1
|
Yoo TJ, Shea J, Ge X, Kwon SS, Yazawa Y, Sener O, Mora F, Mora R, Mora M, Barbieri M, Du X. Presence of Autoantibodies in the Sera of Meniere's Disease. Ann Otol Rhinol Laryngol 2016; 110:425-9. [PMID: 11372925 DOI: 10.1177/000348940111000506] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We examined the sera of patients with Meniere's disease for the presence of antibodies against 8 inner ear antigens by enzyme-linked immunosorbent assay (ELISA). One hundred eight patients with Meniere's disease and 28 control subjects were studied. The antibodies against chicken type II collagen, bovine type II collagen, the cyanogen bromide cleaved peptide 11 (CB11) of each, type IX and XI collagens, C-Raf, and tubulin were measured by ELISA. The sensitivity of each antigen was between 37% and 60% individually, and was 91% when all 8 inner ear antigens were combined. These results showed that 91% of Meniere's disease sera have antibody activities to 1 or more of these inner ear antigens. The results suggest that performing ELISA for these 8 inner ear antigens was useful as a diagnostic tool for Meniere's disease. Further study is required for elucidating the role of these antigens in the pathogenesis of Meniere's disease, which might eventually result in better therapy.
Collapse
Affiliation(s)
- T J Yoo
- Department of Medicine, University of Tennessee, Memphis 38163, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Toubi E, Ben-David J, Kessel A, Halas K, Sabo E, Luntz M. Immune-Mediated Disorders Associated with Idiopathic Sudden Sensorineural Hearing Loss. Ann Otol Rhinol Laryngol 2016; 113:445-9. [PMID: 15224826 DOI: 10.1177/000348940411300605] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Different immune disorders are involved in the development of sudden sensorineural hearing loss (SSNHL). This includes a wide spectrum of immune-mediated disorders such as immune complexes, production of autoantibodies to the inner ear proteins, production of anticardiolipin (aCL) antibodies, and cellular immune defects. Some studies have also found an elevation of total IgE levels and a type 1 immune reaction. Our objective was to establish the association of “idiopathic” SSNHL (ISSNHL) with various autoantibodies, and to analyze the persistence over time of existing aCL and anti–β2 glycoprotein 1 (anti–β2 GP1) antibodies in such patients. Finally, we sought to establish a possible association between ISSNHL and total IgE elevation and whether this elevation is due to a specific type I immune reaction. In this prospective follow-up study, 51 patients considered as having ISSNHL were compared with 35 age-sex matched healthy volunteers over a 3-year period. All participants were tested for serum antinuclear antibodies, antithyroid antibodies, aCL, and rheumatoid factor. All patients who were positive for aCL antibodies were reanalyzed 3 months later for aCL antibody persistence and for the coexistence and persistence of anti-β2 GP1 antibodies. Skin prick tests were performed in patients in whom total IgE was elevated. Antinuclear antibodies were positive in 9 of 51 (17%) and antithyroid antibodies in 11 of 51 (21%) ISSNHL patients, as compared to 1 of 35 (3%) and 2 of 35 (6%), respectively, in the control group. Rheumatoid factor was positive in 6 of the 51 patients (12%) and in none of the control group. Positive aCL antibodies were present in 16 of 51 patients (31%), 6 of whom (12%) were also positive for anti–β2 GP1 antibodies. Three months later, aCL antibodies persisted in 7 patients (14%), and anti–β2 GP1 in 4 patients. Only 2 of the normal subjects (6%) were positive for aCL antibodies, which persisted in only 1 of them (3%). The level of total IgE was elevated in 14 of 51 patients (27%), in contrast to 3 of 35 controls (8%). Six of them (42%) demonstrated a positive skin test to at least 1 allergen, but only 3 presented allergy symptoms. Our findings support the reported existence of multiple immune-mediated disorders in patients with ISSNHL. The lack of aCL antibody persistence in as many as half of our patients strongly suggests that transient phenomena (eg, viral infection) may trigger aCL antibody activity. However, the presence of aCL antibodies, especially in conjunction with anti–β2 GP1 antibodies, suggests that in some patients, SSNHL is included among the rare symptoms of the antiphospholipid syndrome.
Collapse
Affiliation(s)
- Elias Toubi
- Division of Clinical Immunology and Allergy, Bnai Zion Medical Center, Faculty of Medicine, Technion-Haifa Institute of Technology, Haifa, Israel
| | | | | | | | | | | |
Collapse
|
3
|
Ikeda T, Nakamura K, Oku H, Morishita S, Fukumoto M, Suzuki H, Kida T, Horie T, Sugiyama T, Takai S. The role of tryptase and anti-type II collagen antibodies in the pathogenesis of idiopathic epiretinal membranes. Clin Ophthalmol 2015; 9:1181-6. [PMID: 26170611 PMCID: PMC4494616 DOI: 10.2147/opth.s82015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Purpose To investigate the pathogenesis of idiopathic epiretinal membrane (ERM) from a biochemical perspective, the relationships between ERM and tryptase activity, a serine protease, and the levels of anti-type II collagen (anti-IIC) antibodies in the serum. Patients and methods Vitreous samples for measurement of tryptase activity were obtained from 54 eyes of 54 patients who underwent a vitrectomy for vitreoretinal disease, ie, 14 eyes of 14 patients with idiopathic macular hole, 14 eyes of 14 patients with proliferative diabetic retinopathy (PDR), 13 eyes of 13 patients with ERM, and 13 eyes of 13 patients with rhegmatogenous retinal detachment (RRD). Tryptase activity was measured by spectrophotometry. Anti-IIC antibodies were measured in the serum obtained from 17 patients with ERM, eight patients who underwent cataract surgery, 12 patients with PDR, and nine patients with RRD. In these 46 patients, the anti-IIC antibodies were measured using a Human/Monkey Anti-Type I and Type II Collagen IgG Assay Kit. Results Vitreal tryptase activity (mean ± standard deviation [SD]) in macular hole, PDR, ERM, and RRD was 0.0146±0.0053, 0.0018±0.0018, 0.0166±0.0046, and 0.0117±0.0029 mU/mg protein, respectively. Vitreal tryptase activity was significantly higher in macular hole and ERM than in PDR and RRD (P<0.05, Fisher’s protected least significant difference). The serum levels of anti-IIC immunoglobulin G (IgG) antibody (mean ± SD) in ERM, cataract surgery, PDR, and RRD were 58.222±30.986, 34.890±18.165, 55.760±26.008, and 35.453±12.769 units/mL, respectively. The serum levels of anti-IIC IgG antibody were significantly higher in ERM and PDR than in cataract surgery and RRD (P<0.05, Fisher’s protected least significant difference, two-sided). Conclusion In the pathogenesis of ERM, increased vitreal tryptase activity may be involved in tissue fibrosis, and elevated serum anti-IIC antibodies may lead to an immune response at the vitreoretinal interface, thus resulting in membrane formation.
