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Niu X, Chen Y, Zhong Y, Xiao X. The relationship between serum homocysteine levels and sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2091-2097. [PMID: 36658368 DOI: 10.1007/s00405-023-07829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE There was disagreement over the association between serum/plasma homocysteine (HCY) levels and sudden sensorineural hearing loss (SSNHL). Through the use of a meta-analysis, this study aims to determine whether there is a significant difference in serum homocysteine levels between the SSNHL group and the control group. DESIGN The Cochrane Library, EMBASE, and PubMed databases were all thoroughly searched. The two independent reviewers thoroughly examined the initially searched articles. The data results were calculated by standard mean difference (SMD) or odds ratios (OR). Review Manager (version 5.3) was applied to statistical data. STUDY SAMPLE There were 766 participants in the 6 trials with continuous outcomes that were part of the meta-analysis A. In addition, meta-analysis B, which included 961 people, contained a total of 3 studies with dichotomous results. RESULTS Both meta-analyses revealed the same conclusion that serum/plasma HCY levels in the SSNHL patients are higher than those in the controls (SMD 0.41, 95 % confidence interval (CI) 0.11 to 0.72, P < 0.01; OR 3.27, 95 % CI 2.16 to 4.94, P < 0.01). CONCLUSION This study demonstrated that the SSNHL patients' serum/plasma HCY levels were greater than those of the control group.
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Affiliation(s)
- Xun Niu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuzhang Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zhong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiyue Xiao
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Wei Z, Chang K, Fan C. Association between the 4G/5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene and sudden sensorineural hearing loss in Caucasian population: a meta-analysis. Eur Arch Otorhinolaryngol 2020; 278:2203-2208. [PMID: 32901365 DOI: 10.1007/s00405-020-06305-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To clarify the association between the 4G/5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) and sudden sensorineural hearing loss (SSNHL). METHODS A systematic literature search of related studies up to August 30, 2019 in the PubMed and Embase databases was performed, and the results were displayed by odds ratios (ORs), and their 95% confidence intervals (CIs) were assessed using the STATA12.0 software using an allele model and a recessive model. RESULTS Three eligible studies covering 519 subjects (241 cases, 278 controls) were identified. No statistically significant association was detected between the 4G/5G polymorphism and SSNHL in any model (allele model: 5G vs. 4G, OR = 0.952, 95% CI = 0.765-1.185, P = 0.662; recessive model: 5G/5G vs. 4G/5G + 4G/4G, OR = 0.841, 95% CI = 0.415-1.704, P = 0.631). CONCLUSIONS There is no statistically significant association between the 4G/5G polymorphism of PAI-1 gene and SSNHL in the Caucasian population, and well-designed studies covering more patients and institutions should be conducted.
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Affiliation(s)
- Zhenxing Wei
- Department of Otorhinolaryngology-Head and Neck Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Middle No. 288 Zhongzhou Road, Luoyang, 471000, Henan, China.
| | - Kunpeng Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Middle No. 288 Zhongzhou Road, Luoyang, 471000, Henan, China
| | - Chongsheng Fan
- Department of Otorhinolaryngology-Head and Neck Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Middle No. 288 Zhongzhou Road, Luoyang, 471000, Henan, China
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3
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Scuto M, Di Mauro P, Ontario ML, Amato C, Modafferi S, Ciavardelli D, Trovato Salinaro A, Maiolino L, Calabrese V. Nutritional Mushroom Treatment in Meniere's Disease with Coriolus versicolor: A Rationale for Therapeutic Intervention in Neuroinflammation and Antineurodegeneration. Int J Mol Sci 2019; 21:E284. [PMID: 31906226 PMCID: PMC6981469 DOI: 10.3390/ijms21010284] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
Meniere's disease (MD) represents a clinical syndrome characterized by episodes of spontaneous vertigo, associated with fluctuating, low to medium frequencies sensorineural hearing loss (SNHL), tinnitus, and aural fullness affecting one or both ears. To date, the cause of MD remains substantially unknown, despite increasing evidence suggesting that oxidative stress and neuroinflammation may be central to the development of endolymphatic hydrops and consequent otholitic degeneration and displacement in the reuniting duct, thus originating the otolithic crisis from vestibular otolithic organs utricle or saccule. As a starting point to withstand pathological consequences, cellular pathways conferring protection against oxidative stress, such as vitagenes, are also induced, but at a level not sufficient to prevent full neuroprotection, which can be reinforced by exogenous nutritional