Progress in Research on Nrf2 and TGF-β1 in Chronic Suppurative Otitis Media

Chronic suppurative otitis media (CSOM) is a suppurative inflammatory disease involving the mucosa and periosteum of the middle ear and may extend into the bony structures. It is characterized primarily by intermittent otorrhea, tympanic membrane perforation, and hearing loss. With advances in modern medical research, investigations of CSOM have increasingly extended to the genetic level, revealing that its onset is not solely attributable to infection by pathogenic microorganisms but is also a consequence of dysregulated immune responses. Nuclear factor erythroid 2-related factor 2 (Nrf2) participates in the regulation of oxidative injury mainly by modulating the expression of antioxidant genes. Transforming growth factor-β1 (TGF-β1), by contrast, is a multifunctional cytokine that regulates inflammatory responses, immune function, as well as cellular growth and differentiation. To further clarify the anti-inflammatory role of Nrf2 and its influence on the course of CSOM, and to elucidate the dose-dependent effects of TGF-β1 on disease outcomes and on inflammatory and immunomodulatory processes, this review summarizes the basic profiles of Nrf2 and TGF-β1 and discusses their roles and underlying mechanisms in CSOM, thereby providing theoretical evidence and potential new perspectives for the future prevention and treatment of this disease.