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ObjectivesInadequate antibody responses to pathogens may lead to the recurrence of otitis media with effusion (OME). Although B-cell production by antibodies is controlled by transcription factors, the status of these factors has not been assessed in patients with OME.MethodsExpression of immunoglobulin was measured by enzyme-linked immunosorbent assay. Expression of transcription factors Bcl-6, Blimp-1, Pax-5, and XBP-1 was assessed by RT-PCR in the middle-ear fluid of 29 children with >4 OME episodes in 12 months or >3 episodes in 6 months (the OME-prone group) and in 32 children with <3 OME episodes in 12 months (OME group). The relationship between recurrence of OME and expression levels of immunoglobulins and transcription factors in middle-ear fluid was determined.ResultsThe concentration of IgA in middle-ear fluid was significantly lower in the OME-prone than in the OME group, as was the expression of mRNA encoding the transcription factors Blimp-1 and XBP-1 (P<0.05 each). Expression of mRNA encoding the transcription factors Bcl-6 and Pax-5 was more intense in the OME-prone than in the OME group, but these differences were not significant (P>0.05).ConclusionLower concentrations of IgA, Blimp-1 and XBP-1 in middle ear fluid of patients with OME may be related to OME recurrence and chronicity.