approaches. One emerging strategy is supplementation with mushrooms. Mushroom preparations, used in traditional medicine for thousands of years, are endowed with various biological actions, including antioxidant, immunostimulatory, hepatoprotective, anticancer, as well as antiviral effects. For example, therapeutic polysaccharopeptides obtained from Coriolus versicolor are commercially well established. In this study, we examined the hypothesis that neurotoxic insult represents a critical primary mediator operating in MD pathogenesis, reflected by quantitative increases of markers of oxidative stress and cellular stress response in the peripheral blood of MD patients. We evaluated systemic oxidative stress and cellular stress response in MD patients in the absence and in the presence of treatment with a biomass preparation from Coriolus. Systemic oxidative stress was estimated by measuring, in plasma, protein carbonyls, hydroxynonenals (HNE), and ultraweak luminescence, as well as by lipidomics analysis of active biolipids, such as lipoxin A4 and F2-isoprostanes, whereas in lymphocytes we determined heat shock proteins 70 (Hsp72), heme oxygenase-1 (HO-1), thioredoxin (Trx), and γ-GC liase to evaluate the systemic cellular stress response. Increased levels of carbonyls, HNE, luminescence, and F2-isoprostanes were found in MD patients with respect to the MD plus Coriolus-treated group. This was paralleled by a significant (p < 0.01) induction, after Coriolus treatment, of vitagenes such as HO-1, Hsp70, Trx, sirtuin-1, and γ-GC liase in lymphocyte and by a significant (p < 0.05) increase in the plasma ratio-reduced glutathione (GSH) vs. oxidized glutathione (GSSG). In conclusion, patients affected by MD are under conditions of systemic oxidative stress, and the induction of vitagenes after mushroom supplementation indicates a maintained response to counteract intracellular pro-oxidant status. The present study also highlights the importance of investigating MD as a convenient model of cochlear neurodegenerative disease. Thus, searching innovative and more potent inducers of the vitagene system can allow the development of pharmacological strategies capable of enhancing the intrinsic reserve of vulnerable neurons, such as ganglion cells to maximize antidegenerative stress responses and thus providing neuroprotection.
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Affiliation(s)
- Maria Scuto
- Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica. Via Santa Sofia, 97, 95123 Catania, Italy; (M.S.); (M.L.O.); (S.M.); (A.T.S.)
| | - Paola Di Mauro
- Department of Medical and Surgery Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (P.D.M.); (C.A.); (V.C.)
| | - Maria Laura Ontario
- Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica. Via Santa Sofia, 97, 95123 Catania, Italy; (M.S.); (M.L.O.); (S.M.); (A.T.S.)
| | - Chiara Amato
- Department of Medical and Surgery Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (P.D.M.); (C.A.); (V.C.)
| | - Sergio Modafferi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica. Via Santa Sofia, 97, 95123 Catania, Italy; (M.S.); (M.L.O.); (S.M.); (A.T.S.)
| | - Domenico Ciavardelli
- School of Human and Scocial Science, “Kore” University of Enna, Via Salvatore Mazza 1, 94100 Enna, Italy;
- Centro Scienze dell’Invecchiamento e Medicina Traslazionale-CeSI-Met, via Luigi Polacchi 11, 66100 Chieti, Italy
| | - Angela Trovato Salinaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica. Via Santa Sofia, 97, 95123 Catania, Italy; (M.S.); (M.L.O.); (S.M.); (A.T.S.)
| | - Luigi Maiolino
- Department of Medical and Surgery Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (P.D.M.); (C.A.); (V.C.)
| | - Vittorio Calabrese
- Department of Medical and Surgery Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (P.D.M.); (C.A.); (V.C.)
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Koide Y, Teranishi M, Sugiura S, Uchida Y, Nishio N, Kato K, Otake H, Yoshida T, Otsuka R, Ando F, Shimokata H, Hasegawa Y, Nakashima T, Sone M. Association between Uncoupling Protein 2 Gene Ala55val Polymorphism and Sudden Sensorineural Hearing Loss. J Int Adv Otol 2019; 14:166-169. [PMID: 30100544 DOI: 10.5152/iao.2018.5442] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The pathology of sudden sensorineural hearing loss, which is known as sudden deafness (SD), remains unknown. The purpose of this study was to investigate the association between mitochondrial uncoupling protein 2 (UCP2) polymorphism and SD risk. MATERIALS AND METHODS We compared 83 patients suffering from SD and 2048 controls who participated in the Longitudinal Study of Aging at the National Institute for Longevity Sciences. Multiple logistic regression was used to calculate the odds ratios (ORs) for SD with a polymorphism of the UCP2 (rs660339) gene. RESULTS Under the additive model of inheritance, UCP2 polymorphisms showed significant association with a SD risk. The OR was 1.468 (95% confidence interval, 1.056-2.040) with an adjustment for any past history, such as diabetes, dyslipidemia, or hypertension, and for age and sex. CONCLUSION Our results imply that the UCP2 (rs660339) polymorphism has a significant association with the risk of developing SD.
