温州2991例变应性鼻炎患者皮肤点刺试验结果分析

目的　了解温州地区变应性鼻炎患者变应原分布特征。方法　回顾性分析2013年1月～2014年12月具有变应性鼻炎症状、行皮肤点刺试验的患者的临床资料,分析皮肤点刺试验结果的分布特征。结果　①2991例患者总阳性率为82.0%,主要变应原是粉尘螨和屋尘螨;吸入性变应原阳性率高于食入性致敏原（χ2=2006.557,P＜0.01）;变应性鼻炎患者以双重过敏者为主;粉尘螨、屋尘螨反应强度均以（++++）为主,二者间反应强度差异无显著性（Z =-0.391,P =0.696）。②不同季节变应原阳性率有显著性差异（χ2=34.254,P＜0.01）。③不同病程组变应原阳性率差异无显著性（χ2=16.102,P =0.065）。④不同年龄组变应原阳性率差异有显著性（χ2=223.317,P＜0.01）,阳性率随年龄增大而升高,在10～12岁年龄段达高峰,之后减小。结论  尘螨为温州地区变应性鼻炎患者的主要变应原,季节和年龄是影响皮肤点刺试验阳性率及变应性鼻炎发病的重要因素,变应原阳性率与年龄存在一定的关系。     

四川宜宾、云南昭通及部分长江上游地区变应性鼻炎患者的变应原分布特点及结果分析

目的：通过对四川宜宾、云南昭通及部分长江上游地区变应性鼻炎患者行变应原检测及分析,筛查本地区常见变应原,了解常见吸入性变应原的分布情况,为临床诊断和治疗变应性鼻炎提供参考。方法采集2013年3月～2015年6月于四川省宜宾市第一人民医院就诊的661例经皮肤点刺试验（skin prick test,SPT）诊断明确的常年性变应性鼻炎患者的资料,对所测定的致敏变应原进行统计分析。结果在661例患者的SPT中,阳性率最高前5位为粉尘螨（76.55%）、屋尘螨（72.01%）、蟑螂（35.85%）、猫毛（11.35%）、狗毛（8.62%）;不同季节变应原阳性率差异无统计学意义（χ2=4.568,P=0.206）;随着年龄的增加,变应性鼻炎患者变应原阳性率呈下降趋势。结论四川宜宾、云南昭通及部分长江上游地区中导致变应性鼻炎的变应原占主导地位的为粉尘螨、屋尘螨、蟑螂,对于儿童的变应性鼻炎防控应尤为重视。     

Korean Modification of the Nasal Provocation Test With House Dust Mite Antigen Following the EAACI Guidelines

ObjectivesWe evaluated the usefulness of the standardized nasal provocation test (NPT) protocol recently published by the European Academy of Allergy and Clinical Immunology (EAACI) and compared the utility of several parameters for diagnosing allergic rhinitis (AR) caused by house dust mites (HDM). Subjective parameters were nasal and ocular symptoms measured using a visual analog scale (VAS), and objective parameters were peak nasal inspiratory flow (PNIF), minimal cross-sectional area (MCA), and total nasal volume (TNV).MethodsBefore and after spraying Dermatophagoides pteronyssinus (DP) allergen (1,000 AU/mL, 100 μL) into both nostrils of 13 patients with AR (AR group) and 22 patients with non-AR (NAR group), we used VAS scores to measure nasal symptoms (nasal obstruction, rhinorrhea, sneezing, and itching) and ocular symptoms and assessed PNIF, MCA, and TNV.ResultsThe AR group had significantly worse symptoms than the NAR group 15 minutes after DP challenge (P<0.001). After 30 minutes, nasal obstruction and rhinorrhea remained worse in the AR group (P<0.001); a similar but less marked difference was seen for sneezing (P=0.012) and itching (P=0.039). Ocular symptoms, PNIF, MCA, and TNV differed between groups after both 15 and 30 minutes (P<0.05). The area under the receiver operating characteristic curve was higher for nasal obstruction (0.977), rhinorrhea (0.906), and TNV (0.979) than for sneezing (0.755), itching (0.673), and MCA (0.836).ConclusionNPT performed according to the EAACI guidelines could help diagnose AR caused by HDM. TNV and VAS changes in nasal obstruction and rhinorrhea had higher diagnostic accuracy than other parameters.     

