Correlation Analysis Of Pepsin, IL-6, IL-8, MUC5B And Clinical Indexes In Middle Ear Effusion Of Adult With Secretory Otitis Media

Objective: Secretory otitis media(SOM)is a common otorhinolaryngology disease,which is the result of complex interaction among various pathological factors.Recently,laryngeal reflux has been considered as one of the possible pathogenic factors of SOM,and pepsin is the sensitive and specific index in the reflux fluid.However,there is a lack of research on the correlation between pepsin and the expression of middle ear inflammatory factors.The purpose of this study was to investigate the correlation of pepsin,IL-6,IL-8,MUC-5B and clinical indexes in middle ear effusion of patients with SOM.Methods:We collected the middle ear effusion samples and clinical data of 50 patients with SOM who were hospitalized in the First Affiliated Hospital of China Medical University from December 2021 to December 2022.The levels of pepsin,IL-6,IL8 and MUC5 B in the middle ear effusion were detected by enzyme-linked immunosorbent assay(ELISA).According to the results of pepsin,the samples were divided into pepsin positive group(experimental group)and pepsin negative group(control group),and correlation analysis of pepsin,L-6,IL8,MUC5 B and related clinical indicators was performed.Results: A total of 59 middle ear effusion samples were collected,and the pepsin positive rate was 52.5%(31/59).Pepsin in at least one ear was considered positive,and the detection rate was 58%(29/50).The concentrations of IL-6,IL-8 and MUC5 B in pepsin positive group were significantly higher than those in pepsin negative group(p < 0.05).The level of pepsin in middle ear effusion was positively correlated with the expression of IL-6,IL-8 and MUC5B(P < 0.05),but there was not significant correlation with ETDQ-7 and the degree of hearing loss.Conclusion:In patients with SOM associated with laryngeal reflux(pepsin positive),the expression levels of IL-6,IL-8 and MUC5 B in middle ear effusion were significantly upregulated,and were significantly positively correlated with pepsin levels.However,there was no significant correlation with the degree of hearing loss or ETDQ-7.Pepsin may be involved in the pathophysiological process of SOM by mediating the inflammatory cascade of middle ear mucosa and mucin hypersecretion.Pepsin may not significantly increase the severity of hearing loss and subjective symptoms in patients.Pepsin may be a potential therapeutic target for secretory otitis media in the future.