Objective: To investigate the expression and correlation of vascular endothelial growth factor (VEGF) and its receptor with hypoxia-inducible factor-1 alpha (HIF-1 alpha) in otitis media with effusion (OME). Methods: A rat model of OME was induced by injection of lipopolysaccharide (LPS) into the middle ear. Hematoxylin and eosin (HE) staining was used to observe the pathomorphological changes of the tympanic cavity in the middle ear of rats. Immunohistochemistry (IHC), western blotting and RT-qPCR were used to determine the mRNA and protein expression of VEGF, VEGFR-1, VEGFR-2 and HIF-1 alpha in mucosa of tympanic cavity mucosa, respectively. Results: In the OME group, the epithelial space of the middle ear mucosa was significantly thickened and infiltration of a large number of inflammatory cells was found on postoperative day (POD), and the otitis media basically subsided 2 weeks after operation. VEGF mRNA expression was significantly increased on POD 1, and its protein expression peaked on POD 3. HIF-1 alpha mRNA expression was significantly increased and peaked on POD 1, while its protein expression began to increase on POD 3 and was significantly expressed in the middle ear mucosal epithelium. HIF-1 alpha mRNA showed a positive correlation with VEGF mRNA and VEGFR-1 mRNA expression. Conclusion: VEGF mainly plays a role in the acute phase of OME, and it is abundantly expressed mediated by HIF-1 alpha. And then it play a role in vasodilatation and increase of vascular permeability, thus promoting the generation of middle ear effusion.

目的 通过4DCT(four-dimensional CT)动态评估咽鼓管功能障碍(Eustachian tube dysfuction,ETD)患者Valsava动作时的咽鼓管(Eustachian tube,ET)功能.方法 2018年11月～2019年3月期间就诊于首都医科大学附属北京安贞医院的ETD患者15例,无中耳疾病的志愿者15名.使用咽鼓管测压(tubomanometry,TMM),七项咽鼓管功能障碍评分量表(the seven-item Eustachian tube dysfunction questionnaire,ETDQ-7)和咽鼓管评分量表-7(the Eustachian tube score-7,ETS-7)等方法对所有对象咽鼓管功能做初步评价.嘱患者做Valsava动作,行ADCT动态扫描,记录ET开放过程,重建图像.测量ET数值,判断阻塞部位,进行统计学分析.结果 正常对照组可观察到ET全长,ETD组均有不同程度的阻塞.ETD组ET长度和角度显著大于对照组[(44.41±2.21)mm vs(40.60±2.20)mm,P<0.01;(168.73±4.66)mm vs(162.88±5.44)mm,P<0.01],前鼓室部直径显著小于对照组[(3.5±0.8)mm vs(5.3±1.1)mm,P<0.001].结论 ET长度越长、角度越大,越容易发生ETD.ADCT动态扫描可准确评估ETD患者ET阻塞部位,对咽鼓管球囊扩张术适应证具有指导意义,辐射剂量低,可作为ET常规检查方法.

Some studies have demonstrated that vascular endothelial growth factor (VEGF) plays a critical role in the pathogenesis of otitis media with effusion (OME) in animal models. However, the levels of VEGF and its receptors in adult OME have not been clarified. Our study was designed to detect the levels of VEGF and its receptors in adult OME and explore their relationship with effusion types, duration and prognosis of OME.

Vascular endothelial growth factor (VEGF) is a potent and critical mediator of vascular permeability and angiogenesis,and plays an important role in inflammatory events.Otitis media with effusion (OME) is a common reason for hearing loss,which the pathological change is inflammatory reaction.Many studies have identified the expression of VEGF protein and transcripts in middle ear effusion of rats and patients with OME.This review highlights the role of VEGF in otitis media with effusion,in which VEGF may serve a therapeutic purpose.