Neutrophil elastase-α1-antitrypsin in middle ear fluid in chronic otitis media with effusion

Neutrophil elastase-αl-antitrypsin was quantified in samples taken from middle ear effusions collected at operation from 17 children attending for elective myringotomy and grommet insertion. At the time of surgery the effusion was classified as serous or mucoid. Children with a recent history of infection or antimicrobial therapy were excluded. The quantification of immunoreactive neutrophil elastase was by means of enzyme-linked immunosorbant assay (ELISA). The mean value of neutrophil elastase-αl-antitrypsin was 50.6±38.3 (sd) μg/ml in mucoid effusions, which was significantly higher (P <0.05) than that in serous effusions (5.3±4.8 μg/m1). These results indicate that a mucoid effusion may reflect a more severe inflammatory response and that persistence of neutrophil activity in the middle ear mucosa may contribute to the persistence of at least one group of middle ear effusions.