屋尘螨过敏的常年性变应性鼻炎患者皮肤试验同IgE的关系

目的 探讨对屋尘螨过敏的变应性鼻炎患者中变应原皮肤试验反应强度同血清特异性和总IgE水平之间的关系。方法 选择69例对屋尘螨过敏的散发变应性鼻炎患者为实验组,80例为健康对照组。对69例变应性鼻炎患者进行变应原皮肤试验和屋尘螨的特异性IgE水平的检测,所有个体均检测血清中总IgE水平。结果 实验组变应原皮肤试验反应强度同血清特异性IgE之间有相关性（r=0．379,P=0．001）,血清总IgE水平同特异性IgE水平、变应原皮肤试验之间无明显相关性（P〉0.05）,实验组血清总IgE的几何均数水平明显高于对照组（分别为224IU／ml和50IU／ml,P〈0．001）。结论变应原皮肤试验反应结果同血清屋尘螨的特异性IgE水平有相关性,在变应性鼻炎的诊断中有重要作用,变应性鼻炎患者血清总IgE水平明显高于健康对照组,其在疾病诊断中有参考价值,但通过血清总IgE水平对变应原皮肤试验结果和特异性IgE水平进行预测的意义不大。     

尘螨变应原皮肤点刺试验与血清特异性IgE的相关性研究

目的 探讨尘螨变应原皮肤点刺试验(skinprick test,SPT)结果与血清特异性IgE(specific IgE,S-IgE)检测值之间的相关性.方法 分析170例接受尘螨变应原SPT和相应的血清S-IgE检测的变应性鼻炎患者不同皮肤风团直径和不同皮肤反应指数(skin index,SI)对应的血清S-IgE的差异.结果尘螨变应原SPT不同皮肤风团直径和不同SI对应的血清S-IgE存在显著性差异,随着皮肤风团直径或SI的增加,血清S-IgE阳性率和级别也显著增加.结论尘螨变应原SPT结果和血清S-IgE结果存在相关性.     

Nasal Histamine Reactivity; Relationships to Skin-test Responses,Allergen Provocation and Symptom Severity in Patients with Long-continuing Allergic Rhinitis

It has been reported that skin-test reactivity and rhinitis symptom severity weaken in the course of time. A corresponding weakening might also be seen in non-specific nasal hyper-reactivity, but the relationships of these responses are poorly understood. Our aim was to measure nasal responsiveness to histamine in a series of patients with long-continuing allergic rhinitis and to compare these measurements with skin test responses, allergen provocation and changes in severity of allergic rhinitis symptoms. A total of 73 patients in whom allergic rhinitis had been verified over 20 years earlier were re-interviewed and re-investigated. Skin prick tests with common allergens were performed and the presence of nasal allergy was confirmed by allergen provocation. Non-specific nasal hyper-reactivity was determined with nasal histamine challenge using four concentrations of histamine phosphate. The response was registered by counting sneezes, recording changes in nasal discharge and mucosal swelling and measuring nasal airway resistance. Sneezing and discharge scores showed that milder non-specific nasal hyper-reactivity was associated with lack of reactivity in skin prick tests and nasal allergen challenge. No association was observed between allergy test results and changes in nasal airway resistance during the histamine provocation. In most patients the symptoms of rhinitis had become milder or disappeared during the follow-up, but the results of the histamine challenge showed no relationship with the changes in symptom severity. In patients with allergic rhinitis, reactivity to histamine is associated with a concomitant change in skin and nasal mucosal reactivity to allergens.     

变应性鼻炎患者潜在哮喘和下气道高反应的筛查研究

目的探讨问卷调查结合肺功能发现变应性鼻炎(AR)合并哮喘和气道高反应性(airway hyperresponsiveness,AHR)的意义。方法 306例无哮喘的AR患者行问卷调查、肺功能乙酰甲胆碱激发试验(methacholine challenge test,MCT),诊断哮喘或AHR。比较第一秒用力呼气容积占预计值的百分比(FEV1%)和用力呼气中段流速(FEF25-75%)值,绘制ROC曲线。结果 127例有哮喘症状,24例肺功能舒张试验阳性,32例MCT阳性,哮喘漏诊率18%,阳性回答的哮喘发生率44.1%;无阳性回答179例,41例经MCT诊断AHR,发生率13%。各组MCT阳性的FEV1%和FEF25-75%均显著低于阴性组;ROC曲线显示FEF25-75%较FEV1%对哮喘或AHR诊断的准确性高。结论调查问卷利于AR合并哮喘及AHR筛查,小气道功能受损更能提示AR合并哮喘或AHR,可优先行MCT。     