Collapse
Affiliation(s)
- Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | | | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Taeko Horie
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | | | - Shinji Takai
- Department of Pharmacology, Osaka Medical College, Takatsuki City, Osaka, Japan
| |
Collapse
|
4
|
Nakaizumi A, Fukumoto M, Kida T, Suzuki H, Morishita S, Satou T, Oku H, Ikeda T, Nakamura K. Measurement of serum and vitreous concentrations of anti-type II collagen antibody in diabetic retinopathy. Clin Ophthalmol 2015; 9:543-7. [PMID: 25848204 PMCID: PMC4376299 DOI: 10.2147/opth.s75422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Autoimmune mechanisms have been postulated as a cause of diabetic retinopathy (DR), as several autoantibodies have reportedly been detected in the serum of DR patients. In this present study, we measured serum and vitreous levels of anti-type II collagen (anti-II-C) antibodies in DR patients and investigated their association with the mechanism of development of DR. Patients and methods Blood samples were obtained from patients with proliferative DR and from patients with diabetic macular edema who underwent vitrectomy at Osaka Medical College, Takatsuki City, Osaka, Japan. Diabetic patients without DR were also included. The control group consisted of age- and sex-matched patients with noninflammatory eye diseases who underwent eye surgery for retinal detachment or for cataracts. The levels of anti-II-C immunoglobulin (Ig)G antibody in the vitreous and serum were measured using a human/monkey anti-II-C IgG assay kit. Results The serum levels of anti-II-C IgG antibody were significantly higher in the DR patients than in the patients with noninflammatory eye disease (56.8±33.8 units/mL versus 30.5±13.7 units/mL, respectively; P<0.05, Fisher’s exact test). These levels were also significantly higher in the diabetic patients without DR than in the patients with noninflammatory eye disease (76.3±49.7 units/mL versus 30.5±13.7 units/mL, respectively; P<0.01, Fisher’s exact test). However, anti-II-C IgG antibody levels were unable to be detected in all of the obtained vitreous fluid samples. Conclusion The development and progression of DR may be related to a mechanism involving intraocular type II collagen, which normally has immunological tolerance as a sequestered antigen. In DR, the disruption of the blood–retinal barrier leads to contact between the intraocular type II collagen and immunocompetent cells, and to subsequent activation of the autoimmune mechanism.
Collapse
Affiliation(s)
- Atsuko Nakaizumi
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Takaki Satou
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | | |
Collapse
|
5
|
Bel Hadj Ali I, Ben Saida A, Beltaief N, Namouchi I, Besbes G, Ghazoueni E, Ben Arab S. HLA class I polymorphisms in Tunisian patients with otosclerosis. Ann Hum Biol 2012; 39:190-4. [DOI: 10.3109/03014460.2012.671849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Insaf Bel Hadj Ali
- Unité d'Epidémiologie Génétique et Moléculaire, Faculté de Médecine de Tunis, Tunisia
| | - Asma Ben Saida
- Unité d'Epidémiologie Génétique et Moléculaire, Faculté de Médecine de Tunis, Tunisia
| | - Najeh Beltaief
- Unité d'Epidémiologie Génétique et Moléculaire, Faculté de Médecine de Tunis, Tunisia
- Service ORL et de Chirurgie Maxillo-faciale, Hôpital La Rabta de Tunis, Tunisia
| | - Imen Namouchi
- Unité d'Epidémiologie Génétique et Moléculaire, Faculté de Médecine de Tunis, Tunisia
| | - Ghazi Besbes
- Service ORL et de Chirurgie Maxillo-faciale, Hôpital La Rabta de Tunis, Tunisia
| | - Ezzeddine Ghazoueni
- Laboratoire d'Immunologie, Hôpital Militaire Principal d'Instruction de Tunis, Tunisia
| | - Saida Ben Arab
- Unité d'Epidémiologie Génétique et Moléculaire, Faculté de Médecine de Tunis, Tunisia
| |
Collapse
|
6
|
Greco A, Fusconi M, Gallo A, Marinelli C, Macri G, De Vincentiis M. Sudden sensorineural hearing loss: An autoimmune disease? Autoimmun Rev 2011; 10:756-61. [DOI: 10.1016/j.autrev.2011.05.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
|
7
|
Etiopathogenesis of otosclerosis. Eur Arch Otorhinolaryngol 2010; 267:1337-49. [DOI: 10.1007/s00405-010-1292-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 05/20/2010] [Indexed: 10/19/2022]
|
8
|
|
9
|
Suzuki M, Hanamitsu M, Kitanishi T, Kohzaki H, Kitano H. Autoantibodies against inner ear proteins in patients with delayed endolymphatic hydrops and unilateral juvenile deafness. Acta Otolaryngol 2006; 126:117-21. [PMID: 16428186 DOI: 10.1080/00016480500266008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
CONCLUSIONS Patients with the contralateral type of delayed endolymphatic hydrops (DEH) may undergo an autoimmune attack against the other inner ear. As patients with unilateral juvenile deafness show no progression, despite lengthy observation, the autoantibody against the 68-kDa protein may be unrelated to the pathogenesis of DEH. OBJECTIVE The contralateral type of DEH is believed to have an autoimmune etiology, and sometimes develops from unilateral juvenile deafness. The purpose of this study was to determine whether autoantibodies are pathogenetically important in DEH. MATERIAL AND METHODS Sera from 9 patients with DEH, 18 patients with profound unilateral juvenile hearing loss and 15 control volunteer without inner ear diseases were investigated by means of Western blot assay against rat inner ear proteins. RESULTS Among 8 patients with the contralateral type of DEH, 6 (75%) showed at least 1 reactive band on Western blotting. The protein that reacted most frequently had a molecular weight of 28 kDa, which was consistent with our previous results. Among 18 patients with unilateral juvenile deafness, 5 (28%) showed reactive bands, exclusively at 68 kDa.
