Evidence map›Paper›PMID 40820403›Full record

ArticleAudiology & neuro-otology2026

Mapping the Regenerative Pattern in the Human Tympanic Membrane.

Elnaz Sepehri, Cecilia Engmér Berglin, Yan Liu, Per Olof Eriksson, Magnus von Unge, Julia Arebro

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Article in Audiology & neuro-otology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Elnaz SepehriDivision of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden, elnaz.sepehri@ki.se.
Cecilia Engmér BerglinDivision of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Yan LiuDepartment of Clinical Molecular Biology (EpiGen), Akershus University Hospital, Nordbyhagen, Norway.
Per Olof ErikssonDepartment of Surgical Sciences, Otorhinolaryngology, Uppsala University, Uppsala, Sweden.
Magnus von UngeInstitute of Clinical Medicine, Department of Otorhinolaryngology & Head and Neck Surgery, University of Oslo, Oslo, Norway.
Julia ArebroDivision of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: The reason why chronic tympanic membrane (TM) perforations fail to heal is an enigma. A better insight into the premises and cellular events in this process is fundamental. Previous large studies on human TMs are lacking. The main objective of the present study was to map potential stem cells in the human TM and to address the regenerative capacity in the TM keratinocytes. Further, the study aimed to assess the regenerative premises for three regions of the TM: the malleus, the annulus, and the unattached portion of the pars tensa (UPT), including different anatomical levels (inferior, intermediate, and superior) within each region.

methodsTen healthy human TMs were harvested during lateral skull base surgery. Using immunohistochemistry, the TMs were stained for α6 and β1 integrin, CK19, p63, and Ki-67. Semi-quantification was made with two single-blinded observers scoring the staining of the slides. Inter-rater reliability was evaluated with weighted Cohen's kappa, and group differences between the mean grading were further calculated.

resultsAntibodies for α6 and β1 integrin, CK19, p63, and Ki-67 could be detected along the malleus, annulus, and UPT of human TMs displaying diversity in the regenerative capacity of the human TM. The staining of Ki-67 and p63 was more prevalent in the annulus and malleus compared to in the UPT. α6 staining was more prevalent in the annulus, while CK19 staining was more prevalent in the malleus. Finally, several antibodies displayed a higher staining intensity in the inferior anatomical levels of the TM.

conclusionThe present study shows the presence of putative stem cells in all regions of the human TM, with a stronger regenerative capacity close to the annulus and malleus compared to the UPT. These findings may set a baseline for the localization and diversity of putative stem cells in the human TM. </p>.

Indexed as

KeratinocytesRegenerationStem CellsTympanic MembraneAdultFemaleHumansImmunohistochemistryIntegrin alpha6Keratin-19Ki-67 AntigenMaleMalleusMembrane ProteinsMiddle AgedCKAP4 protein, humanIntegrin alpha6Keratin-19Ki-67 AntigenMembrane ProteinsHumanImmunohistochemistryProgenitorStem cellTympanic membrane

Identifiers

PMID40820403
PMCPMC12503694

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.