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Malignant External Otitis and Polymorphonuclear Leukocyte Migration Impairment: Improvement With Ascorbic Acid

Malignant External Otitis and Polymorphonuclear Leukocyte Migration Impairment: Improvement With... Abstract • Malignant external otitis (MEO) is a rare disease due to a Pseudomonas infection of the external ear occurring in an elderly patient with uncontrolled diabetes mellitus. Its high mortality raises the question of an alteration of the defense mechanisms of the body. A 58-year-old man was affected with MEO, and after several months of unsuccessful treatment, a study of the function of his polymorphonuclear neutrophil leukocytes (PMNs) revealed a defect of the migration capability. Ascorbic acid (vitamin C) was proved in vitro to be able to improve the results of the migration test. The patient was treated for one month with ascorbic acid and, parallel to the normalization of the chemotaxis test results, the ear lesions healed. The mechanism of such an alteration of the PMN function, implying several factors (the active infection, old age, and diabetes mellitus), is still unclear. Nevertheless, it is certainly important to test the PMN function in patients with MEO and treat them with immunomodulators. (Arch Otolaryngol 1982;108:122-124) References 1. Chandler JR: Malignant external otitis . Laryngoscope 1968;78:1257-1294.Crossref 2. Nelson RD, Quie PG, Simmons RL: Chemotaxis under agarose: A new and simple method for measuring chemotaxis and spontaneous migration of human polymorphonuclear leukocytes and monocytes . J Immunol 1975;115:1650-1656. 3. Baehner RL, Nathan DG: Quantitative nitroblue tetrazolium test in chronic granulomatous disease . N Engl J Med 1968;278:971-976.Crossref 4. Brandt L: Studies on the phagocytic activity of neutrophilic leukocytes . Scand J Haematol , suppl 2, 1967, pp 16-20. 5. Castro O, Andriole VT, Finch SC: Whole blood phagocytic and bactericidal activity for Staphylococcus aureus . J Lab Clin Med 1972;80:857-870. 6. Schiffman E, Corcoran BA, Aswanikumar S: Molecular events in the response of neutrophils to synthetic f-Met chemotactic peptides: Demonstration of a specific receptor , in Gallin JI, Quie PJ (eds): Leukocyte Chemotaxis: Methods, Physiology, and Clinical Implication . New York, Raven Press, 1978. 7. Gallin JI, Wolff SM: Leukocyte chemotaxis: Physiological considerations and abnormalities . Clin Haematol 1975;4:567-607. 8. Hill HR, Sauls SH, Dettloff JF, et al: Impaired leukotactic responsiveness in patients with juvenile diabetes mellitus . Clin Immunol Immunopathol 1974;2:395.Crossref 9. Miller ME, Baker L: Leukocyte function in juvenile diabetes mellitus: Humoral and cellular aspects . J Pediatr 1972;81:979-982.Crossref 10. Mowat AG, Baum J: Chemotaxis and polymorphonuclear leukocytes from patients with diabetes mellitus . N Engl J Med 1971;284:621-627.Crossref 11. Molenaar DM, Palumbo PJ, Wilson WR, et al: Leukocyte chemotaxis in diabetic patients with their nondiabetic first degree relatives . Diabetes 1976;25:880-883. 12. Endler AT, Zielinsk CH, Schernthaner GC, et al: The influence of metabolic control on chemotactic activity in insulin-dependent diabetes mellitus . Wien Klin Wochenschr 1978;20:747-751. 13. Mowat AG, Baum J: Polymorphonuclear leukocytes chemotaxis in patients with bacterial infections . Br Med J 1971;3:617-619.Crossref 14. Hernandez HN, Henson PM, Otani A, et al: Chemotactic response to human C3a and C5a anaphylatoxins: Evaluation of C3a and C5a leukotaxis in vitro and under simulated in vivo conditions . J Immunol 1977;120:109-115. 15. Frei PC, Hermanovicz A, Pécoud A: Chemotaxis of human polymorphonuclears in vitro: V. Role of the nonsegmented neutrophils and of the experimental conditions in the impairment of chemotaxis observed during bacterial infections . J Lab Clin Med 1978;92:577-583. 16. Hill HR, Book LS, Hemming VG, et al: Defective neutrophil chemotactic responses in patients with recurrent episodes of otitis media and chronic diarrhea . Am J Dis Child 1977;131:433-436. 17. Giebink GS, Mills EL, Huff JS, et al: Host responses in otitis-prone children . Pediatr Res 1976;10:513.Crossref 18. Corberand J, Nguyen F, Laharrague P, et al: Polymorphonuclear functions and aging in humans . J Am Geriatr Soc 1981;29:391-397. 19. Boxer LA, Watanabe AM, Rister M, et al: Correction of leukocyte function in Chediak-Higashi syndrome by ascorbate . N Engl J Med 1976;295:1041-1045.Crossref 20. Goetzl EJ, Wasserman S, Gigli J, et al: Enhancement of random migration and chemotactic response of human leukocytes by ascorbic acid . J Clin Invest 1974;53:813-818.Crossref 21. Sandler JA, Gallin JI, Vaughan M: Effects of serotonin carbonylcholine, and ascorbic acid on leukocyte cyclic GMP and chemotaxis . J Cell Biol 1975;67:480-484.Crossref 22. Wright DG, Kirkpatrick CH, Gallin JI: Effects of levamisole on normal and abnormal leucocyte locomotion . J Clin Invest 1977;59:941-950.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

