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From the Departments of Pediatrics, Microbiology, Otolaryngology, and Medicine, School of Medicine, State University of New York at Buffalo, Buffalo, New York 14214
Abstract
The middle ear washings and biopsy specimens of middle ear mucosa from 20 patients with secretory otitis media were examined for the distribution of major classes of immunoglobulin; presence and nature of antibody activity against mumps, measles, rubella and poliovirus; and immunologic localization of immunocompetent lymphoid cells. Appreciable amounts of secretory component, and 
G, 7SA, and 11S secretory A immunoglobulin were regularly found in the ear fluids. The ratio of G: A immunoglobulin in the serum and middle ear fluids was approximately 10:1 and 10:4, respectively. Fluorescent antibody staining of mucosal tissues of middle ear demonstrated characteristic staining for secretory component in the surface epithelium, and the presence of G and A containing lymphoid tissue in the submucosa. Tissue culture studies demonstrated in vitro synthesis of A and G immunoglobulin and the secretory component in the mucosal tissues of middle ear. Specific antibody activity in the middle ear fluid against the viruses listed above was essentially limited to A immunoglobulin, although such activity in the serum was predominantly associated with G immunoglobulin. These data suggest the existence of a distinct secretory immune system in the middle ear. The implications of these observations may be applicable to the mechanism of protection, or pathogenesis of microbial infections in the middle ear.
Footnotes
1 Presented in part at the annual meetings of the American Pediatric Society and Society for Pediatric Research, May 16 to 19, 1973, San Francisco, California. Supported by grants from National Institute of Allergy and Infectious Diseases (AI09769), National Institute of Child Health and Human Development (HD06321), Clinical Research Center Program (RR628) from the United States Public Health Service, Training Grant TOI05075 from National Institute of Arthritis and Metabolic Diseases, and Clinical Center grant from Arthritis Association of Western New York.
2 Address reprint requests to Dr. Pearay L. Ogra, Division of Virology, Children's Hospital, 219 Bryant Street, Buffalo, New York 14222.
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