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Clinical and biochemical studies of bone destruction in cholesteatoma

  • Mohamed S. Amar (a1), Hussein F. Wishahi (a1) and Madeha M. Zakhary (a2)

Abstract

The exact causative factor(s) of bone erosion in cholesteatoma are not known. In recent years, the possible role of cytokines has drawn attention. Since the studies on cytokines in cholesteatoma are limited and depend on histopathological methods, the present work approached this subject by biochemical determination of TNF-α lysosomal enzymes, acid phosphatase (total and tartrate resistant), cathepsin B, leucyl aminopeptidase lysozyme together with non-lysosomal enzymes calpain I and II in 50 cholesteatoma samples (epithelial and subepithelial tissues) in comparison with 14 normal skin samples from the external ear canal. The study revealed significantly increased levels of all previous indices in cholesteatoma epithelium and subepithelial tissues compared with healthy skin. The levels of these indices reflected the clinical severity of the disease as reflected by their significant increase in cases with erosion of two or three ossicles, erosion of dural plate, sinus plate and facial canal and more extensive cholesteatoma. It is likely that TNF-α acts both directly by causing bone erosion and indirectly by stimulating the release of lysosomal enzymes. The latter mechanism is supported by the significant correlations observed between TNF-α and lysosomal enzymes. The non-lysosomal enzymes calpain I and II seem to participate in the bone erosion associated with cholesteatoma by their involvement in collagen destruction. Due to the suggested role of TNF-α in bone destruction associated with cholesteatoma the use of anti-inflammatory drugs should be taken into consideration in otitis media to diminish bone destruction. Similarly, antibiotics should be used to prevent the deleterious effects of bacterial endotoxin.

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Corresponding author

Address for correspondence: Dr Madeha M. Zakhary, Biochemistry Department, Faculty of Medicine, 12 Khalid Ebn El-Waleed Street, Ferial Region, Assiut, Egypt. Fax: 0720 88332278

