Spiral ligament fibrocyte-derived MCP-1/CCL2 contributes to inner ear inflammation secondary to nontypeable H. influenzae-induced otitis media

<p>Abstract</p> <p>Background</p> <p>Otitis media (OM), one of the most common pediatric infectious diseases, causes inner ear inflammation resulting in vertigo and sensorineural hearing loss. Previously, we showed that spiral ligament fibrocytes (SLFs) recognize OM pathogens and up-regulate chemokines. Here, we aim to determine a key molecule derived from SLFs, contributing to OM-induced inner ear inflammation.</p> <p>Methods</p> <p>Live NTHI was injected into the murine middle ear through the tympanic membrane, and histological analysis was performed after harvesting the temporal bones. Migration assays were conducted using the conditioned medium of NTHI-exposed SLFs with and without inhibition of MCP-1/CCL2 and CCR2. qRT-PCR analysis was performed to demonstrate a compensatory up-regulation of alternative genes induced by the targeting of MCP-1/CCL2 or CCR2.</p> <p>Results</p> <p>Transtympanic inoculation of live NTHI developed serous and purulent labyrinthitis after clearance of OM. THP-1 cells actively migrated and invaded the extracellular matrix in response to the conditioned medium of NTHI-exposed SLFs. This migratory activity was markedly inhibited by the viral CC chemokine inhibitor and the deficiency of MCP-1/CCL2, indicating that MCP-1/CCL2 is a main attractant of THP-1 cells among the SLF-derived molecules. We further demonstrated that CCR2 deficiency inhibits migration of monocyte-like cells in response to NTHI-induced SLF-derived molecules. Immunolabeling showed an increase in MCP-1/CCL2 expression in the cochlear lateral wall of the NTHI-inoculated group. Contrary to the <it>in vitro </it>data, deficiency of MCP-1/CCL2 or CCR2 did not inhibit OM-induced inner ear inflammation <it>in vivo</it>. We demonstrated that targeting MCP-1/CCL2 enhances NTHI-induced up-regulation of MCP-2/CCL8 in SLFs and up-regulates the basal expression of CCR2 in the splenocytes. We also found that targeting CCR2 enhances NTHI-induced up-regulation of MCP-1/CCL2 in SLFs.</p> <p>Conclusions</p> <p>Taken together, we suggest that NTHI-induced SLF-derived MCP-1/CCL2 is a key molecule contributing to inner ear inflammation through CCR2-mediated recruitment of monocytes. However, deficiency of MCP-1/CCL2 or CCR2 alone was limited to inhibit OM-induced inner ear inflammation due to compensation of alternative genes.</p

Endoscopic-assisted septoplasty versus traditional septoplasty: assessment by the NOSE scale

En Abstract Context Nasal obstruction is a very common complaint, which may be caused by various causes, one of the most important being septal deviation. Many techniques have been described to correct these septal deviations since the middle of 19th century. There have been several modifications since its inception. The application of endoscopic techniques to correct septal deformities was initially described by both Lanza and colleagues and by Stammberger in 1991. Aims Comparing the efficacy of endoscopic septoplasty with traditional septoplasty in the treatment of cases with septal deviations. Patients and methods Thirty cases complaining mainly of nasal obstruction due to significant septal deviations were selected. They were randomly divided into two groups: group A patients underwent endoscopic septoplasty and group B underwent traditional septoplasty. The Nasal Obstruction Symptom Evaluation (NOSE) scale was an important step in assessment. Results The two procedures are suitable to correct septal deformities, with a slight upper hand for the endoscope in particular cases. We highlight in this study the advantages and disadvantages of the use of the nasal endoscope to correct nasal septal deviation. Conclusion Although mainly used in sinus surgery, the endoscope has also found its way in nasal septal surgery as it facilitates accurate identification of the pathology due to better illumination, improved accessibility to remote areas and magnification. It allows precise resection of the pathological areas without the need of an extended dissection. Endoscopic septoplasty is associated with a significant reduction in the patient’s morbidity in the postoperative period due to limited extent of flap dissection and limited manipulation and resection of the septal framework. However, the endoscope has its own limitations which include loss of binocular vision and the need for frequent cleaning. The NOSE scale also correlates well with the postoperative results of the study