皮下免疫治疗对儿童变应性鼻炎患者血清人β防御素-2的影响观察

目的：探讨皮下免疫治疗（subcutaneous immunotherapy,SCIT）对变应性鼻炎儿童血清人β防御素-2（human beta defensin-2,HBD-2）的影响。方法30例行SCIT的变应性鼻炎患儿入治疗组,20例健康儿童入对照组,检测对照组及治疗组治疗前、治疗后半年、1年血清HBD-2浓度,并记录鼻部症状总评分（total nasal symptom scores,TNSS）及药物评分。结果对照组、治疗组治疗前、治疗后半年、1年血清HBD-2浓度为4.62[4.08;4.87]、3.74[3.37;4.61]、4.62[4.13;5.54]、4.79[4.45;6.19]ng/ml,随着SCIT进行,HBD-2浓度逐渐上升（P<0.01）。治疗组治疗前、治疗后半年、1年TNSS分别为7.43±2.15、4.17±2.16、4.20±1.92,药物评分分别为1.25[0.75;1.38]、0.25[0;0.75]、0.25[0;0.75]。治疗组各时间点HBD-2浓度与TNSS及药物评分无明显相关（P均>0.05）。结论变应性鼻炎患者血清HBD-2浓度较正常人低,SCIT可上调变应性鼻炎患者血清HBD-2水平。     

南京市9～10岁儿童变应性鼻炎的相关调查

目的 调查南京市9～10岁儿童变应性鼻炎流行病学特征并分析其相关危险因素。方法 2004年3～9月,选择南京市7所小学三年级（9～10岁）学生为研究对象,设计“南京市儿童呼吸道疾病问卷调查表”。调查分两阶段,问卷调查阶段、根据问卷结果筛选变应性鼻炎可疑对象并进行专科检查予以确诊阶段。变应性鼻炎诊断依据ARIA标准。对结果进行统计学处理。结果 发放问卷总数为1087份,回收989份。应答率91％,有效问卷942份。南京市9～10岁儿童变应性鼻炎现患率为5．1％（48／942）,其中男5．6％（27／484）,女4．6％（21／458）,男、女发病率无差异（X^2=0．480,P〉0．05）：按ARIA标准：持续性45．8％（22／48）,其中轻度20．8％（10／48）、中-重度25．8％（12,48）：间歇性54．2％（26／48）,其中轻度45．8％（22／48）、中-重度8．4％（4／48）。在变应性鼻炎危险因素中,40．0％患者伴有支气管哮喘,环境因素中家庭装潢后诱发症状不容忽视,27．1％的患者有家族史。结论 南京市9～10岁儿童变应性鼻炎现患率为5．1％。初步了解南京市变应性鼻炎流行病现状,为变应性鼻炎标准化防治提供流行病学资料。     

Comparison of Component-Resolved Diagnosis by Using Allergen Microarray With the Conventional Tests in Allergic Rhinitis Patients: The First Using in Korea

Objectives

The aim of this study was to evaluate the component-resolved diagnosis using a microarray allergen chip (Immuno Solid-phase Allergen Chip, ImmunoCAP ISAC) and to compare this new diagnostic tool with the established ImmunoCAP methods for allergen-specific IgE detection in allergic rhinitis patients.

Methods

One hundred sixty-eight allergic rhinitis patients were included in this study. All the patients were diagnosed with allergic rhinitis according to their clinical symptoms, physical examination and a positive skin prick test. We analyzed their specific IgEs for house dust mites (Dermatophagoides farine [DF] and Dermatophagoides pteronyssinus [DP]), Alternaria alternata, birch, and mugwort using ImmunoCAP and ImmunoCAP ISAC in the same patient sample. We compared the sensitivity and correlation between the two tests.

Results

In cases of allergies to DP and DF, the sensitivity of the specific IgE was 80% and that of the allergen microarray was 78.9%. The correlation between the two tests was significant for both DP and DF (P<0.001). For the A. alternata, birch and mugwort allergens, the sensitivity of ImmunoCAP ISAC was slightly lower than that of ImmunoCAP.

