The Expression Of TNF-αand IL-1αin Human Middle Ear Cholesteatoma And Granulation Tissue

Object To study the expression of tumor necrosis factor-alpha (TNF-α) andinterleukin -1-alpha(IL-1α) in human middle ear cholesteatoma and granulation tissuefor discussing their roles in the otitis media development.Methods The specimen are selected from the First Clinical Medical College ofShanxi Medical University, department of Otolaryngology-Head and Neck , including35 cases from cholesteatoma specimens, 20 cases from granulation tissue specimensand 26 cases from both including cholesteatoma and granulation tissuespecimens.Write down their age, gender, illness duration, degree of hearing loss,andobserve their bone damage by surgery meanwhile.In addition, patients with normalexternal ear canal epithelium in 10 cases as controls. Finally,all specimens were fixedin 10% neutral formalin and paraffin-embedded.To measure the expression of TNF-αand IL-1αin the middle ear cholesteatoma and granulation tissue byimmunohistochemical technology and computer image analysis system.Results1. The percent of positive expression of TNF-αand IL-1αin middle earcholesteatoma were 89% and 86%, as compared with the normal ear canal skin,there were significant differences in expression (P<0.05.). The positive expressionof TNF-αin normal external ear canal epithelium cytoplasm showed a light browngranular and lowly density,which have a higher dendity expression in allcholesteatoma epithelial layers, the highest density in the basal layer, subepithelialconnective tissue is also have a positive expression.There is a weakly expressionof IL-1αin the external auditory canal epithelium and the positive cells onlyscattered in the basal layer,which have a higher expression in the wholecholesteatoma layer, with the highest density in basal and spinous layer.2. The percent of positive expression of TNF-α, and IL-1αin granulation tissue were85% and 80%, as compared with the normal ear canal skin, there were significantdifferences in expression (P<0.05.).Both have a higher expression in neutrophilegranulocyte and macrophages,also in the vascular endothelial cells.3. The percent of positive expression of TNF-αand IL-1αin the specimen includingcholesteatoma and granulation tissue were 96% and 88%,by the microscope we could observed that positive cells gradually increased from the basal layer to thestratum corneum,particularly have a higher expression around the granulationtissue and stratum spinosum epidermidis.4. By the Oneway ANOVA analysis can observed :The expression of TNF-αin thespecimen including cholesteatoma and granulation tissue have a higher level thanthe granulation tissue and the specimen just contain cholesteatoma, (P<0.05),there was a higher level with the specimen just contain cholesteatoma than thegranulation tissue,(P<0.05); The expression of IL-1αin the specimen includingcholesteatoma and granulation tissue have a higher level than the granulationtissue and the specimen just contain cholesteatoma, (P<0.05), there was a higherlevel with the specimen just contain cholesteatoma than the granulation tissuetoo.(P<0.05).5. There was a positively correlated about the expression of TNF-αand IL-1αin thespecimen including cholesteatoma(r=0.972,P<0.01) ,also in the granulation tissue(r = 0.974, P<0.01); It showed statistically significant correlation betweenexpression of TNF-αand the ability of erosion of middle ear cholesteatoma andgranulation tissue (P<0.01).There was a correlation between the expression ofIL-1αand the ability of erosion of middle ear cholesteatoma and granulation tissue(P<0.01). The lower of the gray value and the higher density of the expression ofTNF-αand IL-α, the stronger of the bone resorption.Conclutions1. The TNF-αand IL-1αin the adult middle ear was highly expressed, comparedwith the skin of external auditory of healthy people,explained that there is animportant role in the forming of cholesteatoma and granulation tissue.Theexpression is correlated, suggesting that the interation between them.2. There was a higher expression of TNF-αand IL-1αin the presence of includingcholesteatoma and granulation tissues than that in the only granulation tissue,indicating that the formation of cholesteatoma and granulation tissue is alwaysin the process of local inflammation.3. There was the statistically significant correlation between the expression ofTNF-αand IL-1αand the degree of bone resorption, suggesting that TNF-αandIL-1αmay be associated with the bone destruction mechanism of cholesteatomaand granulation tissue.4. The high expresstion of TNF-αand IL-1αin cholesteatoma and granulation tissue that play an important role in bone destruction ,which for reveal thepathology and molecular mechanism provides a experimental basis.5. The high expresstion of TNF-αand IL-1αin cholesteatoma and granulationtissue for fully understand their biological behavior provides a theoreticle basis.