Collapse
Affiliation(s)
- Mikio Suzuki
- Division of Otolaryngology, Fukuoka Kinen Hospital, Fukuoka, Japan.
| | | | | | | | | |
Collapse
|
10
|
Abstract
Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) remains one of the major unsolved otologic emergencies. It is characterized by the onset of an unilateral sensorineural hearing loss developing within 24 hours, and averaging on pure tone audiogram at least 30 dB HL for three subsequent octave steps, with no marked vestibular symptoms and no identifiable cause. ISSHL is a syndrome covering several heterogeneous entities resulting from different pathogenetic mechanisms. At this time, the audiogram is the unique tool which may help clinicians to identify these entities and provide a classification based on 5 types of hearing loss. Numerous experimental and clinical studies have investigated the mechanisms by which infectious, ischemic, mechanic or immunologic insults may induce cochlear dysfunction. However, extrapolation to humans and rationale therapeutic approaches to ISSHL remain uncertain. SSHL being a diagnosis of exclusion, retrocochlear and neurologic etiologies should be eliminated. No argument allows to consider ISSHL a therapeutic emergency. More precisely, the experimental data presently available on cochlear physiology suggests that a treatment could have some chance to be effective if undertaken within minutes following the onset of ISSHL, a condition never encountered in daily practice. Conversely, it is not justifiable to impute the absence of hearing recovery to a delay in therapy. The various therapeutic strategies currently recommended are highly empirical and should be questionned in terms of cost-effectiveness, the most common being high-dose corticosteroids. New investigation tests are required for improving our approach to ISSHL.
Collapse
Affiliation(s)
- J-B Charrier
- Service d'ORL et de chirurgie de la face et du cou, Assistance Publique-Hôpitaux de Paris, Université Paris VII Hôpital Lariboisière 2, rue Ambroise Paré 75010 Paris, France
| | | |
Collapse
|
11
|
Crovetto M, Solano D, Centeno J. [Recurrent polychondritis: apropos of a case]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2004; 54:727-30. [PMID: 15164713 DOI: 10.1016/s0001-6519(03)78473-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We present a case of relapsing polychondritis which presented as hypoacusis and showed several peculiarities. The initial diagnosis was serous otitis. After a more careful study we found certain details which made us suspect a relapsing polychondritis. The diagnosis was confirmed by a biopsy of the nasal cartilage and a detailed systemic study was performed. As distinctive characteristics we found a mixed hypoacusis, in which the sensorineural component was partially recovered following corticoid treatment.
Collapse
Affiliation(s)
- M Crovetto
- Servicio de ORL, Hospital de Basurto, Avda. Montevideo, 18, 48013 Bilbao
| | | | | |
Collapse
|
12
|
Hefeneider SH, McCoy SL, Hausman FA, Trune DR. Autoimmune Mouse Antibodies Recognize Multiple Antigens Proposed in Human Immune-Mediated Hearing Loss. Otol Neurotol 2004; 25:250-6. [PMID: 15129101 DOI: 10.1097/00129492-200405000-00009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS Autoimmune diseased mice with hearing loss will have autoantibodies against the various cochlear antigens proposed in clinical autoimmune inner ear disease. BACKGROUND Serum antibodies of patients with hearing loss recognize several proteins that are proposed as possible antigenic targets in the ear. This often leads to a clinical diagnosis of autoimmune inner ear disease, although it is not clear how these antibodies cause inner ear disease. Therefore, to better understand the relationship of autoantibodies and ear disease, an examination was made of serum autoantibodies in the MRL/MpJ-Fas(lpr) autoimmune mouse with hearing loss. Similar antibody patterns in the mouse would provide an animal model in which to investigate potential autoimmune mechanisms of this clinical ear disorder. METHODS Sera from MRL/MpJ-Fas(lpr) autoimmune mice and normal C3H mice were tested by the enzyme-linked immunosorbent assay technique for reactivity against various reported cochlear antigens: heat shock protein 70 (bovine, human, bacterial), laminin, heparan sulfate proteoglycan, cardiolipin, and collagen types II and IV. RESULTS The autoimmune mouse sera showed significantly greater antibody reactivity against all of the antigens when compared with normal mouse sera. CONCLUSIONS Serum antibodies from autoimmune mice recognized several putative autoantigens reported for patients with hearing loss, suggesting that comparable antigen-antibody mechanisms might be operating. However, the recognition of multiple antigens did not identify any one as being the specific target in autoimmune hearing loss. The correlation of antibodies in the MRL/MpJ-Fas(lpr) autoimmune mouse and human studies indicates this animal model should aid further investigations into potential cochlear antigens in autoimmune hearing loss.
Collapse
Affiliation(s)
- Steven H Hefeneider
- Department of Immunology, Veteran's Affairs Medical Center, Portland, Oregon, USA
| | | | | | | |
Collapse
|
13
|
Abstract
Autoimmune sensorineural hearing loss has been increasingly recognized as a clinical entity since its description by McCabe in 1979. Recognition and proper management of this condition is important, as it is one of the very few forms of sensorineural hearing loss that can be successfully treated by medical therapy. Recent studies have provided experimental evidence to suggest that immune processes can cause sensorineural hearing loss in animals and humans. However, antigenic targets within the inner ear are diverse and as a result conclusive evidence for specific autoimmune damage to the inner ear has been elusive. This review focuses on the recent progress in understanding of the aetio-pathogenesis of autoimmune hearing loss along with a description of the various clinical conditions in which they occur. Recent advances in the laboratory diagnosis and management of this interesting condition are also described.