References

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Aberg, B., Bagger Sjoback, D., Edstrom, S., Heyden, G., Jacobsson, M., Kindblom, L. G. (1990) A comparative study of enzyme histochemical features in the gerbilline and human cholesteatoma. Acta Otolaryngologica 109: 130146.
Abramson, M., Huang, C. C. (1977) Localization of collagenase in middle ear cholesteatoma. Laryngoscope 87: 771791.
Barrett, A. J. (1972) A new assay for cathepsin a and other thiol proteinase. Annals of Biochemistry and Experimental Medicine 47: 280293.
Bretlau, P., Sorensen, C., Jorgensen, M. (1982) Bone resorption in human cholesteatoma. Annals Otology 91: 131135.
Carswell, E. A., Old, L. J., Kassel, R. L., Green, S., Fiore, N., Williamson, B. (1975) An endotoxin-induced serum factor that causes necrosis of tumour. Proceedings of the National Academy of Science 72: 36663670.
Chan, W., Dennis, P., Demmer, W., Brand, K. (1982) Inhibition of leucine aminopeptidase by amino acid hydroxamates. Journal of Biological Chemistry 257: 79557957.
Clark, I. A., Codwden, W. B., Butcher, G. A., Hunt, N. H. (1987) Possible roles of tumor necrosis factor in the pathology of malaria. American Journal of Pathology 129: 192199.
Erater-Schroder, M., Risan, W., Hallman, R., Gautschi, P., Bohlen, P. (1987) Tumor necrosis factor type x, a potent inhibitor of endothelial growth in vitro, is angiogenic in vivo. Proceedings of the National Academy of Science 84: 52775281.
Felix, R., Fleisch, H., Elford, P. R. (1989) Bone-resorbing cytokines enhance release of macrophage colony-stimulating activity by the osteoblastic cell MC3T3-E1. Calcified Tissue International 44: 356360.
Gantz, B. J., Maynand, J., Huang, C. C. (1979) Bone resorption in chronic otitis media. Annals of Otology, Rhinology and Laryngology 88: 693700.
Gyo, K., Saski, Y. (1994) Solubilization of keratin debris in conservative treatment of middle ear cholesteatoma, an in vitro study. Journal of Laryngology and Otology 168: 113115.
Harris, E. D., Krane, S. M. (1974) Collagenases. New England Journal of Medicine 291: 605609. Quoted by Iwanaga et al. (1985): Annals of Otology, Rhinology and Laryngology 94: 309–312.
Harrison, J. F., Lunt, J. S., Scott, P., Blainey, J. (1968) Urinary lysozyme, ribonuclease and low molecular weight protein in renal disease. Lancet 75397540.
lino, Y., Hoshino, E., Tomioka, S., Takasaka, T. (1983) Organic acids and anaerobic microorganism in the contents of the cholesteatoma sac. Annals of Otology, Rhinology and Laryngology 92: 9196.
Iwanaga, M., Yamamoto, E., Fukumoto, M. (1985) Cathepsin activity in cholesteatoma. Annals of Otology, Rhinology and Laryngology 94: 309312.
Lowry, O., Rosenbrough, N., Farr, A., Randall, R. (1951) Protein measurement with folin phenol reagent. Journal of Biological Chemistry 193: 265275.
Moriyama, H., Huang, C. C., Kato, M., Abramson, M. (1985) Effects of pressure on bone resorption in the middle ear of rats. Annals of Otology, Rhinology and Laryngology 94: 60.
Moriyama, H., Huang, C. C., Shirahata, Y., Abramson, M. (1984) Effects of keratin on bone resorption in experimental otitis media. Archives of Otorhinolaryngology 230: 6168.
Murachi, T., Hatanaka, M., Yasumoto, Y., Nakayama, N., Tanaka, K. (1981) A quantitative distribution study on calpain and calpastatin in rat tissue and cells. Biochemistry International 2: 651656.
Myrvik, Q., Weiser, R. S., Agar, H. (1952) Lethal and cytologic effects of lysozyme on tubercle bacilli. American Review of Tuberculosis and Respiratory Diseases 67: 217231.
Myrivik, Q., Weiser, R. S., Kelly, M. C. (1953) Studies on the mode of action of lysozyme on mycobacteria. American Review of Tuberculosis and Respiratory Diseases 68: 564574.
Newman, J., Josephson, A., Cacatian, A. (1974) Spinal fluid lysozyme in the diagnosis of central nervous system tumours. Lancet Vol ? 756757.
Oxholm, A., Oxholm, P., Statberg, B., Bendtzen, K. (1988) Immunohistological detection of interleukin 1-like molecules and tumor necrosis factor in human epidermis before and after UVB-irradiation in vivo. British Journal of Dermatology 118: 369376.
Robinson, D. R., Tashjian, A. H., Levine, L. (1975) Prostaglandin stimulated bone resorption by rheumatoid synovia. A possible mechanism for bone destruction in rheumatoid arthritis. Journal of Clinical Investigations 56: 11811188.
Rubin, B. Y., Andersson, S. L., Sullivan, S. A., Williamson, B. D., Carswell, E. A., Old, L. J. (1985) High affinity binding of 1251-labelled human tumor necrosis factor (LUKII) to specific cell surface receptors. Journal of Experimental Medicine 162: 10991104.
Suzuki, K., Shimizu, K., Hamamoto, T., Nakagawa, Y. (1990) Biochemical demonstration of calpains and calpastatin in osteoarthritic synovial fluid. Arthritis and Rheumatism 33: 728732.
Takano, E., Young, H. P., Kitahara, A., Yamagata, Y., Kannagi, R., Murachi, T. (1988) Distribution of calpains and calpastatin in human blood cells. Biochemistry International 16: 391395.
Tashjian, A. H., Voelkel, E. F., Lazzaro, M., Goad, D., Bosma, T., Levine, L. (1987) Tumor necrosis factor-ot (cachectin) stimulates bone resorption in mouse calvaria via a prostaglandin-mediated mechanism. Endocrinology 120: 20292036.
Yan, S., Huang, C. (1991a) The role of tumor necrosis factor-ct in bone resorption of cholesteatoma. American Journal of Otolaryngology 100: 8588.
Yan, S., Huang, C. (1991b) Tumour necrosis factor alpha in middle ear cholesteatoma and its effect on keratinocytes in vitro. Annals of Otology, Rhinology and Laryngology 100: 157161.
Yellon, R. F., Leonard, G., Marucha, Ph. T., Craven, R., Carpenter, R. J., Lehmann, W. B., Burleson, J. A., Kreutzer, D. L. (1991) Characterization of cytokines present in middle ear effusions. Laryngoscope 101: 165169.

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