Upper airway immunity (UAI)
Research type
Research Study
Full title
Topographical and functional characterisation of adeno-tonsillar immune surveillance cells and their relationship to otitis media in children
IRAS ID
252734
Contact name
Michael Mather
Contact email
Sponsor organisation
Newcastle Hospitals NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Otitis media (OM) is the medical term for an ear infection which occurs behind the ear drum (i.e. in the ‘middle ear’). It is the most common infection occurring in children and is also the most common reason for children to have hearing loss, need antibiotics, and to have surgery.
Our current approach to treatment is unsustainable; firstly, due to the costs involved (>£2000/operation). Secondly, due to of risks of surgery (bleeding/permanent ear drum perforation). Thirdly, recently published data has shown that removing tonsils and adenoids leads to increased long-term risks of allergic and respiratory diseases.
Research has identified that the tonsils and adenoids (tissue at back of the mouth and nose) are important in setting up our immune response to bacteria and viruses, and that problems arising here may be linked to OM. Presently the immune cells active in both tonsils/adenoids and in the lining (mucosa) of the middle ear are not well understood and this is limiting our ability to develop much-needed new treatments.
We propose to retain tonsils which are normally thrown away, and to take a small (1mm) biopsy of adenoids from patients undergoing routine surgery to remove the tonsils/adenoids. Age-matched patients having surgery where the middle ear is accessed shall have a mucosal biopsy. We will then use cutting-edge laboratory techniques to provide an ‘atlas’ of the cells present at these location which are involved in immunity and we shall analyse their function by looking at their genetic instructions. This will lead to identification of pathways we can manipulate to reduce persistent inflammation in OM, which will provide a route towards reducing our unsustainable dependence on antibiotics and expensive surgery. It will also help us understand why surgical removal of tonsils and adenoids leads to increased-long term risk of allergic and respiratory disease as children grow up.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
18/WM/0318
Date of REC Opinion
15 Oct 2018
REC opinion
Further Information Favourable Opinion