Collapse
Affiliation(s)
- J Mathews
- Department of Otolaryngology, Royal Liverpool University Hospital, Wigan, UK.
| | | |
Collapse
|
14
|
Yoo T, Tanaka H, Kwon S, Mora F, Mora M, Yazawa Y, Suzuki M, Kitajima K. β-Tubulin as an autoantigen for autoimmune inner ear disease. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0531-5131(03)00814-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
15
|
Cadoni G, Agostino S, Manna R, De Santis A, Fetoni AR, Vulpiani P, Ottaviani F. Clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss. Laryngoscope 2003; 113:797-801. [PMID: 12792313 DOI: 10.1097/00005537-200305000-00006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES/HYPOTHESIS The role of antiendothelial cell antibodies in systemic vasculitis has been reported. The aim of the study was to define the clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss. STUDY DESIGN A prospective study in patients with sudden sensorineural hearing loss. METHODS Serum samples were taken from 59 consecutive patients with sudden sensorineural hearing loss at time of presentation and from 28 normal control subjects. Indirect immunofluorescence assay was used to detect antiendothelial cell antibodies. RESULTS The prevalence of antiendothelial cell antibody detection was 54% (32 of 59 patients), with a statistically significant difference between patients and control subjects (P =.0004). Antiendothelial cell antibody positivity was significantly associated with absent recovery of hearing loss (P =.0020). CONCLUSIONS The cytotoxicity to endothelial cells of the inner ear by antiendothelial cell antibody-positive sera might play a role in causing the stria vascularis damage in immune-mediated sudden sensorineural deafness. The appearance of antiendothelial cell antibody is related to the poor outcome of hearing loss, and its detection could be helpful in the selection of particular patients with sensorineural hearing loss for specific immunosuppressive treatments.
Collapse
Affiliation(s)
- Gabriella Cadoni
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
16
|
Cadoni G, Fetoni AR, Agostino S, De Santis A, Manna R, Ottaviani F, Paludetti G. Autoimmunity in sudden sensorineural hearing loss: possible role of anti-endothelial cell autoantibodies. Acta Otolaryngol 2003:30-3. [PMID: 12211354 DOI: 10.1080/00016480260094947] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In order to verify whether anti-endothelial cell autoantibodies (AECAs) can be used as serological markers of inner ear vasculitis in sudden sensorineural hearing loss (SSHL), 32 patients affected by idiopathic SSHL were investigated. All patients underwent a routine general physical examination and extensive audiovestibular, microbiological and immunological investigations. Fourteen normal subjects without a history of HL, autoimmune or metabolic disease served as controls. Detection of AECAs was performed using an indirect immunofluorescence technique. AECA-positive patients were treated with methylprednisone, while AECA-negative patients were treated with a combined regimen of steroids, plasma expander and aspirin. The average hearing recovery for 5 frequencies (0.25-4 kHz) was analyzed in each subject 1 month after treatment and every 3 months thereafter; median follow-up was 12 months (range 9-18 months). A total of 15/32 patients (46.8%; 11/19 females, 4/13 males) were AECA-positive and thus differed significantly from the normal population in whom only 2/14 tested cases were positive (p = 0.03). Severe hearing loss was associated with being AECA-positive in 8/11 cases. During follow-up, 25/32 patients improved their hearing and 17 of these patients were AECA-negative. The seven cases without hearing improvement were all AECA-positive. In patients with SSHL, immune-mediated vascular damage may have a pathogenetic role and AECAs may represent a serological marker of vasculitis even if they are not inner ear-specific and even if they represent an epi-phenomenon rather than the only cause of SSHL.
Collapse
Affiliation(s)
- Gabriella Cadoni
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
Molecules considered as autoantigens in autoimmune sensorineural hearing loss and Meniere's diseases are type II collagens, type IX collagens, 30 kD proteins of inner ear membranes, laminin, 68 kD proteins of inner ear, PO protein, Raf I protein and beta-tubulin are reviewed in relation to molecular mechanisms of autoimmune injury of inner ear resulting in hearing loss.
Collapse
Affiliation(s)
- T J Yoo
- Department of Medicine, University of Tennessee Health Science Center, Memphis 38163, USA.
| | | | | |
Collapse
|
18
|
Berrocal JRG, Ramírez-Camacho R. Sudden sensorineural hearing loss: supporting the immunologic theory. Ann Otol Rhinol Laryngol 2002; 111:989-97. [PMID: 12450172 DOI: 10.1177/000348940211101107] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sudden deafness constitutes a diagnostic challenge. Classically, 2 causes, viral and vascular, are considered in the origin of idiopathic sudden hearing loss. More recently added to the list of possibilities are rupture of the membranous labyrinth and immune-mediated sensorineural hearing loss. The latter can be either primary and localized to the inner ear or, in perhaps fewer than one third of cases, secondary to generalized systemic autoimmune disease. The purpose of the present review is to define immune-mediated sudden sensorineural hearing loss as a distinctive entity, on the basis of clinical, immunologic, and pathological findings, and suggest a profile of the typical patient.
Collapse
MESH Headings
- Adrenal Cortex Hormones/therapeutic use
- Autoantibodies/analysis
- Autoimmune Diseases/complications
- Blotting, Western
- Complement Activation
- Ear, Inner/immunology
- Ear, Inner/physiopathology
- Genotype
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/drug therapy
- Hearing Loss, Sensorineural/etiology
- Hearing Loss, Sensorineural/immunology
- Hearing Loss, Sensorineural/physiopathology
- Hearing Loss, Sudden/diagnosis
- Hearing Loss, Sudden/drug therapy
- Hearing Loss, Sudden/etiology
- Hearing Loss, Sudden/immunology
- Hearing Loss, Sudden/physiopathology
- Humans
- Immunosuppressive Agents/therapeutic use
- Magnetic Resonance Imaging
- Major Histocompatibility Complex/genetics
- Major Histocompatibility Complex/immunology
- Polymerase Chain Reaction
- T-Lymphocytes/immunology
- Temporal Bone/pathology
- Virus Diseases/complications
Collapse
|
19
|
Abstract
PURPOSE Sudden idiopathic deafness is a sensorineural hearing loss with no recognized causes at the time of onset. The impairment site is usually localized in the cochlea, but some cases of retrocochlear lesions (e.g., cerebellopontine angle tumors, degenerative neural diseases, neuraxial ischemic lesions) can induce sensorineural deafness. The medical management of patients presenting with sudden deafness aims at detecting a causal mechanism, and at administering emergency therapeutic drugs. The diagnosis of idiopathic sudden deafness can be definitely made when no causes are found. Usually, the impairing mechanism involves the cochlea. The pathophysiology of this sensorineural alteration is still unknown. It is most likely that several mechanisms are associated together, their common point being an impairment to the feedback loop of the organ of Corti. CURRENT KNOWLEDGE AND KEY POINTS It is very likely that reactivation of neurotropic viruses and/or cochlear ischemia are frequent etiologies. Whatever the cause, the treatment is to be administered urgently, and consists of a high-dose corticotherapy at the least. Other treatments have never really proven to be effective. It is secondarily checked that no retrocochlear pathological processes, such as a cerebellopontine angle tumor, is present, in particular in young people. FUTURE PROSPECTS AND PROJECTS One of the current objectives is to determine when cochlear ischemia is involved, in a mini-invasive manner, such as with laser Doppler flowmetry, so that the treatment can be optimized. From a therapeutic point of view, early acoustic protection has been proven to be effective in cases of cochlear ischemia in small laboratory animals. Its efficacy in case of sudden deafness, non-exclusive of other causes than ischemia, is being assessed in a multicentric project.
