Quantitative determination of bacterial endotoxin in middle ear effusions by chromogenic substrate method.

It is known that bacterial endotoxin on the outer surface of most gram-negative bacteria (GNB) is not only biologically active material, but also the modulator of the immune response. The earlier experiment documented that the endotoxin of killed Haemophilus influenzae was responsible for induction of chronic otitis media with effusion (OME). Recent study by DeMaria et al. determined the endotoxin of human middle ear effusion (MEE) by means of limulus amebocyte lysate assay. It was concluded the endotoxin was present in a high percentage of the effusion in human tympanic cavities. The present study was undertaken to quantitatively determine the endotoxin in human MEE by use of chromogenic substrate technique which is more sensitive and accurate than limulus assay. Sixty samples of mucoid and serous effusion were subjected to chromogenic substrate method. It was revealed that the mucoid effusion showed a significantly high level of endotoxin at 282 pg/ml in average, though the serous effusion contained only 35.9 pg/ml. It is assumed that the bacterial endotoxin may greatly contribute to the pathogenesis of otitis media with mucoid effusion.