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Based on these observations, we investigated if human middle ear epithelial cells could release IL-1 alpha upon exposure to a lysate of NTHi and if this cytokine could have a synergistic effect on beta-defensin 2 up-regulation by the bacterial components.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The studies described herein were carried out using epithelial cell lines as well as a murine model of acute otitis media (OM). Human cytokine macroarray analysis was performed to detect the released cytokines in response to NTHi exposure. Real time quantitative PCR was done to compare the induction of IL-1 alpha or beta-defensin 2 mRNAs and to identify the signaling pathways involved. Direct activation of the beta-defensin 2 promoter was monitored using a beta-defensin 2 promoter-Luciferase construct. An IL-1 alpha blocking antibody was used to demonstrate the direct involvement of this cytokine on DEFB4 induction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Middle ear epithelial cells released IL-1 alpha when stimulated by NTHi components and this cytokine acted in an autocrine\/paracrine synergistic manner with NTHi to up-regulate beta-defensin 2. This synergistic effect of IL-1 alpha on NTHi-induced beta-defensin 2 up-regulation appeared to be mediated by the p38 MAP kinase pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate that IL-1 alpha is secreted by middle ear epithelial cells upon exposure to NTHi components and that it can synergistically act with certain of these molecules to up-regulate beta-defensin 2 via the p38 MAP kinase pathway.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-6-12","type":"journal-article","created":{"date-parts":[[2006,1,27]],"date-time":"2006-01-27T19:15:35Z","timestamp":1138389335000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Synergistic effect of interleukin 1 alpha on nontypeable Haemophilus influenzae-induced up-regulation of human beta-defensin 2 in middle ear epithelial cells"],"prefix":"10.1186","volume":"6","author":[{"given":"Sung-Kyun","family":"Moon","sequence":"first","affiliation":[]},{"given":"Haa-Yung","family":"Lee","sequence":"additional","affiliation":[]},{"given":"Huiqi","family":"Pan","sequence":"additional","affiliation":[]},{"given":"Tamotsu","family":"Takeshita","sequence":"additional","affiliation":[]},{"given":"Raekil","family":"Park","sequence":"additional","affiliation":[]},{"given":"Kiweon","family":"Cha","sequence":"additional","affiliation":[]},{"given":"Ali","family":"Andalibi","sequence":"additional","affiliation":[]},{"given":"David J","family":"Lim","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2006,1,24]]},"reference":[{"issue":"1","key":"276_CR1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1001\/archotol.1985.00800030044003","volume":"111","author":"TJ Fria","year":"1985","unstructured":"Fria TJ, Cantekin EI, Eichler JA: Hearing acuity of children with otitis media with effusion. 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