Collapse
Affiliation(s)
- T Mom
- Service d'ORL et de chirurgie cervicofaciale, laboratoire de biophysique sensorielle (EA 2667), CHU, 30, place Henri-Dunant, 63000 Clermont-Ferrandcedex, France.
| | | | | |
Collapse
|
20
|
Hansson AS, Lu S, Holmdahl R. Extra-articular cartilage affected in collagen-induced, but not pristane-induced, arthritis models. Clin Exp Immunol 2002; 127:37-42. [PMID: 11882030 PMCID: PMC1906294 DOI: 10.1046/j.1365-2249.2002.01712.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily affecting cartilaginous joints but also extra-articular tissues such as the nose and upper respiratory tract. We have investigated extra-articular cartilage involvement in two commonly used animal models for RA, collagen-induced and pristane-induced arthritis, by immunizing rats with different susceptibility to disease (LEW.1 A, LEW.1F and DA rats). We found that nasal and tracheolaryngeal cartilage is affected in LEW.1 A and DA rats to varying degrees in collagen-induced arthritis but not in any strain in the pristane-induced model. Antibodies to matrilin-1, a cartilage-specific protein expressed mainly in tracheolaryngeal and nasal cartilage but not in joints, were positively associated with the presence of inflammation in nasal cartilage. In contrast, no antibody response to matrilin-1 could be detected in pristane-induced arthritis. In addition, nasal vaccination with collagen type II prior to immunization in DA rats significantly decreased the antibody response to matrilin-1 at day 56, but not at earlier time points, indicating a late protective effect on extra-articular cartilage. We conclude that pristane-induced arthritis is a joint-specific model whereas collagen-induced arthritis affect joints as well as extra-articular cartilage. Furthermore, collagen immunization induces an antibody response to matrilin-1.
Collapse
Affiliation(s)
- A-S Hansson
- Medical Inflammation Research, Biomedical Center, Lund University, Lund, Sweden.
| | | | | |
Collapse
|
21
|
Abstract
OBJECTIVE To review current knowledge of the pathophysiology of otosclerosis and to review hypotheses for the amelioration of this disease. DATA SOURCES Review of the literature and experimental observations by the authors. CONCLUSIONS Otosclerosis is a localized disease of bone remodeling within the otic capsule of the human temporal bone. Unlike other similar bone diseases, it does not occur outside of the temporal bone. These lesions seem to begin by resorption of stable otic capsule bone in adults, followed by a reparative phase with bone deposition. There are clearly genetic factors that lead to this disease, but measles virus infection and autoimmunity also may play contributing roles. Surgical correction of the conductive hearing loss is highly effective, but nonsurgical intervention has not yet been shown to prevent or slow the disease. Of the factors that may inhibit this process, fluorides, cytokine inhibitors, and bisphosphonates, third-generation bisphosphonates appear to hold the most promise.
Collapse
Affiliation(s)
- R A Chole
- Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | | |
Collapse
|
22
|
Boulassel MR, Guérit JM, Denison S, de Tourtchaninoff M, Wenderickx L, Botterman N, Deggouj N, Gersdorff M, Tomasi JP. No evidence of auditory dysfunction in guinea pigs immunized with myelin P0 protein. Hear Res 2001; 152:10-6. [PMID: 11223277 DOI: 10.1016/s0378-5955(00)00212-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent data have focused on the peripheral nerve myelin glycoprotein P0 as a putative autoantigen involved in the autoimmune etiology of some cases of Meniere's disease, idiopathic sensorineural hearing loss and sudden deafness. To determine whether antibodies to myelin P0 can alter cochlear function, 13 healthy guinea pigs were immunized with purified porcine myelin P0 while 10 controls were injected with saline water. The animals were then evaluated for evidence of evolving inner ear disease using immunological, electrophysiological and morphological methods. Twenty-six experimental ears were tested weekly with a brainstem auditory evoked potential technique for a period of 4 months and were compared to 20 control ears. Uniformly, all P0-sensitized guinea pigs showed antibodies to myelin protein P0 as evidenced by ELISA. Clinical signs of inflammatory demyelination were not discernible in P0-sensitized guinea pigs and all the animals were qualitatively normal. No significant increase of evoked potential thresholds was found in the P0-sensitized animals when compared to controls (P>0.05). Peak latencies of waves I, II, III, IV and V and inter-peak latencies in P0-sensitized guinea pigs did not significantly differ from those of controls (P>0.05). Histological sections of inner ear and peripheral nerves were free of disease in both groups. These findings indicate that the sole presence of antibodies to myelin P0 in the sera of guinea pigs or patients suspected of having autoimmune inner ear diseases is unlikely to elicit auditory abnormalities and that additional factors are necessary for the pathogenic development of these disorders.
Collapse
Affiliation(s)
- M R Boulassel
- Laboratory of Antoimmunity, Department of Microbiology, University of Louvain Medical School, UCL 5490, Ave. Hippocrate 54, 1200 Brussels, Belgium.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Cheng KC, Matsuoka H, Lee KM, Kim N, Krug MS, Kwon SS, Mora M, Yoo TJ. Proto-oncogene Raf-1 as an autoantigen in Meniere's disease. Ann Otol Rhinol Laryngol 2000; 109:1093-8. [PMID: 11130817 DOI: 10.1177/000348940010901201] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The 28 kd protein extracted from the guinea pig inner ear membranous fraction, which reacted with sera from patients with Meniere's disease, has been subjected to microsequencing. Nineteen amino acids were obtained (IVQQFGFQRRASDDGKLTQ). A protein data bank search showed that this sequence corresponded to residues 41 to 60 of human Raf-1 protein. Sera from 16 of 27 patients with Meniere's disease showed reactivity to the recombinant purified glutathione-S-transferase-Raf-1 protein. These results support the hypothesis that a subgroup of patients who suffer from Meniere's disease, as well as some other kinds of autoimmune inner ear diseases, have an autoantibody against Raf-1 protein.
