1. TGF-b participates in regulation of the middle ear inflammation. 2. TGF-b is a negative regulator of acute inflammation in the middle ear. Early activation of TGF-b together with another antiinflammatory cytokine, IL-10, in the course of acute otitis media demonstrates the involvement of TGF-b in the correct resolution of acute inflammatory response. TGF-b as well as IL-10 can inactivate macrophages and inhibit pro-inflammatory cytokine production at the site of inflammation (Fig. 2 ). 3. TGF-b can be also involved in down-regulation of bacterial-induced MUC5AC mucin production, and that is the additional evi- Thus, TGF-b can contribute to the pathogenesis and persistence of chronic OME in many ways.