Mediterr J Otol 2006:2(2):70-77

Otitis Media with Effusion and BCG Vaccine: Cytokines and Immunoglobulins

Erol Keleş, Ahmet Gödekmerdan, Turgut Kalıdağ, İrfan Kaygusuz, Şinasi Yalçın, H. Cengiz Alpay, Ayça Tazegül.

Fırat University Otorhinolaryngology Department, Elazığ, Turkey;  keleserol@yahoo.com

OBJECTIVE: In this study, we investigated the effects of bacille Calmette-Guérin vaccine, known to activate the immune response through T lymphocytes and macrophages, on the course of otitis media with effusion.

MATERIALS AND METHODS: We evaluated 2042 first-grade students of state-run basic-education schools at the centers of their provinces. These children had similar socioeconomic indicators and were considered clinically healthy. The children who were diagnosed with otitis media with effusion were invited to our clinic. Of the 55 students who accepted, 46 were recruited to this study. We drew 5 mL of venous blood from these children and vaccinated them with bacille Calmette-Guérin. Following vaccination, the patients were scheduled for control visits at 1-month intervals. Ear, nose, and throat examinations of the patients were repeated at each visit. Following otoscopic examination, tympanometric examinations were performed. On the third visit, an additional 5-mL venous blood sample was obtained (fourth month). The children were followed for 6 months after vaccination.

The control group consisted of healthy children (n = 30) of the same age group not vaccinated with bacille Calmette-Guérin, living in the same region, and sharing similar socioeconomic indicators.

Interferon gamma, interleukin 4, total immunoglobulin E, G, M, and A serum levels of the children with otitis media were measured before and 4 months after vaccination with bacille Calmette-Guérin and compared with the corresponding serum levels of the control group.

RESULTS: In the 46 children with otitis media with effusion who participated in the study, a significant difference existed among serum levels of interferon gamma, interleukin 4, and total immunoglobulin E, G, M, and A before and 4 months after vaccination with bacille Calmette-Guérin compared with the control group (P < .05). However, 4 months after vaccination, the difference between the IgA levels of the study and control groups was not significant (P > .05).

CONCLUSIONS: Bacille Calmette-Guérin vaccine is an effective stimulant for cell-mediated immunity. In this study, we identified a short-lasting positive effect of bacille Calmette-Guérin vaccine (which activates an immune response mechanism through macrophages and T lymphocytes) on the course of otitis media with effusion.