Collapse
Affiliation(s)
- K C Cheng
- Department of Medicine, University of Tennessee, Memphis 38163, USA
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Boulassel MR, Tomasi JP, Deggouj N, Gersdorff M. Identification of beta-actin as a candidate autoantigen in autoimmune inner ear disease. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2000; 25:535-41. [PMID: 11122295 DOI: 10.1046/j.1365-2273.2000.00416.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
It has been shown that sera from patients with autoimmune inner ear disease contain antibodies to several inner ear antigens. We report here the characterization of the 42-43 kDa protein against which a significant number of patients' sera react strongly. After separation of inner ear proteins from guinea-pig cochleas by SDS-PAGE, the band corresponding to the 42-43 kDa protein was digested with trypsin and the peptide fragments were separated by high-performance liquid chromatography. Two fractions were then subjected to amino acid sequencing by the classical automated Edman degradation. The sequence of a stretch of 15 amino acids of the first fragment was identical to that of amino acids 148-162 of beta-actin. The sequence of the 10 amino acids of the second fragment was also identical to beta-actin. On Western blots, monoclonal antibody directed against beta-actin reacted with the inner ear 42-43 kDa proteins. The serum samples from the patients and the monoclonal antibody reacted with the non-muscle actin used as antigen in Western blotting. Immunoblot analysis of inner ear proteins after two-dimensional gel electrophoresis showed a spot, corresponding to the region of the 43 kDa as compared to the protein standards. On the basis of these data it is concluded that the target 42-43 kDa protein for antibodies in sera of patients with autoimmune inner ear disease is beta-actin, a molecule, which has important and numerous functions inside cells. This is the first report to identify the cytoskeletal protein beta-actin as a candidate autoantigen in autoimmune inner ear disease.
Collapse
Affiliation(s)
- M R Boulassel
- Laboratory of Autoimmunity and Department of Otorhinolaryngology, University of Louvain Medical School, 1200 Brussels, Belgium.
| | | | | | | |
Collapse
|
25
|
Khan DC, DeGagne JM, Trune DR. Abnormal cochlear connective tissue mineralization in the palmerston north autoimmune mouse. Hear Res 2000; 142:12-22. [PMID: 10748324 DOI: 10.1016/s0378-5955(99)00221-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Inner ear fibrosis and osteogenesis are common features of human autoimmune disease, although the cellular mechanisms are unknown. The Palmerston North (PN) autoimmune strain mouse has been shown to develop modiolar sclerotic lesions with progression of its systemic disease. Therefore, lesion development was studied in the cochleas of PN mice to gain insight into potential autoimmune osteogenic processes in the human ear. Cochleas from PN mice were examined with electron microscopy to characterize the cellular and extracellular matrix changes that lead to abnormal mineralization. Initially, activated fibroblasts produced extracellular matrix fibers, ranging in size from fine fibrils to larger collagen-like fibers. These proliferating fibers appeared to 'seed' the mineralizing lesions by serving as the framework for mineral deposition. As mineralization continued, the foci grew in size and fused to form large sclerotic masses within the connective tissue. However, the lesions never invaded nor degraded the normal modiolar bone. These observations of abnormal mineralization of cochlear connective tissue fibers show some parallels with human cochlear autoimmune osteogenesis, suggesting similar molecular processes may be involved.
Collapse
Affiliation(s)
- D C Khan
- Oregon Hearing Research Center, NRC04, Department of Otolaryngology- Head and Neck Surgery, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR, USA
| | | | | |
Collapse
|
26
|
Dahiya R, Cleveland S, Megerian CA. Spondyloepiphyseal Dysplasia Congenita Associated with Conductive Hearing Loss. EAR, NOSE & THROAT JOURNAL 2000. [DOI: 10.1177/014556130007900312] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Spondyloepiphyseal dysplasia is a disorder characterized by abnormalities of growth. Previous studies of this disorder have identified a significant incidence of associated hearing loss. Hearing loss has been reported to occur in 25 to 30% of affected patients. To date, all reports of associated hearing loss have indicated the presence of a sensorineural component. In this article, we report the case of a child who was diagnosed with spondyloepiphyseal dysplasia congenita and who was found to have a significant conductive hearing loss with a Carhart's notch, indicating the likely presence of stapes footplate fixation. We also review the diagnosis of this condition and the literature associated with hearing loss as it occurs with this disorder.
Collapse
Affiliation(s)
- Ravinder Dahiya
- Department of Otolaryngology, University of Massachusetts Medical Center, Worcester
| | - Sandra Cleveland
- Department of Audiology, University of Massachusetts Medical Center, Worcester
| | - Cliff A. Megerian
- Department of Otolaryngology, University of Massachusetts Medical Center, Worcester
| |
Collapse
|
27
|
Abstract
Otosclerosis is a genetically based disease in which the development of autoimmune mechanisms can lead to its clinical expression. Anti-type II collagen antibodies have been found in otosclerotic patient serum. The first clinically unexpressive phase of the disease can be diagnosed from a family history and ON-OFF stapedial reflexes with evidence of an autoimmune disorder. The use of antigenic oral hyposensitization is accepted, based on autoimmune pathogenesis. Hyposensitization should be initiated during this subclinical period of otosclerosis with a type II collagen oral vaccine.
