K V Sastry1, S C Sharma, S B Mann, N K Ganguly, N K Panda. 1. Department of Otolaryngology and Head & Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
HYPOTHESIS: The bone destruction in cholesteatoma is multifactorial. This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with cholesteatoma. BACKGROUND: Tumor necrosis factor-alpha is an important inflammatory cytokine secreted by activated macrophages. It stimulates keratinocytes as an autocrine growth regulator. Few authors have localized TNF-alpha in aural cholesteatoma. An attempt was made in this study to show a correlation between TNF-alpha and cholesteatoma associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level. METHODS: Serum TNF-alpha levels were measured in 20 patients with cholesteatoma of temporal bone and histochemical staining was used to localize TNF-alpha in pathologic tissue excised at surgery. RESULTS: Serum TNF-alpha levels in patients with cholesteatoma were significantly higher than in controls. In addition, TNF-alpha levels in patients with bone destruction were higher than in those without bone destruction. However, there was no correlation between age of the patient and serum TNF-alpha levels. The TNF-alpha was localized in various layers of cholesteatoma epithelium using indirect immunoperoxidase staining. CONCLUSION: TNF-alpha is one of the cytokines produced by cholesteatoma that may be an important mediator of bone destruction associated with cholesteatoma. TNF-alpha has been localized in various layers of cholesteatoma and exerts a locally destructive effect on bone. Serum TNF-alpha levels are related to the extent of bone destruction.
HYPOTHESIS: The bone destruction in cholesteatoma is multifactorial. This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with cholesteatoma. BACKGROUND:Tumor necrosis factor-alpha is an important inflammatory cytokine secreted by activated macrophages. It stimulates keratinocytes as an autocrine growth regulator. Few authors have localized TNF-alpha in aural cholesteatoma. An attempt was made in this study to show a correlation between TNF-alpha and cholesteatoma associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level. METHODS: Serum TNF-alpha levels were measured in 20 patients with cholesteatoma of temporal bone and histochemical staining was used to localize TNF-alpha in pathologic tissue excised at surgery. RESULTS: Serum TNF-alpha levels in patients with cholesteatoma were significantly higher than in controls. In addition, TNF-alpha levels in patients with bone destruction were higher than in those without bone destruction. However, there was no correlation between age of the patient and serum TNF-alpha levels. The TNF-alpha was localized in various layers of cholesteatoma epithelium using indirect immunoperoxidase staining. CONCLUSION:TNF-alpha is one of the cytokines produced by cholesteatoma that may be an important mediator of bone destruction associated with cholesteatoma. TNF-alpha has been localized in various layers of cholesteatoma and exerts a locally destructive effect on bone. Serum TNF-alpha levels are related to the extent of bone destruction.