Proliferation markers, remodelling factors and antimicrobial peptides in cholesteatoma

Introduction: The complex appearance of proliferation markers, remodelling factors, antimicrobial peptides and genes still have not been studied together despite their possible crucial role in the development of cholesteatoma. Therefore, the aim of this study was complex research of appearance and distribution of remodelling markers, local tissue defensins of the cholesteatoma tissue. Materials and methods: Four cholesteatoma tissue samples were obtained from children, 5 cholesteatoma specimens were obtained from adults, and 7 deep external meatal skin controls were obtained from cadavers. Tissues were stained for Ki-67, MMP-2, TIMP-2, HβD–2, HβD–4 immunohistochemically. Non-parametric statistic, Mann–Whitney and Spearman’s coefficient were used. Results: A statistically significant difference was seen between the numbers of HβD-2, HβD-4 positive cells in perimatrix in comparison to control group connective tissue. A very strong positive correlation was detected in control tissue epithelium between Ki-67 and TIMP-2; between MMP-2 and TIMP-2. A strong correlation was detected in epithelium between Ki-67 and MMP-2. Conclusions: • Ki-67 correlations with HβD-2 and HβD-4 in cholesteatoma indicate the direct link between the proliferation and expression of antimicrobial peptides. • HβD-2 seems to be the most important factor for antimicrobial defence, but the correlations between HβD-2 and HβD-4 suggest their common action against chronic middle ear infection in case of choleasteatoma. • Higher levels of MMP-2 positive cells in cholesteatoma and lower levels of TIMP-2 positive cells suggest the prevalence of enzymatic processes over their suppression, possibly being characteristic for cholesteatoma of different age patients.