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. 2012 Oct;19(10):1593-6.
doi: 10.1128/CVI.05443-11. Epub 2012 Aug 1.

Antibody in middle ear fluid of children originates predominantly from sera and nasopharyngeal secretions

Ravinder Kaur  1 , Thomas Kim, Janet R Casey, Michael E Pichichero
Affiliations

Antibody in middle ear fluid of children originates predominantly from sera and nasopharyngeal secretions

Ravinder Kaur et al. Clin Vaccine Immunol. 2012 Oct.

Abstract

The human middle ear is devoid of any immunocompetent cells in normal mucosa. We sought to determine the source of antibody present in the middle ear of children. Total IgG, IgA, and secretory IgA antibodies were determined by enzyme-linked immunosorbent assay from the nasopharyngeal, middle ear, and serum samples of children with acute otitis media. The two-dimensional gel electrophoresis pattern of the entire array of IgA antibodies in the nasal wash (NW) and middle ear fluid (MEF) was compared from the MEF and NW samples using isoelectric focusing and Western blotting. The total IgG and IgA antibodies in the MEF and NW samples of 137 children were compared. The ratio of IgG to IgA in the MEF was significantly different (P < 0.008) compared to NW because IgA levels were higher and IgG levels lower in NW. The IgG/IgA ratio of MEF resembled serum consistent with transudation to the MEF. Small amounts of secretory IgA were detected in MEF but the electrophoresis patterns of the entire array of IgA antibodies in the MEF and NW were virtually identical in each child evaluated; thus, IgA in MEF derived predominantly from serum and the nasopharynx by reflux via the Eustachian tube. The IgG/IgA antibody levels in the MEF and the same composition of IgA antibody in the MEF and NW identifies the predominant source of antibody in the MEF as a transudate of serum combined with nasal secretions refluxed from the nasopharynx in children.

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Figures

Fig 1
Fig 1
Dot plot of ratio of total IgG to IgA in the serum, MEF, and NW samples of children with AOM. The ratio of total IgG to IgA was not significantly different between serum and MEF samples, but the IgG/IgA ratio of both sera and MEF was significantly different compared to NW samples. The y axis is changed to a log2 scale.
Fig 2
Fig 2
(A) sIgA antibody level in the MEF versus NW of children with AOM. (B) Ratio of sIgA to total IgA calculated for each NW and MEF samples of 15 children, and the results are shown as means with standard errors. The paired t test shows that NW samples have significant higher sIgA level compared to MEF samples of the same child.
Fig 3
Fig 3
2D gel electrophoresis of IgA from MEF (A) and NW (B) samples from the same child, with the heavy chains on top and the light chains below. The banding pattern is interpreted to show that the IgA in the MEF and NW samples are virtually identical.
See this image and copyright information in PMC

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