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Current Allergy and Asthma Reports
Published in: Current Allergy and Asthma Reports 5/2017

01-05-2017 | Otitis (DP Skoner, Section Editor)

Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death

Authors: Shigeharu Ueki, Nobuo Ohta, Masahide Takeda, Yasunori Konno, Makoto Hirokawa

Published in: Current Allergy and Asthma Reports | Issue 5/2017

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Abstract

Purpose of Review

Eosinophilic otitis media (EOM) is a refractory disease characterized by the accumulation of eosinophils in middle ear effusion and mucosa. We summarize current knowledge regarding the clinical characteristics and management of EOM. Although eosinophil activation in inflamed foci is involved in the pathogenesis of EOM, little is known about the fate of the eosinophils and aftermath of their cell death. We discuss the possibility that eosinophils undergo non-apoptotic cell death that worsens tissue damage and increases effusion viscosity.

Recent Findings

Unlike chronic otitis media, EOM is strongly associated with an allergic background. Corticosteroids are currently the only effective pharmacological treatment, and surgical intervention is often required. Mucosal eosinophils infiltrate extensively into the middle ear cavity where they are stimulated by locally produced activators including interleukin-5 and eotaxin. The eosinophils undergo cytolysis in the effusion, which represents a major fate of activated eosinophils in vivo. Recent data revealed cytolysis could be renamed as extracellular trap cell death (ETosis). ETosis represents suicidal cell death involving total cell degranulation and development of sticky chromatin structures (extracellular traps (ETs)). The characteristics of eosinophil- and neutrophil-derived ET polymers might contribute to the difference in viscosity of secretions between EOM and common chronic otitis media.

Summary

The extracellular products remaining after eosinophil ETosis are an important aspect of EOM pathology. The concept of ETosis also has novel implications for potential therapeutic modalities in various eosinophilic disorders.
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Metadata
Title
Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death
Authors
Shigeharu Ueki
Nobuo Ohta
Masahide Takeda
Yasunori Konno
Makoto Hirokawa
Publication date
01-05-2017
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 5/2017
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-017-0702-5

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