Otitis Media With Effusion (OME) and Eustachian Tube Dysfunction: The Role of Allergy and Immunity-An EAACI Position Paper
Por:
Klimek L, Brough HA, Arasi S, Toppila-Salmi S, Bergmann C, Jutel M, Bousquet J, Hox V, Gevaert P, Tomazic PV, Rondón Segovia C, Cingi C, Cuevas M, Gröger M, Huber P, Reitsma S, Rudenko M, Maza-Solano J, Gane S, Karavelia A, van Gerven L, Schiappoli M, Bozkurt B, Becker S, Chaker A, Wollenberg B, Mösges R, Huppertz T, Hagemann J, Palomares O, Bärhold F, Pfaar O, Del Giacco S, Bonadonna P, Moreira A, Agache I, Akdis CA, Fokkens W, Walusiak-Skorupa J, de Las Vecillas L, Alvaro-Lozano M, Giovannini M, Untersmayr E, Feleszko W, Cianferoni A, Sahiner UM, Eguiluz-Gracia I, Shamji M and Torres Jaén MJ
Publicada:
1 sep 2025
Ahead of Print:
1 abr 2025
Resumen:
IgE-mediated allergies play a significant role in respiratory diseases. Given the similar mucosal epithelium of the upper and lower respiratory tracts and their shared (patho)physiological immune responses, the "unified airways" concept views these tracts as a single system. Recently, this model has been extended to include the middle ear, with studies confirming that the Eustachian tube and middle ear are both anatomically and functionally part of the upper airways. However, the relationship between allergies and middle ear disorders remains controversial, with conflicting findings regarding pathogenesis and treatment. The increasing prevalence of allergies highlights the importance of further research. In Germany, the current sensitization rate to aeroallergens is 33.6%, with similar trends across Europe, where rates commonly range up to 30%. This widespread increase underscores the urgent need for a deeper understanding of the correlation between allergies and middle ear disorders across diverse European populations. Ineffective pharmacotherapy or possibly harmful medication for acute and chronic OME, such as systemic steroids, is most likely used globally in an uninformed way, due to a lack of evidence on the connection between allergic inflammation and eustachian tube dysfunction. Further research is essential to clarify the mechanisms linking IgE-mediated allergies to middle ear pathologies and to develop effective treatment strategies. Addressing these knowledge gaps is critical for improving patient outcomes and managing the rising burden of allergic diseases.
Filiaciones:
Klimek L:
Center for Allergy and Rhinology, Wiesbaden, Germany
Brough HA:
Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital, London, UK
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Arasi S:
Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, Rome, Italy
Toppila-Salmi S:
Department of Otorhinolaryngology, University of Eastern Finland, Joensuu and Kuopio, Finland and Wellbeing Services County of Pohjois-Savo, Kuopio, Finland
Department of Allergology, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Bergmann C:
Department of Otorhinolaryngology, RKM740 Interdisciplinary Clinics, Düsseldorf, Germany
Jutel M:
Department of Clinical Immunology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
ALL-MED Medical Research Institute, Wroclaw, Poland
Bousquet J:
Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany
University Hospital Montpellier, France and MACVIA-France, Montpellier, France
Hox V:
Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
Gevaert P:
Department of Otorhinolaryngology, Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
Tomazic PV:
Department of General Otorhinolaryngology, H&N Surgery, Medical University of Graz, Graz, Austria
Rondón Segovia C:
Allergy Unit, Hospital Regional Universitario de Malága, Malaga, Spain
Allergy Group, Biomedical Research Institute of Malaga (IBIMA)-BIONAND Platform, RICORS Inflammatory Diseases, Malaga, Spain
Cingi C:
Department of Otorhinolaryngology, Eskisehir Osmangazi University, Eskisehir, Turkey
Cuevas M:
Department of Otorhinolaryngology Head and Neck Surgery, Technische Universität Dresden, Faculty of Medicine (And University Hospital) Carl Gustav Carus, Dresden, Germany
Gröger M:
Department of Otorhinolaryngology, Grosshadern Medical Center of the University of Munich, Munich, Germany
Huber P:
Department of Otorhinolaryngology, Grosshadern Medical Center of the University of Munich, Munich, Germany
Reitsma S:
Otolaryngology-HNS, University of Amsterdam, Amsterdam, the Netherlands
Rudenko M:
The London Allergy and Immunology Centre, London, UK
Maza-Solano J:
Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Sevilla, Spain
Gane S:
The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
Royal National Throat Nose and Ear Hospital, UCLH, London, UK
Karavelia A:
ENT Department, General Hopsital of Nafplio, Nafplio, Greece
van Gerven L:
Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
Schiappoli M:
Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
Bozkurt B:
Department of Ophthalmology, Selcuk University Faculty of Medicine, Konya, Turkey
Becker S:
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center, Tübingen, Germany
Chaker A:
Technical University of Munich, TUM School of Medicine and Health, TUM University Hospital, Munich, Germany
Wollenberg B:
Technical University of Munich, TUM School of Medicine and Health, TUM University Hospital, Munich, Germany
Mösges R:
IMSB, Medical Faculty, University Cologne, Cologne, Germany
Huppertz T:
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center, Mainz, Germany
Hagemann J:
Center for Allergy and Rhinology, Wiesbaden, Germany
Palomares O:
Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University, Madrid, Spain
Bärhold F:
Center for Allergy and Rhinology, Wiesbaden, Germany
Pfaar O:
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
Del Giacco S:
Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
Bonadonna P:
Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
Moreira A:
EPIUnit-Instituto de Saúde Pública, Universidade do Porto, and Laboratório de Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Porto, Portugal
Immunoallergology Service, Centro Hospitalar Universitário São João, Porto, Portugal
Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, Universidade do Porto, Porto, Portugal
Agache I:
Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
Akdis CA:
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Fokkens W:
Department of Otorhinolaryngology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
Walusiak-Skorupa J:
Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
de Las Vecillas L:
Department of Allergy, La Paz University Hospital, Madrid, Spain
IdiPAZ, Madrid, Spain
Alvaro-Lozano M:
Pediatric Allergology and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain
Giovannini M:
Department of Health Sciences, University of Florence, Florence, Italy
Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Untersmayr E:
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Feleszko W:
Department of Pediatric Allergy and Pneumonology, Medical University of Warsaw, Warsaw, Poland
Cianferoni A:
The Children's Hospital of Philadelphia, University of Pennsylvania, Pediatrics Allergy and Immunology Division, Philadelphia, USA
Sahiner UM:
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
Eguiluz-Gracia I:
Allergy Unit, Hospital Regional Universitario de Malága, Malaga, Spain
Allergy Group, Biomedical Research Institute of Malaga (IBIMA)-BIONAND Platform, RICORS Inflammatory Diseases, Malaga, Spain
Shamji M:
National Heart and Lung Institute, Imperial College London, London, United Kingdom, NIHR Imperial Biomedical Research Centre, London, UK
Torres Jaén MJ:
Allergy Unit, Hospital Regional Universitario de Malága, Malaga, Spain
Allergy Group, Biomedical Research Institute of Malaga (IBIMA)-BIONAND Platform, RICORS Inflammatory Diseases, Malaga, Spain
Green Accepted, Green Submitted, Bronze
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