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Affiliation(s)
- Yusuke Koide
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Saiko Sugiura
- Toyota Josui Mental Clinic, Aichi, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yasue Uchida
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Aichi, Japan; Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ken Kato
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hironao Otake
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rei Otsuka
- Section of National Institute for Longevity Sciences, Longitudinal Study of Aging Aichi, Japan
| | - Fujiko Ando
- Section of National Institute for Longevity Sciences, Longitudinal Study of Aging (NISL-LSA), National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroshi Shimokata
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan; Section of National Institute for Longevity Sciences, Longitudinal Study of Aging Aichi, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tinelli C, Di Pino A, Ficulle E, Marcelli S, Feligioni M. Hyperhomocysteinemia as a Risk Factor and Potential Nutraceutical Target for Certain Pathologies. Front Nutr 2019; 6:49. [PMID: 31069230 PMCID: PMC6491750 DOI: 10.3389/fnut.2019.00049] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/03/2019] [Indexed: 01/08/2023] Open
Abstract
Hyperhomocysteinemia is recognized as a risk factor for several diseases, including cardiovascular and neurological conditions. Homocysteine (HCys) is a key metabolite involved in the biosynthesis and metabolism of methionine (Met), which plays a pivotal role in the physiological cell's life cycle. The biochemistry of Met is finely regulated by several enzymes that control HCys concentration. Indeed, balanced activity among the enzymes is essential for the cell's well-being, while its malfunction could raise HCys concentration which can lead to the onset of several pathological conditions. The HCys concentration increase seems to be caused mainly by the widely diffused polymorphisms of several enzymes. Nowadays, a blood test can easily detect elevated concentrations of HCys, referred to as Hyperhomocysteinemia (HHCys). Prolonged exposure to this condition can lead to the onset of cardiovascular disease and can lead to the development of atherosclerosis, stroke, inflammatory syndromes like osteoporosis and rheumatism, as well as neuronal pathologies including Alzheimer's and Parkinson's diseases. In this review, we analyzed the literature of several pathological conditions in which the molecular pathways of HHCys are involved. Interestingly, several observations indicate that the calibrated assumption of correct doses of vitamins such as folic acid, vitamin B6, vitamin B12, and betaine may control HHCys-related conditions.
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Affiliation(s)
- Caterina Tinelli
- Golgi Cenci Foundation, Abbiategrasso, Italy
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, Italy
| | - Antonella Di Pino
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, Italy
| | - Elena Ficulle
- Laboratory of Neurobiology in Translational Medicine, Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Serena Marcelli
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, Italy
| | - Marco Feligioni
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, Italy
- Laboratory of Neurobiology in Translational Medicine, Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
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Cao Z, Gao J, Huang S, Xiang H, Zhang C, Zheng B, Zhan X, Chen R, Chen B. Genetic Polymorphisms and Susceptibility to Sudden Sensorineural Hearing Loss: A Systematic Review. Audiol Neurootol 2019; 24:8-19. [PMID: 30870848 DOI: 10.1159/000497032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/16/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recently, genetic factors have been considered as an important risk factor for sudden sensorineural hearing loss (SSNHL). Many studies analyzed the association between SSNHL and polymorphisms. However, most of them gave inconclusive results. Key Message: We performed a systematic review to find out the association between polymorphisms and susceptibility to SSNHL. Finally, 47 studies involving 5,230 SSNHL patients and 68 genes were included for analysis and discussion of results. Polymorphisms in 26 genes have been suggested to be correlated with the susceptibility to SSNHL. SUMMARY Although a great number of studies support that polymorphisms in genes are associated with susceptibility to SSNHL, we need large multicenter studies, which evaluate multiple single nucleotide polymorphisms in SSNHL patients, to find real genetic risk factors for susceptibility to SSNHL. This is very helpful in designing more effective prevention and treatment strategies for patients with SSNHL.
