The analysis for clinical utility and role of the myeloperoxidase-deoxyribonucleic acid complex in otitis media with antineutrophil cytoplasmic antibody-associated vasculitis

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K09744
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56050:Otorhinolaryngology-related
• Research Institution: Hokkaido University
• Principal Investigator: Morita Shinya 北海道大学, 大学病院, 講師 (80443951)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: ANCA関連血管炎性中耳炎 / 好中球細胞外トラップ / バイオマーカー

Outline of Final Research Achievements

This analysis revealed that neutrophil extracellular traps (NETs) formation was identified in all patients with otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). The levels of NETs in the middle ear fluid from patients with systemic as well as localized forms of OMAAV were elevated in comparison to those in the middle ear fluid from patients with otitis media with effusion. Excessive formation of NETs has been suggested to be involved in the pathogenesis of OMAAV. It is noteworthy that the levels of NETs were elevated regardless of serum ANCA status. Therefore, the detection and quantification of NETs in the otitis media fluid may aid in providing a definite diagnosis of OMAAV.

Free Research Field

耳鼻咽喉科学

Academic Significance and Societal Importance of the Research Achievements

ANCA関連血管炎症候群の初期段階として、中耳炎のみを呈している段階での治療が臨床的には重要であるにも関わらず、その診断に難渋するために実際には治療が遅れるケースが珍しくない。本研究にて、中耳腔における好中球細胞外トラップ（NETs）の形成はANCA関連血管炎性中耳炎（OMAAV）の病態に関与し、中耳貯留液におけるNETs発現量を定量化することは、OMAAVを診断する上で有用性が高いことが示唆された。OMAAVに対する早期診断や治療のモニタリングの指標として用いることで、死亡率低減、難聴悪化の防止などANCA関連血管炎症候群全体の克服に向けたアプローチが可能になるという意義を持つ。