Conclusion

These results suggest that the allergen microarray chip method is a reliable new method to diagnose the components of an allergen in patients with allergic rhinitis sensitive to house dust mites. Further study about the utility of the allergen microarray is needed.     

儿童变应性鼻炎舌下特异性免疫治疗的近期疗效观察

目的　观察舌下特异性免疫治疗（sublingual immunotherapy,SLIT）应用于治疗儿童变应性鼻炎的近期临床疗效。方法　采用前后自身对照,比较44例3～13岁尘螨过敏的变应性鼻炎患者治疗前及治疗3、6个月的症状评分、药物评分、视觉模拟量表（visual analogue scale,VAS）评分及血液嗜酸性粒细胞（eosinophil,Eos）水平,评价SLIT的近期临床疗效。结果　SLIT治疗3个月和6个月后,患者的鼻部症状评分、药物评分及VAS评分较治疗前显著下降,差异有统计学意义（P 均<0.05）;SLIT治疗3个月 与治疗6个月相比,患者鼻塞、流涕、喷嚏症状评分,鼻部总症状评分、药物评分及VAS评分相似,差异无统计学意义（P 均>0.05）,而鼻痒症状评分差异具统计学意义 （Z =-4.185,P <0.05）;SLIT治疗6个月与治疗前相比,血液Eos水平显著下降,差异具有统计学意义（Z=-4.544,P<0.05）。结论　舌下含服标准化粉尘螨滴剂是治疗尘螨变应性鼻炎儿童患者的一种安全有效的治疗方法,可在治疗3个月左右观察到疗效,SLIT治疗6个月后患者Eos百分比显著降低。     

天津地区变应性鼻炎患儿吸入性变应原的流行病学特征分析

目的　分析天津地区变应性鼻炎患儿吸入性变应原检测结果,了解变应性鼻炎患儿常见吸入性变应原及其分布规律。方法　应用德国Mediwiss公司敏筛变应原检测系统（Allergy Screen）测定血清中相应变应原特异性免疫球蛋白E（specific immunoglobulin E,sIgE）。根据性别、年龄、季节分层,描述吸入性变应原的分布特征。结果　天津地区变应性鼻炎患儿最常见的吸入性变应原为混合霉菌（52.35%）,其次是户尘螨（35.88%）、狗毛皮屑（24.31%）、猫毛皮屑（15.10%）。单一变应原阳性（59.03%）最常见,其次为双重变应原阳性（25.88%）。分组研究显示,男性患儿吸入性变应原阳性率大于女性患儿;婴幼儿期患儿吸入性变应原阳性率明显低于学龄前期、学龄期、青春期患儿,夏秋季变应性鼻炎患儿吸入性变应原阳性率明显高于冬春两季,以上差异均有统计学意义（P <0.05）。结论　混合霉菌,户尘螨,狗、猫毛皮屑是天津地区变应性鼻炎患儿最常见的吸入性变应原。吸入性变应原阳性率在性别、年龄、季节分布上都存在一定规律。     

粉尘螨点刺试验与粉尘螨鼻黏膜激发实验相关性分析

目的评价目前粉尘螨过敏的常年性变应性鼻炎（AR）患者皮肤点刺试验（skin prick test,SPT）和鼻黏膜激发实验（nasal provocation test,NPT）的相关性。方法选择90例临床症状及体征符合常年性AR的患者行SPT及NPT。结果粉尘螨SPT及NPT灵敏度分别为84.6%和100%,其SPT及NPT的特异度分别为94.1%和98.0%。阳性级别在（＋＋）、（＋＋＋）和（＋＋＋＋）的SPT阳性患者,NPT阳性率分别为24.2%、30.3%和45.5%。结论 SPT为诊断AR的必要先行检查手段,NPT对于可疑变应原的确诊、鼻黏膜的非特异性高反应性的诊断及特异性免疫治疗（specific immunotherapy,SIT）具有较高价值。SPT级别强度越高,NPT阳性率越高,但SPT级别强度与NPT液浓度之间无明显相关性。     