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Affiliation(s)
- Zaizai Cao
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jinjian Gao
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Saiyu Huang
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Haijie Xiang
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Chuqin Zhang
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Bo Zheng
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Xiang Zhan
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Ruru Chen
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Bobei Chen
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China, .,The Second School of Medicine, Wenzhou Medical University, Wenzhou, China,
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Manche SK, Jangala M, Dudekula D, Koralla M, Akka J. Polymorphisms in folate metabolism genes are associated with susceptibility to presbycusis. Life Sci 2018; 196:77-83. [DOI: 10.1016/j.lfs.2018.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/04/2018] [Accepted: 01/15/2018] [Indexed: 12/14/2022]
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Mirvakili A, Dadgarnia MH, Baradaranfar MH, Atighechi S, Zand V, Ansari A. Role of Platelet Parameters on Sudden Sensorineural Hearing Loss: A Case-Control Study in Iran. PLoS One 2016; 11:e0148149. [PMID: 26829393 PMCID: PMC4734775 DOI: 10.1371/journal.pone.0148149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/13/2016] [Indexed: 01/05/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a common otological disorder characterized by a hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours. It has been established that platelet parameters, such as mean platelet volume, are associated with ischemic heart events, whose clinical manifestations are similar to those of SSNHL. Hence, we aimed to determine if the platelet count, mean platelet volume and platelet distribution width are related to the occurrence and severity of sudden sensorineural hearing loss. A case-control prospective study was conducted in a teaching hospital in Iran. One hundred-eight patients with SSNHL and an equal number of healthy, age- and sex-matched controls were enrolled in the study. Peripheral venous blood samples were collected from the subjects, and the platelet count, mean platelet volume and platelet distribution width were measured with an automated blood cell counter. Analysis of the audiometry and hematological test results using SPSS22 software showed no statistical correlation between the platelet parameters and the occurrence of SSNHL, but correlation coefficients showed a significant correlation between PDW and hearing loss severity in patients group. However, further investigation is required to unequivocally establish the absence of correlation between the platelet parameters and occurrence of SSNHL.
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Affiliation(s)
- Abbas Mirvakili
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
| | - Mohammad Hossein Dadgarnia
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
| | - Mohammad Hossein Baradaranfar
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
| | - Saeid Atighechi
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
| | - Vahid Zand
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
| | - Abdollah Ansari
- Otorhinolaryngology Research Center, Department of Otolaryngology, Head & Neck Surgery, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran
- * E-mail:
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Shu J, Si Y, Yin S, He M. Association between the V Leiden G1691A mutation and sudden sensorineural hearing loss in Italian population: a meta-analysis. Eur Arch Otorhinolaryngol 2015; 273:2467-72. [DOI: 10.1007/s00405-015-3844-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/21/2015] [Indexed: 12/28/2022]
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Shu J, Yin S, Tan AZ, He M. Association between the prothrombin G20210A mutation and sudden sensorineural hearing loss in European population: a meta-analysis. Thromb Res 2014; 135:73-7. [PMID: 25466842 DOI: 10.1016/j.thromres.2014.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 10/29/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Epidemiological studies have reported inconsistent findings on the association between the prothrombin G20210A mutation and sudden sensorineural hearing loss (SSNHL) in European population. The aim of this meta-analysis was to clarify the association of this polymorphism with SSNHL in European population. METHODS PubMed, Embase, and the China National Knowledge Infrastructure (CNKI) were searched up to August 1, 2014. We used STATA12.0 to calculate summary odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Eight studies including 1972 patients were identified. Pooled data showed no significant association between the prothrombin G20210A mutation and risk of SSNHL in European population : A vs. G (OR =1.645, 95% CI:0.78-3.49,POR =0.194); AG vs.GG (OR =1.660, 95% CI:0.77-3.60,POR=0.199). CONCLUSIONS The present meta-analysis suggests that the prothrombin G20210A mutation is not significantly associated with an increased risk of SSNHL in European population.
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Affiliation(s)
- Jingcheng Shu
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shihua Yin
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
| | - An-Zhou Tan
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Meirong He
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
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Kanzaki S, Sakagami M, Hosoi H, Murakami S, Ogawa K. High fibrinogen in peripheral blood correlates with poorer hearing recovery in idiopathic sudden sensorineural hearing loss. PLoS One 2014; 9:e104680. [PMID: 25166620 PMCID: PMC4148242 DOI: 10.1371/journal.pone.0104680] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/16/2014] [Indexed: 11/19/2022] Open
Abstract
Objectives We used hearing tests and peripheral blood sample analyses to characterize the pathology of idiopathic sudden sensorineural hearing loss (ISSNHL) and to identify possible prognostic factors for predicting recovery of hearing loss. Study Design A retrospective, multicenter trial was conducted. Methods Two hundred three patients examined within 7 days after the onset of ISSNHL received prednisone with lipo-prostaglandin E1. Pure-tone auditory tests were performed before and after treatment with these drugs. Blood tests were performed on blood samples collected during the patients’ initial visit to our clinic. Results In all patients, elevated white blood cell (WBC) counts, fasting blood sugar levels, HgbA1c, and erythrocyte sedimentation rate (ESR) significantly correlated with high hearing threshold measurements obtained on the initial visit. High fibrinogen levels, WBC counts, ESR, and low concentrations of fibrinogen degradation products (FDP) were associated with lower hearing recovery rates. Additionally, different audiogram shapes correlated with different blood test factors, indicating that different pathologies were involved. Conclusions High fibrinogen levels measured within seven days after ISSNHL onset correlated with poorer hearing recovery. This may be a consequence of ischemia or infections in the inner ear. The high WBC counts also observed may therefore reflect an immune response to inner ear damage induced by ischemic changes or infections. Our data indicate that therapeutic strategies should be selected based on the timing of initial treatment relative to ISSNHL onset.
