SARS-CoV-2感染后成人急性分泌性中耳炎细胞因子水平分析

Cytokine expression among patients with acute secretory otitis media after SARS-CoV-2 infection

目的探讨中耳积液及血清细胞因子在新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引起成人急性分泌性中耳炎发病中的作用。方法收集SARS-CoV-2感染后发生急性分泌性中耳炎的成人患者45例,所有患者4周内均有SARS-CoV-2感染史;采集患者血液标本行细胞因子检测;患耳鼓膜穿刺采集中耳积液标本行上述细胞因子及SARS-CoV-2核酸检测。比较患者血清及中耳积液细胞因子水平变化。结果患者中耳积液细胞因子IL-5、IL-6、IL-8、IL-10水平与血清细胞因子水平相比明显升高(P<0.05);中耳积液中IL-2、IFN-α、IFN-γ、TNF-α水平,与血清水平比较无明显差异(P>0.05);中耳积液SARS-CoV-2核酸检测阳性者(包括疑似阳性者)与阴性者中耳积液的IL-5、IL-6、IL-8、IL-10表达无明显差异(P>0.05)。混合性聋患者较传导性聋患者中耳积液细胞因子IL-6、IL-8水平明显升高(P<0.05)。结论SARS-CoV-2感染人体后可通过咽鼓管感染中耳并诱使中耳局部免疫细胞产生大量细胞因子,IL-5、IL-6、IL-8、IL-10是SARS-CoV-2引起分泌性中耳炎形成的主要细胞因子,其中IL-6、IL-8是患者中耳感音神经功能损害的主要细胞因子。

Objective We investigated the role of middle ear effusion and serum cytokines in the pathogenesis of acute secretory otitis media caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in adults.Methods Forty-five adult patients with acute secretory otitis media after SARS-CoV-2 infection were enrolled in this study.All patients had been infected with SARS-CoV-2 within the past 4 weeks.Blood samples were collected for cytokine analyses,and cytokines and SARS-CoV-2 nucleic acid were detected by ear effusion after tympanocentesis,to analyze changes in serum and middle ear effusion cytokines.Results The expression of cytokines IL-5,IL-6,IL-8,and IL-10 in middle ear effusions was significantly elevated relative to their levels in serum(P<0.05);IL-2,IFN-α,IFN-γand TNF-αexpression was not significantly different between serum and middle ear effusion(P>0.05).IL-5,IL-6,IL-8,and IL-10 expression level in middle ear effusion displayed no significant difference between SARS-CoV-2 positive individuals(including suspected positive individuals)and negative individuals(P>0.05).Individuals with mixed hearing loss exhibited significantly elevated IL-6 and IL-8 expression in middle ear effusion than individuals with conductive hearing loss(P<0.05).Conclusion SARS-CoV-2 can infect the middle ear through the eustachian tube and induce middle ear immune cells to produce high levels of cytokines,promoting secretory otitis media.IL-5,IL-6,IL-8,and IL-10 were the main inflammatory cytokines that promoted adult acute secretory otitis media caused by the novel coronavirus.IL-6 and IL-8 can be used as primary indicators to predict the severity of impairment of sensory nerve function in patients.