Collapse
Affiliation(s)
- M A Lopez-Gonzalez
- Unit of Pediatric Otorhinolaryngology, Virgen del Rocio University Infantile Hospital, Seville, Spain
| | | |
Collapse
|
28
|
López-González MA, Lucas M, Sánchez B, Wichmann I, García-Monge E, Núñez-Roldán A, Delgado F. Autoimmune deafness is not related to hyperreactivity to type II collagen. Acta Otolaryngol 1999; 119:690-4. [PMID: 10587003 DOI: 10.1080/00016489950180649] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The pathogenic role of anti-type II collagen was analysed in a variety of hearing losses, in age-matched controls and in different autoimmune diseases. The immune reactivity of peripheral blood lymphocytes to type II collagen was studied by the degree of proliferation measured as the incorporation of bromodeoxyuridine in cultured lymphocytes. The anti-type II collagen antibodies showed a very low incidence in the hearing loss group. Lymphocytes of otosclerosis, Meniere's disease and other sensorineural deafness patients proliferated in response to concanavalin A and to type II collagen to a lower extent than peripheral blood lymphocytes from healthy controls. Nonetheless, these differences were not statistically significant. The immune hyperreactivity to type II collagen cannot explain the autoimmune mechanism of hearing losses. Humoral and cellular hyperreactivities to inner ear proteins different from type II collagen, could explain the autoimmune mechanism of deafness.
Collapse
Affiliation(s)
- M A López-González
- Unit of Pediatric Otorhinolaryngology, Virgen del Rocio University Infantile Hospital, Seville, Spain
| | | | | | | | | | | | | |
Collapse
|
29
|
Matsuoka H, Cheng KC, Krug MS, Yazawa Y, Yoo TJ. Murine model of autoimmune hearing loss induced by myelin protein P0. Ann Otol Rhinol Laryngol 1999; 108:255-64. [PMID: 10086618 DOI: 10.1177/000348949910800307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Myelin protein P0 has been identified as an autoantigen in inner ear diseases. In order to study autoimmune hearing loss, we performed brain stem auditory-evoked potential (BAEP) studies on P0-sensitized mice. Two P0-sensitized mice showed hunched posture, poor coat, loss of body weight, and abnormal walking with a waddling gait. About 25% of the P0-sensitized mice developed hearing loss. In the BAEP study, peak latencies of waves I, III, and V and the interpeak latency I-III were prolonged in the P0-sensitized hearing loss group of mice. Hearing thresholds were elevated in this group of mice in comparison with the control mice. Inflammatory cell infiltration was observed in the cochlear nerve region, and a reduced number of spiral ganglion cells was also detected. These results suggest that P0-sensitized mice are a useful model for studying autoimmune inflammation of the peripheral portion of the auditory system.
Collapse
Affiliation(s)
- H Matsuoka
- Department of Medicine, University of Tennessee, Memphis 38163, USA
| | | | | | | | | |
Collapse
|
30
|
Tsuprun V, Santi P. Ultrastructure and immunohistochemical identification of the extracellular matrix of the chinchilla cochlea. Hear Res 1999; 129:35-49. [PMID: 10190750 DOI: 10.1016/s0378-5955(98)00219-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The molecular composition and three-dimensional organization of the extracellular matrix (ECM) was studied by immunofluorescent microscopy, transmission and scanning electron microscopy in three connective tissue structures of the cochlea: the spiral limbus, basilar membrane and spiral ligament. Type II collagen, fibronectin, tenascin, chondroitin sulfate proteoglycans, alphav and beta1 integrins were immunolocalized in the ECM of these connective tissue structures. Electron micrographs showed a continuum of cross-striated collagen fibrils having a similar diameter and axial periodicity that spread from the spiral limbus via the basilar membrane and into the spiral ligament. Some of collagen fibrils were aggregated laterally into bundles. Bundle images, and their digital Fourier transformations, showed a major 67-nm axial D-repeat characteristic for collagen fibrils. Transmission electron microscopy showed numerous proteoglycans associated with the collagen fibrils. The spiral limbus, basilar membrane and spiral ligament demonstrated regional differences in molecular composition and structural organization of their ECM. The glycoproteins fibronectin, tenascin and alphav integrin were immunolocalized mainly in the basilar membrane. Collagen fibrils of the spiral limbus and spiral ligament did not appear to be strongly oriented. However, most of the collagen fibrils in the basilar membrane were arranged into radially directed bundles. Collagen fibrils in the basilar membrane were also surrounded by a homogeneous matrix, which was immunoreactive to fibronectin and tenascin antibodies. A more complete understanding of the composition and structural organization of the ECM in these connective tissue structures in the cochlea provides a foundation upon which micromechanical models of cochlear function can be constructed.
Collapse
Affiliation(s)
- V Tsuprun
- Department of Otolaryngology, University of Minnesota, Minneapolis 55455, USA
| | | |
Collapse
|
31
|
Heller S, Sheane CA, Javed Z, Hudspeth AJ. Molecular markers for cell types of the inner ear and candidate genes for hearing disorders. Proc Natl Acad Sci U S A 1998; 95:11400-5. [PMID: 9736748 PMCID: PMC21654 DOI: 10.1073/pnas.95.19.11400] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/1998] [Indexed: 11/18/2022] Open
Abstract
To identify genes expressed in the vertebrate inner ear, we have established an assay that allows rapid analysis of the differential expression pattern of mRNAs derived from an auditory epithelium-specific cDNA library. We performed subtractive hybridization to create an enriched probe, which then was used to screen the cDNA library. After digoxigenin-labeled antisense cRNAs had been transcribed from hybridization-positive clones, we conducted in situ hybridization on slides bearing cryosections of late embryonic chicken heads, bodies, and cochleae. One hundred and twenty of the 196 clones analyzed encode 12 proteins whose mRNAs are specifically or highly expressed in the chicken's inner ear; the remainder encode proteins that occur more widely. We identified proteins that have been described previously as expressed in the inner ear, such as beta-tectorin, calbindin, and type II collagen. A second group of proteins abundant in the inner ear includes five additional types of collagens. A third group, including Coch-5B2 and an ear-specific connexin, comprises proteins whose human equivalents are candidates to account for hearing disorders. This group also includes proteins expressed in two unique cell types of the inner ear, homogene cells and cells of the tegmentum vasculosum.