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Affiliation(s)
- Sho Kanzaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, School of Medicine, Shinjuku, Tokyo, Japan
- * E-mail:
| | - Masafumi Sakagami
- Department of Otorhinolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hiroshi Hosoi
- Department of Otorhinolaryngology, Nara Medical University, Kashihara, Nara, Japan
| | - Shingo Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Mizuho, Nagoya, Aichi, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, School of Medicine, Shinjuku, Tokyo, Japan
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Shu J, Yin S, Tan AZ, He M. Association between the methylenetetrahydrofolate reductase gene C677T polymorphism and sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 2014; 272:2267-74. [DOI: 10.1007/s00405-014-3198-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/04/2014] [Indexed: 01/16/2023]
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Teranishi M, Uchida Y, Nishio N, Kato K, Otake H, Yoshida T, Suzuki H, Sone M, Sugiura S, Ando F, Shimokata H, Nakashima T. Polymorphisms in genes involved in the free-radical process in patients with sudden sensorineural hearing loss and Ménière's disease. Free Radic Res 2013; 47:498-506. [DOI: 10.3109/10715762.2013.793319] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Teranishi M, Uchida Y, Nishio N, Kato K, Otake H, Yoshida T, Suzuki H, Sone M, Sugiura S, Ando F, Shimokata H, Nakashima T. Polymorphisms in genes involved in oxidative stress response in patients with sudden sensorineural hearing loss and Ménière's disease in a Japanese population. DNA Cell Biol 2012; 31:1555-62. [PMID: 22877234 PMCID: PMC3458618 DOI: 10.1089/dna.2012.1631] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 06/11/2012] [Accepted: 07/05/2012] [Indexed: 02/02/2023] Open
Abstract
The etiologies of idiopathic sudden sensorineural hearing loss (SSNHL) and Ménière's disease remain unclear. Recently, accumulating evidence has demonstrated that oxidative stress is related to the pathology of inner ear disease. Because genetic factors may contribute partly to the etiologies of SSNHL and Ménière's disease, we investigated the associations between genetic polymorphisms located in oxidative stress response genes and susceptibility to SSNHL and Ménière's disease. We compared 84 patients affected by SSNHL, 82 patients affected by Ménière's disease, and 2107 adults (1056 men and 1051 women; mean age, 59.2 years; range, 40-79 years) who participated in the National Institute for Longevity Sciences, Longitudinal Study of Aging. Multiple logistic regression was used to calculate odds ratios for SSNHL and Ménière's disease in individuals with polymorphisms in the genes glutathione peroxidase 1 (GPX1) (Pro198Leu, rs1050450), paraoxonase 1 (PON1) (Gln192Arg, rs662; and Met55Leu, rs854560), PON2 (Ser311Cys, rs7493), and superoxide dismutase 2 (SOD2) (Val16Ala, rs4880), with adjustment for age and gender. No significant differences in the distribution of the genotypes at these polymorphisms were observed among individuals with SSNHL and Ménière's disease and controls. No significant risk for SSNHL and Ménière's disease was observed in the additive genetic model, regardless of moderating variables. The C allele of SOD2 (rs4880) was more frequent in Ménière's disease cases with a hearing level over 50 dB compared with cases with a hearing level below 50 dB, suggesting that this polymorphism is associated with progression of a hearing loss in Ménière's disease. In conclusion, no significant associations between the polymorphisms of GPX1, PON1, PON2, and SOD2 and risk of SSNHL and Ménière's disease were observed in this Japanese case-control study.
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Affiliation(s)
- Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Fusconi M, Chistolini A, de Virgilio A, Greco A, Massaro F, Turchetta R, Benincasa AT, Tombolini M, de Vincentiis M. Sudden sensorineural hearing loss: a vascular cause? Analysis of prothrombotic risk factors in head and neck. Int J Audiol 2012; 51:800-5. [PMID: 22928918 DOI: 10.3109/14992027.2012.705904] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This aim of this study was to determine the prevalence of thrombophilic risk factors in sudden sensorineural hearing loss, central retinal vein occlusion, and stroke associated with small vessel disease, with the purpose of investigating and reinforcing the vascular hypothesis in the pathogenesis of sudden sensorineural hearing loss. DESIGN Case-control study. Genetic and acquired risk factors of these three groups were compared with healthy controls. STUDY SAMPLE Forty-nine, 60, and 101 patients affected respectively by sudden sensorineural hearing loss, central retinal vein occlusion, or stroke associated with small vessel disease, enrolled during a three-year period were compared with 210 healthy controls. RESULTS The frequency of hyperhomocysteinemia (homocysteine ≥ 15 μmol/L) was higher in each disease group than in controls. A statically significant, albeit weak, correlation between the MTHFR C677T mutation and hyperhomocysteinemia was found in all three diseases. CONCLUSIONS Hyperhomocysteinemia proved to be a risk factor for sudden sensorineural hearing loss. Based on these results, we propose to analyse homocysteine in sudden sensorineural hearing loss patients and, if its values are high, to evaluate the presence of MTHFR C677T mutation.
