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ARRA Investments in Otitis Media


Public Health Burden
Parents of infants and toddlers have become accustomed to recognizing the signs and symptoms of middle ear infections, or otitis media (OM): irritability, tugging at ears, loss of appetite, loss of sleep, pain, or fever. OM is one of the most common reasons for a sick infant to visit a doctor. Seventy-five percent of children experience at least one episode of OM by their third birthday. Almost half of these children will have three or more ear infections during their first 3 years. It is estimated that medical costs and lost wages because of OM amount to $5 billion a year in the United States. Although OM is primarily a disease of infants and young children, it can also affect adults

Etiology
Otitis media often begins when viral or bacterial infections that cause sore throats, colds, or other respiratory or breathing problems spread to the middle ear. The three main bacterial causes of OM are Streptococcus pneumoniae, Moraxella catarrhalis, and Nontypeable Haemophilus influenzae (NTHi). Scientists hope to develop new ways to prevent or to treat these infections by understanding how the bacteria cause infection in the middle ear. A variety of ARRA funded grants and supplements are exploring the characteristics of these bacteria, and how the middle ear responds to them. A few include:
  • Scientists are studying how NTHi causes OM at the molecular level, providing new leads into the development of strategies for treating this illness.1
  • Another scientist will use supplement funds to hire a new postdoctoral research fellow, who will focus her/his efforts to describe the genomics of Moraxella catarrhalis, and on how this bacteria forms antibiotic-resistant biofilms.2
  • Scientists are also working to understand how chronic OM leads to destructive changes in the inner ear that compromise hearing. The ARRA funds are being used to obtain new laboratory equipment to improve the quality and speed of data acquisition.3
  • Scientists are studying how the middle ear mucosa responds to infection – recruiting white blood cells, thickening, generating new blood vessels, and eliminating some infected cells through cell death, or apoptosis. They hope to use their knowledge to learn how to intervene in the infection process to prevent hearing loss caused by middle ear infection. ARRA funds were used to hire scientists to screen possible new infection-fighting drugs that cross the eardrum, and to purchase new equipment to support this study. The equipment will benefit the entire department, since it is to be located in a shared equipment facility.4
Prevention
A specific ARRA Challenge Grant program was developed for “Prevention of Otitis Media”. Resistance of bacterial pathogens to traditional antibiotic therapy is making this approach to treating this disorder increasingly problematic. The Challenge Grants will develop and utilize knowledge of the basic biology underlying bacterial colonization and infection of the middle ear to create new approaches to preventing infection.

A safe and effective means of preventing acute OM without the use of antibiotics would be of great public health importance. Examples of research projects in this area include:
  • A scientist is comparing differences in immune response between children who clear infections with those who experience prolonged infection. This type of data may help scientists develop ways to boost immune response in children who are more susceptible to OM, thus preventing infection.5
  • Another scientist is working to identify naturally-occurring infection fighting molecules already present in the human ear. The laboratory hopes to learn how to stimulate release and activity of these infection-fighting molecules, in order to prevent infection, or to help fight off existing infections. ARRA funds are being used to hire more scientists to speed the rate of research discoveries, to develop a new human middle ear cell line, and to add two types of extremely sensitive electron microscopy imaging to the existing project.6



  1. 1R03DC010048-01 -- Regulation of Inflammation by EGFR in Otitis Media -- Xu, Xiangbin (CA).
  2. 3R01DC005837-07S1 -- Genetics & Biology of M. catarrhalis LOS in Otitis Media -- Campagnari, Anthony A. (NY).
  3. 3R01DC009455-01A2S1 -- Inner Ear Impact of Chronic Middle Ear Inflammation -- Trune, Dennis Royal (OR).
  4. 3R01DC000129-30S1 -- Middle Ear Response in Otitis Media -- Ryan, Allen F. (CA).
  5. 3R01DC008671-03S3 -- NTHi Immunity in Young Children-- Pichichero, Michael E. (NY).
  6. 3R01DC005025-06S1 -- Innate Immunity in Otitis Media Pathogenesis -- Lim, David J. (CA).


 
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