Antibodies specific to outer membrane antigens of Moraxella catarrhalis in sera and middle ear effusions from children with otitis media with effusion.

Objective: Recent studies have shown that bacterial DNA is present in a significant percentage of middle ear effusions, suggesting that persistent bacterial infection may be more important in pathogenesis and recurrence of otitis media with effusion (OME) than previously considered. Although Moraxella (M.) catarrhalis is one of the most common pathogens of otitis media, relatively little is known about immune response to the organism. The objective of the present study is to investigate how systemic and local immune activities against M. catarrhalis may be associated with severity of OME.

Methods: The antibody levels specific to outer membrane antigens of M. catarrhalis in sera and middle ear effusions (MEEs) from 59 children with OME were measured by enzyme-linked immunosorbent assay. Their ages ranged from 1 to 12 years with a median 5.0 years. The children were followed 1 year prospectively and classified into two groups with or without recurrent/persistent OME according to severity of OME during the follow-up 1 year.

Results: Serum IgG, IgM, and IgA antibodies specific to outer membrane antigens of M. catarrhalis were detected in all samples and the median levels were 35, 0.93, and 1.2 microg/ml respectively. The MEE IgG, IgM, IgA, and secretory IgA antibodies were detected in over 95% samples tested and the median levels were 371, 158, 20, and 50 ng/mg total protein respectively. A comparison between acute and subacute/chronic phases revealed that the median levels of MEE IgG and IgM antibodies were higher at the acute phase (692 vs. 340, P = 0.06; 35 vs. 10, P = 0.02, respectively); while the MEE secretory IgA antibody level was increased at the subacute/chronic phase (74 vs. 35, P = 0.02). Either serum or MEE IgG antibody level was significantly lower in recurrent/persistent OME group than that in nonrecurrent/non-persistent OME group (13 vs. 43 ,microg/ml, P = 0.009; 238 vs. 577 ng/mg protein, P = 0.006, respectively).

Conclusions: These data provide additional information on the immunologic aspects of children with OME. Decreased serum and MEE IgG antibody levels specific to outer membrane antigens of M. catarrhalis may lead to failure to eliminate this organism, resulting in persistent and/or recurrent appearance of MEE.