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Affiliation(s)
- Massimo Fusconi
- Department of Sensory Organs, Sapienza University of Rome, Italy.
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Hiramatsu M, Teranishi M, Uchida Y, Nishio N, Suzuki H, Kato K, Otake H, Yoshida T, Tagaya M, Suzuki H, Sone M, Sugiura S, Ando F, Shimokata H, Nakashima T. Polymorphisms in genes involved in inflammatory pathways in patients with sudden sensorineural hearing loss. J Neurogenet 2012; 26:387-96. [PMID: 22385075 DOI: 10.3109/01677063.2011.652266] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although the etiology of idiopathic sudden sensorineural hearing loss (SSNHL) remains unclear, the pathologically increased permeability of blood vessels, elucidated by gadolinium-enhanced magnetic resonance imaging (MRI), suggests the involvement of inflammation. Because SSNHL is considered a multifactorial disease, possibly caused by interactions between genetic factors and environmental factors, the authors investigated the associations of polymorphisms of inflammatory mediator genes with susceptibility to SSNHL. The authors compared 72 patients affected by SSNHL and 2010 adults (1010 men and 1000 women; mean age 59.2 years; range 40-79) who participated in the National Institute for Longevity Sciences Longitudinal Study of Aging. Multiple logistic regression was used to obtain odds ratios (ORs) for SSNHL in subjects with polymorphisms in the genes IL-6 C - 572G, IL-4R G1902A, IL-10 A - 592C, TNFα C - 863A, TNFRSF1B G593A, VEGF C936T, VEGF C - 2578A, and VEGF G - 1154A, with adjustment for age, gender, and any history of hypertension, diabetes, or dyslipidemia. The per-allele OR for the risk of SSNHL in subjects bearing IL-6 C - 572G was 1.480 (95% confidence interval [CI], 1.037-2.111) in model 1 (no adjustment), 1.463 (CI, 1.022-2.094) in model 2 (adjusted for age and gender), and 1.460 (CI, 1.016-2.097) in model 3 (adjusted for age, gender, and a history of hypertension, diabetes, or dyslipidemia). Under the dominant model of inheritance, the ORs were 1.734 (CI, 1.080-2.783) in model 1, 1.690 (CI, 1.050-2.721) in model 2, and 1.669 (CI, 1.035-2.692) in model 3. The remaining seven polymorphisms failed to show any associations with the risk of SSNHL. These data need to be confirmed on larger series of patients. In conclusion, the IL-6 C - 572G polymorphism is associated with a risk of SSNHL. Because permeability of blood vessels in the inner ear is frequently increased in patients with SSNHL, inflammation of the inner ear might be involved.
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Affiliation(s)
- Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lin RJ, Krall R, Westerberg BD, Chadha NK, Chau JK. Systematic review and meta-analysis of the risk factors for sudden sensorineural hearing loss in adults. Laryngoscope 2012; 122:624-35. [PMID: 22252719 DOI: 10.1002/lary.22480] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 10/26/2011] [Accepted: 11/02/2011] [Indexed: 12/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS To review the medical literature evidence of potential risk factors for sudden sensorineural hearing loss (SSNHL) in the adult general population. STUDY DESIGN Systematic review of prospective and retrospective studies; meta-analysis of case-controlled studies. METHODS Three researchers independently reviewed MEDLINE (January 1, 1950-November 30, 2010), Embase (January 1, 1980-November 30, 2010), and Evidence-Based Medicine Reviews databases in addition to conducting a manual reference search. Randomized controlled trials, prospective cohort studies, consecutive/nonconsecutive case series, and retrospective reviews in which a clear definition of SSNHL was stated were included in the study. Researchers individually extracted data regarding patient information and the presumed risk factors. Discrepancies were resolved by mutual consensus. RESULTS Twenty-two articles met the inclusion criteria. Cardiovascular risk factors (smoking, increased alcohol consumption) appeared to be associated with a higher risk of developing SSNHL. A low level of serum folate may also be implicated as a risk factor. Factor V Leiden and MTHFR gene polymorphisms were found to occur more frequently in patients with SSNHL in several studies, suggesting these inherited prothrombophilic mutations could be independent risk factors of SSNHL. CONCLUSIONS Acquired and inherited cardiovascular risk factors appeared to be associated with an increased risk of developing SSNHL.
