Authors:
Thornton RB, Wiertsema SP, Kirkham LAS, Rigby PJ, Vijayasekaran S, Coates HL, Richmond PC
Authors notes:
PLoS ONE. 2013;8(2):e53837
Keywords:
Bacterial biofilms, otitis media, Dornase alfa, Neutrophil extracellular traps, middle ear effusions
Abstract:
Bacteria persist within biofilms on the middle ear mucosa of children with recurrent and chronic otitis media however the mechanisms by which these develop remain to be elucidated.
Biopsies can be difficult to obtain from children and their small size limits analysis.
Most middle ear effusions (MEE) had live bacteria present using viability staining (32/36) and all effusions had bacteria present using the universal FISH probe (26/26).
Of these, 70% contained 2 or more otopathogenic species. Extensive DNA stranding was also present.
This DNA was largely host derived, representing neutrophil extracellular traps (NETs) within which live bacteria in biofilm formations were present.
When treated with the recombinant human deoxyribonuclease 1, Dornase alfa, these strands were observed to fragment.
Bacterial biofilms, composed of multiple live otopathogenic species can be demonstrated in the MEEs of children with rAOM and that these contain extensive DNA stranding from NETs.
The NETs contribute to the viscosity of the effusion, potentially contributing to its failure to clear as well as biofilm development.
Our data indicates that Dornase alfa can fragment these strands and may play a role in future chronic OM treatment.