VI. |
Scientific Presentation
Dr. Thomas F. DeMaria |
Dr. Snow introduced the invited scientific speaker, Thomas F.
DeMaria, Ph.D., of the Otological Research Laboratories of the
Department of Otolaryngology at the Ohio State University. Dr.
DeMaria is Director of the Ear Research Group, Department of Otolaryngology,
where he is also Associate Professor. Dr. DeMaria is currently
conducting a project, supported by the NIDCD, which was the subject
of his presentation.
The following is a summary of his presentation:
The Role of Nontypeable Haemophilus influenzae in the Pathogenesis
of Otitis Media
Otitis media (middle ear inflammation/infection) in its various
clinical forms, is recognized as one of the most common childhood
diseases. The prevalence, medical care costs and hearing related
morbidity of otitis media (OM) are significant. A recent prospectie
study demonstrated that virtually all children (99 percent) will experience
at least one episode of OM by age two. OM accounted for 24.5
million physician's office visits in 1993, and suppurative and
unspecified OM ranked first in the list of the 30 most common
diagnoses for patients up to age two. OM was also the most common
reason for prescribing antibiotics in 1995. Over 3.5 billion
dollars per year, including medical treatment, surgical management
and the related loss of income for working parents is expended
on OM in the United States. Hearing loss is the most common complication
of OM, and this hearing loss, caused by the presence of fluid
in the middle ear space for an extended period of time, can affect
a child's language development and education during a highly critical
period.
Nontypeable Haemophilus influenzae (NTHi) bacteria have been identified
as the second most frequent causative agent and account for 25
to 30 percent of all cases of OM; 53 percent of recurrent OM; and are the primary
pathogens isolated from 62 percent of cases of chronic OM with effusion.
Very little, however, is actually known about this micro-organism's
virulence factors and the mechanisms whereby it induces disease
in the middle ear. Obtaining this information is a complex undertaking
because NTHi are actually an extremely diverse and heterogenous
group of bacteria. Despite the inherent challenges to studying
this particular OM pathogen, considerable data have been generated
in Dr. DeMaria's laboratory, as well as others, which attribute
significant roles to NTHi endotoxin and fimbriae in the pathogenesis
of OM. The role of these two surface components in the pathogenesis
of NTHi-induced otitis media was discussed within the context
of developing more effective prevention and treatment modalities.
(Supported by NIDCD/NIH R01 DC 00090-24).
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