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Affiliation(s)
- Rui Jun Lin
- St. Paul's Rotary Hearing Clinic, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Quaranta N, Ramunni A, De Luca C, Brescia P, Dambra P, De Tullio G, Vacca A, Quaranta A. Endothelial progenitor cells in sudden sensorineural hearing loss. Acta Otolaryngol 2011; 131:347-50. [PMID: 21171834 DOI: 10.3109/00016489.2010.536990] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Endothelial progenitor cells (EPCs) are a unique subtype of circulating cells with properties similar to those of embryonal angioblasts. They have the potential to proliferate and to differentiate into mature endothelial cells. EPCs are reduced in patients with vascular risk factors due to a decreased mobilization, an increased consumption at the site of damage or a reduced half-life. The results of this study confirm the existence of an endothelial dysfunction in patients with sudden sensorineural hearing loss (SSHL) and support the vascular involvement in the pathogenesis of the disease. OBJECTIVE The aim of this study was to evaluate the concentration of EPCs in patients affected by SSHL. METHODS Twenty-one patients affected by SSHL were evaluated. The number of EPCs was analyzed by flow cytometry analysis of peripheral blood CD34+KDR+CD133+ cells. RESULTS Circulating levels of EPCs were significantly lower in SSHL patients compared with controls. In particular, CD34+KDR+ cells and CD34+CD133+KDR+ cells were significantly reduced (p < 0.05).
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Affiliation(s)
- Nicola Quaranta
- Otolaryngology Clinic "G. Lugli", Otology and Neurotologic Surgery, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy.
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Uchida Y, Sugiura S, Ando F, Shimokata H, Nakashima T. Association of the C677T polymorphism in the methylenetetrahydrofolate reductase gene with sudden sensorineural hearing loss. Laryngoscope 2010; 120:791-5. [PMID: 20213658 DOI: 10.1002/lary.20809] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate the recently reported association of the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene with sudden sensorineural hearing loss (SSNHL), we analyzed data from a community-based Japanese population. STUDY DESIGN Nested case-control study. METHODS Among 2,174 adults (1,096 males and 1,078 females) aged 40 to 79 years old who participated in the National Institute for Longevity Sciences-Longitudinal Study of Aging, we compared 33 cases of prevalent SSNHL, defined as a self-reported otolaryngologist diagnosis, with the other cases. Multiple logistic regression was used to obtain odds ratios (ORs) for SSNHL in subjects with the MTHFR C677T polymorphism, with adjustment for other possibly influential factors under additive, dominant, and recessive genetic models. RESULTS The per-allele ORs for SSNHL risk were 1.687 (95% confidence interval [CI], 1.023-2.780) in model 1, with adjustment for age and sex, and 1.654 (CI, 1.003-2.728) in model 2, with adjustment for smoking status, body mass index, histories of heart disease, hypertension, and diabetes, in addition to the factors in model 1. In model 3, a significant association between SSNHL and the C677T polymorphism was observed under all genetic models independent of factors including folic acid and homocysteine, although there were only 25 cases and 1,677 controls due to the addition of moderating factors. CONCLUSIONS Our results suggest that the T allele of MTHFR C677T could be associated with susceptibility to SSNHL, and even imply that this mutation could be a risk factor that is independent of blood folic acid and homocysteine.
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Affiliation(s)
- Yasue Uchida
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Japan.
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Methylenetetrahydrofolate reductase C677T gene mutation as risk factor for sudden sensorineural hearing loss: association with plasma homocysteine, folate and cholesterol concentrations. The Journal of Laryngology & Otology 2010; 124:1268-73. [DOI: 10.1017/s002221511000099x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:Impaired cochlear perfusion appears to be the most important event in the development of sudden sensorineural hearing loss. Methylenetetrahydrofolate reductase gene mutations at nucleotide 677 cause reduced methylenetetrahydrofolate reductase enzyme activity, resulting in vascular impairment.Methods:Thirty-three patients and 68 control subjects underwent audiological and haematological investigation.Results:No statistically significant association was found between sudden sensorineural hearing loss and the methylenetetrahydrofolate reductase C677T gene mutation. Mean homocysteine and cholesterol concentrations were significantly higher in patients than in controls. Mean folate levels were significantly lower in patients than in controls. Amongst patients with sudden sensorineural hearing loss, no significant differences in mean cholesterol, homocysteine or folate concentration were found, comparing patients with methylenetetrahydrofolate reductase C677T mutation genotypes with those without.Conclusion:No statistically significant association was found between the methylenetetrahydrofolate reductase C677T gene mutation and sudden sensorineural hearing loss. There was a statistically significant difference between the homocysteine, folate and cholesterol concentrations of sudden sensorineural hearing loss patients, compared with controls. However, there was no statistically significant difference in these levels, comparing patients with and without the methylenetetrahydrofolate reductase C677T mutation.