Malignant External Otitis and Polymorphonuclear Leukocyte Migration Impairment: Improvement With Ascorbic Acid

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1982.00790500058015
Publisher site
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Abstract

Abstract • Malignant external otitis (MEO) is a rare disease due to a Pseudomonas infection of the external ear occurring in an elderly patient with uncontrolled diabetes mellitus. Its high mortality raises the question of an alteration of the defense mechanisms of the body. A 58-year-old man was affected with MEO, and after several months of unsuccessful treatment, a study of the function of his polymorphonuclear neutrophil leukocytes (PMNs) revealed a defect of the migration capability. Ascorbic acid (vitamin C) was proved in vitro to be able to improve the results of the migration test. The patient was treated for one month with ascorbic acid and, parallel to the normalization of the chemotaxis test results, the ear lesions healed. The mechanism of such an alteration of the PMN function, implying several factors (the active infection, old age, and diabetes mellitus), is still unclear. Nevertheless, it is certainly important to test the PMN function in patients with MEO and treat them with immunomodulators. (Arch Otolaryngol 1982;108:122-124) References 1. Chandler JR: Malignant external otitis . Laryngoscope 1968;78:1257-1294.Crossref 2. Nelson RD, Quie PG, Simmons RL: Chemotaxis under agarose: A new and simple method for measuring chemotaxis and spontaneous migration of human polymorphonuclear leukocytes and monocytes . J Immunol 1975;115:1650-1656. 3. Baehner RL, Nathan DG: Quantitative nitroblue tetrazolium test in chronic granulomatous disease . N Engl J Med 1968;278:971-976.Crossref 4. Brandt L: Studies on the phagocytic activity of neutrophilic leukocytes . Scand J Haematol , suppl 2, 1967, pp 16-20. 5. Castro O, Andriole VT, Finch SC: Whole blood phagocytic and bactericidal activity for Staphylococcus aureus . J Lab Clin Med 1972;80:857-870. 6. Schiffman E, Corcoran BA, Aswanikumar S: Molecular events in the response of neutrophils to synthetic f-Met chemotactic peptides: Demonstration of a specific receptor , in Gallin JI, Quie PJ (eds): Leukocyte Chemotaxis: Methods, Physiology, and Clinical Implication . New York, Raven Press, 1978. 7. Gallin JI, Wolff SM: Leukocyte chemotaxis: Physiological considerations and abnormalities . Clin Haematol 1975;4:567-607. 8. Hill HR, Sauls SH, Dettloff JF, et al: Impaired leukotactic responsiveness in patients with juvenile diabetes mellitus . Clin Immunol Immunopathol 1974;2:395.Crossref 9. Miller ME, Baker L: Leukocyte function in juvenile diabetes mellitus: Humoral and cellular aspects . J Pediatr 1972;81:979-982.Crossref 10. Mowat AG, Baum J: Chemotaxis and polymorphonuclear leukocytes from patients with diabetes mellitus . N Engl J Med 1971;284:621-627.Crossref 11. Molenaar DM, Palumbo PJ, Wilson WR, et al: Leukocyte chemotaxis in diabetic patients with their nondiabetic first degree relatives . Diabetes 1976;25:880-883. 12. Endler AT, Zielinsk CH, Schernthaner GC, et al: The influence of metabolic control on chemotactic activity in insulin-dependent diabetes mellitus . Wien Klin Wochenschr 1978;20:747-751. 13. Mowat AG, Baum J: Polymorphonuclear leukocytes chemotaxis in patients with bacterial infections . Br Med J 1971;3:617-619.Crossref 14. Hernandez HN, Henson PM, Otani A, et al: Chemotactic response to human C3a and C5a anaphylatoxins: Evaluation of C3a and C5a leukotaxis in vitro and under simulated in vivo conditions . J Immunol 1977;120:109-115. 15. Frei PC, Hermanovicz A, Pécoud A: Chemotaxis of human polymorphonuclears in vitro: V. Role of the nonsegmented neutrophils and of the experimental conditions in the impairment of chemotaxis observed during bacterial infections . J Lab Clin Med 1978;92:577-583. 16. Hill HR, Book LS, Hemming VG, et al: Defective neutrophil chemotactic responses in patients with recurrent episodes of otitis media and chronic diarrhea . Am J Dis Child 1977;131:433-436. 17. Giebink GS, Mills EL, Huff JS, et al: Host responses in otitis-prone children . Pediatr Res 1976;10:513.Crossref 18. Corberand J, Nguyen F, Laharrague P, et al: Polymorphonuclear functions and aging in humans . J Am Geriatr Soc 1981;29:391-397. 19. Boxer LA, Watanabe AM, Rister M, et al: Correction of leukocyte function in Chediak-Higashi syndrome by ascorbate . N Engl J Med 1976;295:1041-1045.Crossref 20. Goetzl EJ, Wasserman S, Gigli J, et al: Enhancement of random migration and chemotactic response of human leukocytes by ascorbic acid . J Clin Invest 1974;53:813-818.Crossref 21. Sandler JA, Gallin JI, Vaughan M: Effects of serotonin carbonylcholine, and ascorbic acid on leukocyte cyclic GMP and chemotaxis . J Cell Biol 1975;67:480-484.Crossref 22. Wright DG, Kirkpatrick CH, Gallin JI: Effects of levamisole on normal and abnormal leucocyte locomotion . J Clin Invest 1977;59:941-950.Crossref

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Feb 1, 1982

References