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What did the project achieve?
“We’ve identified a specific immunological difference in the adenoids of children with glue ear,” says Mr Michael Mather, a surgeon at Newcastle University. “While this research is still at an early stage, it has also revealed new avenues for the development of safe and effective treatments that could help improve the lives of children without the need for surgery.”
Glue ear is a common childhood condition where the middle ear – the space that lies behind the ear drum – fills up with sticky fluid, causing hearing loss. While it will often clear up by itself, some children will have persistent symptoms that can start to affect their speech, language and education. They may need to have an operation to insert small tubes (grommets) into their eardrum – and, in some cases, to also remove their adenoids, which are located at the back of the nose and are part of the immune system.
This research looked at the immune cells in adenoid samples* collected from children with and without glue ear. Using cutting-edge technologies, the team analysed gene activity and used this information to determine which type of immune cells were present and how well they were functioning.
The team identified several important differences in the immune cells of the adenoids of children who have glue ear and those who don’t. A particular cell type was found less often in children with glue ear than in healthy children. These cells produce a molecule which plays a crucial role in preventing infection at places in the body that interact with the outside world.
“This new discovery could help to explain why some children are more likely to get glue ear than others,” says Mr Mather.
The researchers then used other techniques to see where these immune cells exist within the adenoid – revealing they are located close to the surface facing the nose.
“This is a very exciting finding because it opens the possibility of designing treatments that could be sprayed into the nose – reducing the risk of side effects and making it easy to administer to children,” says Mr Mather. “We now plan to investigate the best way to alter the number and function of these cells – with the long-term goal of translating this discovery into a future treatment option for this common condition.”
* As a result of the disruptive effects of the COVID-19 pandemic on the number of ear surgeries that took place, coupled with the recent discovery that immune cells in the adenoids played a critical role in glue ear, and the limited access to certain technologies during this period, the researchers adapted their original plan to focus on adenoid instead of middle ear tissue. This approach achieved the same overall goal of understanding the immune cell dynamics in children with glue ear.
This research was completed on
Research Training Fellowship*:Mr Michael Mather
Inflammation of the middle ear, caused by a bacterial or viral infection, is one of the most common diseases in childhood. More than two-thirds of children will experience at least one acute episode before their third birthday.
Around half will have repeated infections and some will also go on to develop chronic inflammation and need antibiotics or surgery.1 But these treatments aren’t ideal – bacteria can develop resistance and surgery requires a general anaesthetic. Mr Michael Mather, a surgeon at Newcastle University, is using cutting-edge techniques to investigate how immune cells in the middle ear respond to infection. His ultimate goal is to identify new targets for the development of new, better treatments for this very common childhood illness.
How are children’s lives affected now?
The small space behind the eardrum – known as the middle ear – usually contains air. But it can become filled with fluid, typically when a child has a cold – and if this gets infected by germs, it becomes inflamed and painful.
A child with a middle ear infection may experience a range of distressing symptoms including earache and a high temperature. Although most will usually clear up within a few days, many children will get repeated infections – and some will develop long-term middle ear problems.
“Middle ear infections are not only painful and distressing for children, but they can also result in regular absences from school and hearing issues that impact on their social and educational development,” says Mr Mather.
Children with recurring bacterial infections or with long-term middle ear problems are usually treated with antibiotics and surgery.
“But prolonged or repeated antibiotic treatment can lead to drug resistance and surgery has risks, including the need for a general anaesthetic,” says Mr Mather.
Our goal is to gain a better understanding of how middle ear infections develop, which we hope will ultimately lead to the development of safe and effective new treatments that can reduce the need for antibiotics and surgery
How could this research help?
“Our goal is to gain a better understanding of how middle ear infections develop, which we hope will ultimately lead to the development of safe and effective new treatments that can reduce the need for antibiotics and surgery,” says Mr Mather.
The team is using cutting-edge technologies to compare the immune cells and molecules within the tissues of middle ear samples collected from children undergoing surgery for recurring infections or long-term problems – with samples from healthy ears.
“By analysing the data, we hope to identify key differences between healthy and inflamed tissues that could be targeted with new treatments to stop an initial infection becoming a long-term problem,” says Mr Mather.
The team will also create a new and unique 3D laboratory model of middle ear cells – a so-called ‘disease in a dish’, which will provide an invaluable tool for studying ear infections and for testing potential new treatments.
* Research Training Fellowships: Each year, Action Medical Research awards these prestigious grants to help develop some of the UK’s brightest doctors and scientists as future leaders in children’s research.
Research table
Project details
| Project Leader | Mr Michael W Mather, MBBS MRes MRCS (ENT) |
| Location | Institute of Cellular Medicine, Newcastle Medical School |
| Project Team | Professor Janet A Wilson, MBChB MD FRCSEng FRCSLT Professor Muzlifah Haniffa, BSc MBBCh (Hons) MRCP PhD Professor Colin D Bingle, BSc PhD Mr Jason Powell, MBBS MClinRes MRCS DOHNS PhD |
| Other Locations | Institute of Cellular Medicine, Newcastle University, Otolaryngology, Freeman Hospital, Newcastle, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield |
| Grant Awarded | |
| Grant Amount | £241,819 |
| Start Date | |
| End Date | |
| Duration | 36 months |
| Grant Code (GN number) | GN2779 |
References
- Patient, Professional Reference article: Acute Otitis Media in Children. https://patient.info/doctor/acute-otitis-media-in-children#ref-6 [website accessed 09 March 2019]
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