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Abstract
Sudden sensorineural hearing loss is usually unilateral and can be associated with tinnitus and vertigo. In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed. A careful examination is needed to exclude life threatening or treatable causes such as vascular events and malignant diseases, and patients should be referred urgently for further assessment. About half of patients completely recover, usually in about 2 weeks. Many treatments are used, including corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments. Although no treatment is proven, we recommend a short course of oral high-dose corticosteroids. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.
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Altomare I, Adler A, Aledort LM. The 5, 10 methylenetetrahydrofolate reductase C677T mutation and risk of fetal loss: a case series and review of the literature. Thromb J 2007; 5:17. [PMID: 17941987 PMCID: PMC2098747 DOI: 10.1186/1477-9560-5-17] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 10/17/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The true relationship between methylenetetrahydrofolate reductase C677T homozygosity and risk of recurrent spontaneous abortion is unknown, and it is unclear if women with these mutations should be anticoagulated during pregnancy. OBJECTIVES We report a series of 8 patients with this issue and review the current literature. METHODS 8 patients (3 of whom were actively pregnant) were referred with histories of spontaneous fetal loss; hypercoaguability work-ups revealed each were homozygous for the MTHFR C677T mutation without other thrombophilias. RESULTS In the 3 women who have conceived, treatment with LMW heparin during pregnancy led to two full-term births and one additional pregnancy without complication. For the 5 who have not, we recommended treatment with LMW heparin upon conception. CONCLUSION We provide evidence to support the relationship between MTHFR C677T mutations and recurrent fetal loss, and to suggest that anticoagulation of these patients during pregnancy can lead to a successful pregnancy outcome.
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Affiliation(s)
- Ivy Altomare
- Mount Sinai Medical Center, 1 Gustave L, Levy Pl,, New York, USA.
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Capaccio P, Ottaviani F, Cuccarini V, Bottero A, Schindler A, Cesana BM, Censuales S, Pignataro L. Genetic and acquired prothrombotic risk factors and sudden hearing loss. Laryngoscope 2007; 117:547-51. [PMID: 17334320 DOI: 10.1097/mlg.0b013e31802f3c6a] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Idiopathic sudden sensorineural hearing loss (ISSNHL) is a frequently encountered condition, and various pathogenetic mechanisms have been hypothesized, such as viral infections, autoimmune processes, and ischemic events; however, whatever the cause, impaired cochlear perfusion appears to be the most important event. A number of inherited prothrombotic risk factors and their related genetic alterations have recently been correlated with vascular disorders. METHODS To investigate the mechanisms of vascular thrombosis of the inner ear leading to sudden HL, we examined 100 patients with SSNHL for the presence of acquired or inherited prothrombotic risk factors and 200 healthy volunteers as controls. All of the subjects underwent hematologic examinations, including MTHFR C677T and A1298C, prothrombin G20210A, platelet GlyIIIaA1/A2, V Leiden G1691A genotyping, fibrinogenemia, cholesterolemia, homocystinemia, and folatemia. Genomic DNA was isolated from peripheral blood leukocytes using standard methods, and gene mutations were investigated using a LightCycler DNA analyser and polymerase chain reaction. RESULTS A statistically significant association was found between SSNHL and the MTHFR C677T/A1298C polymorphisms, the prothrombin G20210A transition, and the platelet GlyIIIa and V Leiden G1691A mutations. Furthermore, the SSNHL patients had significantly higher levels of fibrinogenemia, cholesterolemia, and homocystinemia and lower levels of folatemia than the controls (P < .0001). CONCLUSIONS The association between inherited and acquired prothrombotic factors and sudden HL suggests that the microvascular impairment causing SSNHL may be caused by a multifactorial mechanism. All patients with ISSNHL should undergo a comprehensive hematologic investigation of inherited and acquired prothrombotic factors, including MTHFR polymorphisms, the prothrombin transition, and the platelet and V Leiden mutations, to identify a subset of patients at high risk of recurrent HL.
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Affiliation(s)
- Pasquale Capaccio
- Department of Otorhinolaryngological and Ophthalmological Sciences, Policlinico Foundation I.R.C.C.S., University of Milan, Milan, Italy.
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