太原市迎泽区10～11岁儿童变应性鼻炎自报患病率调查分析

目的调查太原市迎泽区10-11岁儿童变应性鼻炎自报患病率并分析其相关危险因素。方法参照国际相关资料,自行设计调查问卷,随机抽取太原市迎泽区3所小学10-11岁小学生为研究对象,进行流行病学调查。所有调查数据录入Epidata,用SPSS软件进行统计分析,筛选变应性鼻炎自报阳性儿童,进行相关因素分析。结果共发放问卷800份,回收有效问卷752份。太原市10～11岁儿童变应性鼻炎自报患病率为22．61％（170厅52）,其中男26．5％（90／339）,女19．4％（80／413）,有统计学差异。在变应性鼻炎的危险因素中,是否足月出生、母乳喂养时间、居住环境、家族过敏史可能与变应性鼻炎有一定相关性。结论初步了解太原市10～11岁儿童变应性鼻炎的流行现状,为变应性鼻炎的防治及公共卫生政策的制订提供流行病学依据。     

颗粒物PM10和CD4+T淋巴细胞IL-4 DNA甲基化在儿童变应性鼻炎发病机制中的研究

目的　探讨大气污染PM10对变应性鼻炎儿童CD4+T淋巴细胞IL-4基因启动子区域甲基化的表观遗传调控及相关转录水平表达的影响。方法　选择2012年上海儿童医学中心耳鼻咽喉科就诊的35例6～12岁变应性鼻炎患儿随访1年,收集血样及设立匹配对照组（30例）,进行IL-4基因启动子区域甲基化克隆测序及mRNA表达水平检测。评估PM2.5和PM10的个人综合暴露。结果　变应性鼻炎组CD4+T淋巴细胞中IL-4基因启动子区域平均甲基化程度低于对照组（P =0.038）;其中-48、+54甲基化程度有差异（P =0.041、0.032）;变应性鼻炎组IL-4转录水平升高（P =0.039）,与其平均DNA甲基化水平呈负相关（r =-0.452,P =0.032）。转录水平与对照组无显著性差异。校正后,变应性鼻炎儿童PM10暴露与其IL-4基因启动子区域甲基化程度呈负相关（r 2=0.419,β=-0.470,SD =0.781,P =0.045）。结论　变应性鼻炎儿童IL-4基因启动子区域低甲基化水平可能受到PM10影响。     

Compositional Alterations of the Nasal Microbiome and Staphylococcus aureus–Characterized Dysbiosis in the Nasal Mucosa of Patients With Allergic Rhinitis

ObjectivesHost–microbial commensalism can shape the innate immune response in the nasal mucosa, and the microbial characteristics of nasal mucus directly impact the mechanisms of the initial allergic responses in the nasal epithelium. We sought to determine alterations of the microbial composition in the nasal mucus of patients with allergic rhinitis (AR) and to elucidate the interplay between dysbiosis of the nasal microbiome and allergic inflammation.MethodsIn total, 364,923 high-quality bacterial 16S ribosomal RNA-encoding gene sequence reads from 104 middle turbinate mucosa samples from healthy participants and patients with AR were obtained and analyzed using the Quantitative Insights into Microbial Ecology pipeline.ResultsWe analyzed the microbiota in samples of nasal mucus from patients with AR (n=42) and clinically healthy participants (n=30). The Proteobacteria (Ralstonia genus) and Actinobacteria (Propionibacterium genus) phyla were predominant in the nasal mucus of healthy subjects, whereas the Firmicutes (Staphylococcus genus) phylum was significantly abundant in the nasal mucus of patients with AR. In particular, the Ralstonia genus was significantly dominant in the clinically healthy subjects. Additional pyrosequencing data from 32 subjects (healthy participants: n=15, AR patients: n=17) revealed a greater abundance of Staphylococcus epidermidis, Corynebacterium accolens, and Nocardia coeliaca, accounting for 41.55% of mapped sequences in the nasal mucus of healthy participants. Dysbiosis of the nasal microbiome was more pronounced in patients with AR, and Staphylococcus aureus exhibited the greatest abundance (37.69%) in their nasal mucus, in association with a positive response to house dust mites and patients’ age and height.ConclusionThis study revealed alterations in the nasal microbiome in the nasal mucus of patients with AR at the levels of microbial genera and species. S. aureus-dominant dysbiosis was distinctive in the nasal mucus of patients with AR, suggesting a role of host-microbial commensalism in allergic inflammation.     

