Bergeron M. Assessing the Role of Nasal Irrigation in Chronic Otorrhea in Children With Tympanostomy Tubes. J Otolaryngol Head Neck Surg 2025; 54:19160216251315055. [PMID: 39910888 PMCID: PMC11800241 DOI: 10.1177/19160216251315055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 10/17/2024] [Indexed: 02/07/2025] Open
Abstract
IMPORTANCE Nasal irrigation (NI) is effective in the treatment of sinonasal disease; however, its efficacy in treating otologic conditions is undetermined. Chronic otorrhea (CO) is an important complication in children with tympanostomy tubes (TT), requiring additional treatment. OBJECTIVE Determine potential factors of NI that put children with TT at risk of developing CO. STUDY DESIGN Case-control study. SETTING Single tertiary level of care pediatric hospital. PARTICIPANTS Consecutive patients under the age of 18 with bilateral TT presenting between June and September 2023 were selected. INTERVENTION All patients in this study used NI. MAIN OUTCOME MEASURES The main outcome was the development of CO, defined as 10 or more consecutive days of ear drainage despite proper treatment. RESULTS Twenty consecutive patients with CO were recruited and compared to 100 consecutive controls without CO. The mean age was similar, with 22.9 ± 18.4 months for the CO group and 25.2 ± 16.4 months for the control group (P = .59). An immediate discharge occurred more frequently in the CO group (80%) than in the control group (46%, P = .005; OR: 4.70; 95% CI: 1.5-13.5). A fast rate of administration of NI was more prevalent in the CO group (75%) compared to the control group (51%, P = .049; OR: 2.88; 95% CI: 1.0-7.6). TT insertion under local anesthesia occurred more frequently in the CO group (45%) than in the control group (22%, P = .03; OR: 2.9; 95% CI: 1.1-7.4). No statistical difference was found between groups in the frequency and volume of NI. No patients with CO used a small volume of NI (≤5 mL). CONCLUSION AND RELEVANCE A fast rate of administration of NI was correlated with an increased risk of CO. Patients should be encouraged to apply gentle pressure as it could potentially prevent this complication.
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Affiliation(s)
- Michal Kulasek
- Faculty of Medicine, University de Montreal, Montreal, QC, Canada
| | - Erika Mercier
- Department of Pediatric Otolaryngology-Head and Neck Surgery, CHU Ste-Justine, Montreal, QC, Canada
| | - Mathieu Bergeron
- CHU Sainte Justine Research Institute, CHU Ste-Justine, Montreal, QC, Canada
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Ma X, Li Y, Lv M, Li J, Zhao S. Comparing of anteroinferior and posteroinferior tympanostomy tube insertion: a cohort study. Transl Pediatr 2022; 11:1209-1215. [PMID: 35958000 PMCID: PMC9360827 DOI: 10.21037/tp-22-273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Tympanostomy tube insertion (TTI) is one of the primary treatments for Otitis media with effusion (OME) in children, a common condition in children. However, there is still no conclusion on the better choice of tube position, and no relevant research has been found in the literature. This study analyzed the results of the two commonly selected tube insert positions, anteroinferior quadrant (AQ) and posteroinferior quadrant (PQ), in order to determine which is the better choice. METHODS Children with bilateral OME who received TTI in Beijing Tongren Hospital from May 2020 to January 2021 were selected as subjects. one side on AQ and the other side on PQ randomly. Follow-up visits were arranged at 1 week, 1 month, 6 months and 12 months after surgery. The results of audiology and the tube status of the two positions were recorded and compared statistically. RESULTS A total of 90 patients with bilateral OME were selected. There was no difference in preoperative hearing between the 2 groups. The AQ group's average air conduction threshold was significantly higher than that of the PQ group 1 week after surgery. Although there was no significant difference in tube fall-off rate between the two groups within 6 months, it was significantly higher in AQ group than that in PQ group at 12 months after surgery. CONCLUSIONS Compared to TTI on AQ, TTI on PQ is more stable and better improves hearing, and the operation is also more convenient for surgeons. This study provides reference for a better position of TTI in OME therapy.
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Affiliation(s)
- Xiaobo Ma
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mengshuang Lv
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Li
- Department of Otolaryngology - Head and Neck Surgery, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Shouqin Zhao
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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