RESUMEN
Cholesteatoma of the middle ear is characterized by the presence of hyperproliferative keratinizing squamous epithelium in the middle ear cavity and destruction of adjacent bone. Interleukin 1 (IL-1) is an autocrine growth factor for normal keratinocytes and is capable of inducing bone degradation. The distribution of two molecular species of IL-1, IL-1 alpha and IL-1 beta, was investigated immunohistochemically in the hyperproliferative epithelium of cholesteatoma, in normal epidermis of the auditory canal and of the retroauricular region, and in nonkeratinizing tonsillar epithelium. In all squamous epithelia examined, IL-1 alpha and IL-1 beta were present in comparable amounts. The IL-1 content of cholesteatoma epithelium was clearly increased in relation to normal skin keratinocytes. All cellular layers of cholesteatoma epithelium stained strongly and uniformly for Il-1 alpha and IL-1 beta, whereas the keratin layer was negative for IL-1. No particularly strong reaction with basal cells was detected. In the connective tissue under the squamous epithelium of cholesteatoma, intensely positive cells were scattered between negative stromal cells. Our results suggest that IL-1 could be liberated from disintegrating keratinocytes and cells of the monocyte-macrophage lineage, stimulate the proliferation of the cholesteatoma epithelium in an autocrine manner, and contribute to the enhancement of bone destruction in the presence of cholesteatoma.
Asunto(s)
Colesteatoma/química , Oído Medio/química , Interleucina-1/análisis , Colesteatoma/etiología , Colesteatoma/patología , Conducto Auditivo Externo/química , Conducto Auditivo Externo/patología , Enfermedades del Oído/etiología , Enfermedades del Oído/patología , Enfermedades del Oído/fisiopatología , Oído Externo/química , Oído Externo/patología , Oído Medio/patología , Epidermis/química , Epidermis/patología , Epitelio/química , Epitelio/patología , Humanos , Inmunohistoquímica , Interleucina-1/fisiología , Queratinas , Tonsila Palatina/química , Tonsila Palatina/patologíaRESUMEN
Monoclonal antibodies with defined specifications for individual cytokeratins were used to stain the epithelia of the external auditory meatus, the middle ear and cholesteatoma. The observed staining indicated that the epithelium of the external auditory meatus has a pattern of keratin expression typical of epidermis in general and the epithelium of the middle ear resembles simple columnar epithelia. The pattern of staining of cholesteatoma closely resembled that of the skin of the external auditory meatus.
Asunto(s)
Colesteatoma/patología , Enfermedades del Oído/patología , Anticuerpos Monoclonales , Colesteatoma/química , Colesteatoma/inmunología , Enfermedades del Oído/inmunología , Oído Externo/patología , Oído Medio/patología , Epitelio/química , Epitelio/patología , Humanos , Queratinas/química , Queratinas/inmunología , Coloración y Etiquetado , Membrana Timpánica/patologíaRESUMEN
Tumor necrosis factor alpha (TNF-alpha) was found in human middle ear cholesteatoma tissues by the immunoperoxidase method using rabbit anti human TNF-alpha immunoglobulin G. It appeared to be localized in the epithelium and connective tissue of cholesteatomas studied, particularly on basal and spinous cells, and macrophages. The epithelium of normal external ear canal skin was lightly stained, but the staining was much weaker than that of the cholesteatomas observed. In vitro, recombinant mouse TNF-alpha stimulated proliferation, protein synthesis, and terminal differentiation of basal keratinocytes. These stimulatory effects were blocked by the anti-TNF-alpha immunoglobulin G, which by itself had no effect on basal keratinocytes. These findings suggest that TNF-alpha plays an important role in the development of cholesteatomas seen clinically.
Asunto(s)
Colesteatoma/química , Oído Medio , Factor de Necrosis Tumoral alfa/análisis , Células Cultivadas , Enfermedades del Oído , Humanos , Técnicas para Inmunoenzimas , Queratinocitos/enzimología , Biosíntesis de Proteínas , Transglutaminasas/análisisRESUMEN
A variety of solutions were tested in vitro to find a suitable solvent of cholesteatoma debris for use in clinical practice. The specimens were taken during surgery from the patients of otitis media with cholesteatoma. They were divided in pieces and put in test tubes. Each tube was then admixed with one of the test solutions and incubated at 37 degrees C for 48 hours. Hydrochloric acid (1N) and sodium hydroxide (1N) had no substantial effect to solve the debris. Urea (10N), acetylcysteine (20%) and chymotrypsin (1%) had a weak such effect. Proteolytic agents such as diiodosalitylic acid (0.1N), sodium dodecyl sulfate (0.1N) and cholic acid (0.1N) showed a stronger effect but not enough for clinical use. In contrast, a detergent which contains interfacial active agents and a proteolytic enzyme (alkaline cellulase), such as Attack and Hi-Top, proved to be more effective to solve the debris. However, biological effect of such detergent on the ear is not clear. Further study will be necessary before actual application in the patients.