Serum 25-hydroxyvitamin D3 levels in children with allergic or nonallergic rhinitis

ObjectivesThe relationship between vitamin D and allergic diseases such as asthma and atopic dermatitis is shown in several studies. But there is a lack of knowledge about vitamin D status in children with allergic rhinitis (AR). We aimed to investigate serum vitamin D levels of children with AR or nonallergic rhinitis (NAR), to compare with normal subjects and to evaluate the relationship between vitamin D and the severity of AR.MethodsThe study included a total of 141 children (76 patients with rhinitis and 65 control subjects), who applied to the Pediatric allergy immunology outpatient. Skin prick tests were performed using the same antigens for all patients. Serum 25-hydroxyvitamin D3 (25OHD3) levels were measured. AR was classified according to the ARIA guidelines.ResultsMean 25OHD3 levels were 18.07 ± 6.1 ng/mL in the AR group, 14.81 ± 4.86 in the NAR, and 24.03 ± 9.43 ng/mL in the control group. These differences among groups were statistically significant (p = 0.001). Vitamin D status was determined as deficient in 32 (66.7%) patients, insufficient in 14 (29.2%) and normal in 2 (4.2%) of the AR group. These frequencies for NAR and control groups are 25 (89.3%), 3 (10.7%), 0, and 25 (38.5%), 32 (49.2%), 8 (12.3%), respectively. Vitamin D status was found to be different among groups (p = 0.001). There were not any association between 25OHD3 levels and allergen sensitivity (p > 0.05). The comparison of the mean 25OHD3 levels according to the severity and duration of AR did not detect statistically significant difference among groups (respectively, p = 0.384, p = 0.23 Denburg J, Fokkens WJ, Togias A5).ConclusionsThe mean serum 25OHD3 levels of the children both with AR and NAR were lower than control group. No association between 25OHD3 levels and allergen sensitivities was found in our study. We did not find any relationship between 25OHD3 levels and the severity and duration of allergic rhinitis     

昆明市青少年变应性鼻炎患者变应原谱分析

目的调查昆明地区变应性鼻炎（allergicrhinitis,AR）患者的变应原谱。方法将具有典型AR临床症状的567例患者按年龄分为9组,采用13种当地常见变应原对不同性别年龄组患者进行变应原分布情况分析。结果①女性患者粉尘螨、户尘螨、蒿属花粉和法国梧桐的过敏阳性率显著高于男性（t=2．701,P=0．012）。②不同年龄组中,过敏原分布比较差异无统计学意义（P〉0．05）。③93．5％患者检测出过敏原,其中2．1％患者对一种过敏原过敏,91．4％患者为多重过敏。在粉尘螨与户尘螨两种过敏原中,5．46％仅对其中一种尘螨过敏,85．4％同时对两种尘螨过敏。④平均过敏原的个数随年龄增大而增多（F=8．738,P=0．012）,而各年龄组男女性别间比较差异无统计学意义（F=1．873,P=0．400）。结论尘螨、蒿属花粉和法国梧桐是昆明地区最常见的过敏原,随年龄增长,患者的人均变应原个数增多。     

Decreased Pattern-Recognition Receptor-Mediated Cytokine mRNA Expression in Obese Children With Otitis Media With Effusion

Objectives

To assess innate and humoral immune responses in middle ear effusion of obese pediatric patients with otitis media with effusion (OME).

Methods

We evaluated 219 children with OME, of whom 21 were obese and 198 were non-obese. We compared the expression in middle ear effusion of mRNAs encoding toll-like receptors (TLR) 2, 4, 5, and 9; nucleotide-binding oligomerization domains (NOD) 1 and 2; retinoic acid-inducible gene (RIG)-I; interleukins (IL)-6, -10, and -12; interferon (IFN)-γ; and tumor necrosis factor (TNF)-α mRNAs. We also compared the expression of immunoglobulins IgG, IgA, and IgM and the bacterial detection rate in the two groups.

Results

TLR2-mediated expression of IL-6 mRNA, TLR4-mediated expression of IL-6 and IL-10 mRNA, TLR5-mediated expression of IL-6, IL-10, and TNF-α mRNA, TLR9-mediated expression of IL-6 mRNA, and NOD2-mediated expression of IL-6, IL-12, and TNF-α mRNA were significantly lower in obese than in non-obese children (P<0.05). However, concentrations of IgG, IgA, and IgM in middle ear effusion were lower in obese than in non-obese children, but none of these differences was significant (P>0.05).

Conclusion

Mean body mass index was higher and pattern-recognition receptor-mediated cytokine mRNA expression was lower in obese than in non-obese children with OME.