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Transcript analysis reveals a hypoxic inflammatory environment in human chronic otitis media with effusion

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Original languageEnglish
Article number1327
JournalFrontiers in genetics
Publication statusPublished - 21 Feb 2020


Chronic otitis media with effusion (COME) is the most common cause of childhood hearing loss in the developed world. Underlying
pathophysiology is not well understood, and in particular the factors that lead to the transition from acute to chronic
inflammation. Here we present the first genome-wide transcript analysis of white blood cells in the effusion of children with
COME. Analysis of microarray data for enriched pathways reveals upregulation of hypoxia pathways, which is confirmed using
real-time PCR and determining VEGF protein titres. Other pathways upregulated in both mucoid and serous effusions include
Toll-like receptor signalling, complement, and RANK-RANKL. Cytology reveals neutrophils and macrophages predominated in both
serous and mucoid effusions, however, serous samples had higher lymphocyte and eosinophil differential counts, while mucoid
samples had higher neutrophil differential counts. Transcript analysis indicates serous fluids have CD4+ and CD8+ T-lymphocyte, and
NK cell signatures. Overall, our findings suggest that inflammation and hypoxia pathways are important in the pathology of COME
and targets for potential therapeutic intervention, and that mucoid and serous COME may represent different immunological

    Research areas

  • otitis media (OM), Effusion analysis, Transcriptome, Inflammation, Hypoxia

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