Collapse
Affiliation(s)
- S Heller
- Howard Hughes Medical Institute and Laboratory of Sensory Neuroscience, The Rockefeller University, 1230 York Avenue, New York, NY 10021-6399, USA
| | | | | | | |
Collapse
|
32
|
Trune DR, Kempton JB, Mitchell CR, Hefeneider SH. Failure of elevated heat shock protein 70 antibodies to alter cochlear function in mice. Hear Res 1998; 116:65-70. [PMID: 9508029 DOI: 10.1016/s0378-5955(97)00198-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Heat shock protein 70 (HSP70) has been suggested as the putative cochlear antigen underlying a proposed autoimmune etiology in certain cases of Meniere's disease and idiopathic hearing loss. To determine if antibodies to this cellular protein are capable of altering cochlear function, BALB/c (N= 3) and CBA/J (N= 9) mice were inoculated with bovine HSP70 by intraperitoneal injections (10 microg in saline) every 10 days for 7 or 10 months, respectively. An equal number of control mice were injected with PBS according to the same schedule. ABR thresholds at 4, 8, 16, and 32 kHz in the HSP70-inoculated mice did not change over the 10 month period and were similar to saline controls. Furthermore, serum immune complexes and antinuclear antibodies did not increase over the inoculation period. ELISA analysis demonstrated the mice created antibodies to the foreign HSP70, but these apparently caused no abnormalities in the auditory or immune systems. It was concluded that foreign HSP70 is antigenic and inoculation with it will raise antibodies, but these antibodies were neither immunopathogenic nor cochleopathic. Therefore, these findings do not support current theories that elevated anti-HSP70 antibodies are the underlying cause of hearing loss in patients with such antibodies present.
Collapse
Affiliation(s)
- D R Trune
- Oregon Hearing Research Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health Sciences University, Portland 97201, USA
| | | | | | | |
Collapse
|
33
|
Maurer D, Stingl G, Röcken M, Merk HF, Rappersberger K, Bialasiewicz AA, Müller U, Leonhardt L, Schwanitz HJ, John SM, Gieler U, Baur X, Bischoff SC, Heppt W, Wahn U. Klinik. ALLERGOLOGIE 1998. [DOI: 10.1007/978-3-662-05660-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
34
|
Yoo TJ, Fujiyoshi T, Cheng KC, Krug MS, Kim NS, Lee KM, Shen T, Matsuoka H. Molecular basis of type II collagen autoimmune ear diseases. Ann N Y Acad Sci 1997; 830:221-35. [PMID: 9616681 DOI: 10.1111/j.1749-6632.1997.tb51893.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T J Yoo
- Department of Medicine, Microbiology and Immunology Neuroscience Program, University of Tennessee, Memphis 38163, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Affiliation(s)
- R Filipo
- Otolaryngology Department, University La Sapienza, Rome, Italy
| | | | | |
Collapse
|
36
|
Suzuki M, Cheng KC, Matsuoka H, Kim NS, Krug M, Bernstein J, Yoo TJ. The cochlear protein antigens 28 kd and 30 kd, and their antibodies in Ménière's disease. Ann N Y Acad Sci 1997; 830:211-20. [PMID: 9616680 DOI: 10.1111/j.1749-6632.1997.tb51892.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M Suzuki
- Shiga University Medical Center, Otsu, Japan
| | | | | | | | | | | | | |
Collapse
|
37
|
Lopez-Gonzalez MA, Guerrero JM, Delgado F. Presence of the pineal hormone melatonin in rat cochlea: its variations with lighting conditions. Neurosci Lett 1997; 238:81-3. [PMID: 9464660 DOI: 10.1016/s0304-3940(97)00844-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Within the normal inner ear, there are elements that belong to the immune system. Different inner ear disorders can be explained by autoimmune mechanisms, affecting both humoral and cellular immunity. Melatonin, the principal hormone of the pineal gland, modulates the immune system and extensively participates in the autoimmune processes related to type II collagen. Therefore, we have studied the presence of melatonin in rat cochlea, proving that its concentrations change depending on lighting conditions. Rats show high levels when confined to darkness and low levels when subject to continuous light exposure. The results correlate with the concentration of melatonin in peripheral circulation. Further experimental and clinical studies are necessary to clarify the role and the possible therapeutic applications of melatonin.
Collapse
Affiliation(s)
- M A Lopez-Gonzalez
- Unidad de ORL Pediátrica, Hospital Infantil Universitario Virgen del Rocío, Seville, Spain.
| | | | | |
Collapse
|
38
|
Trune DR, Kempton JB, Hefeneider SH, Bennett RM. Inner ear DNA receptors in MRL/lpr autoimmune mice: potential 30 and 70 kDa link between autoimmune disease and hearing loss. Hear Res 1997; 105:57-64. [PMID: 9083804 DOI: 10.1016/s0378-5955(96)00191-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inner ear function and systemic autoimmune disease were evaluated in the MRL/lpr mouse to determine their relationship with alterations in cell surface DNA receptors of 28-30 and 68-70 kDa size. Auditory brainstem response thresholds in the autoimmune disease mice were significantly elevated as early as 2 months of age when compared to MRL/++ controls. Hearing thresholds continued to rise with progression of the disease, manifested as increasing spleen weights, antinuclear (anti-DNA) antibodies, and serum immune complexes. Cochlear membranous labyrinth cells in the autoimmune mice bound less DNA, suggesting the DNA receptors were abnormally occupied by circulating antibodies. Western blots of a murine T-cell line probed with autoimmune mouse sera demonstrated reactivity to 28-30 and 68-70 kDa proteins after disease onset. It is hypothesized that cell surface DNA binding molecules could be masked or down-regulated by circulating antibodies in autoimmune disease. This interference with DNA receptor activity may be occurring within the inner ear and underlie the cochlear dysfunction seen in autoimmune sensorineural hearing loss.
Collapse
MESH Headings
- Analysis of Variance
- Animals
- Antibodies, Antinuclear/immunology
- Antigen-Antibody Complex/blood
- Auditory Threshold/physiology
- Autoimmune Diseases/etiology
- Autoimmune Diseases/immunology
- Binding, Competitive
- Blotting, Western
- Cell Line
- Cochlea/cytology
- Cochlea/immunology
- Deoxyribonucleases/metabolism
- Ear, Inner/immunology
- Ear, Inner/metabolism
- Electrophoresis, Polyacrylamide Gel
- Evoked Potentials, Auditory, Brain Stem/physiology
- Hearing Loss, Sensorineural/etiology
- Hearing Loss, Sensorineural/immunology
- Mice
- Mice, Inbred MRL lpr
- Molecular Weight
- Organ Size/physiology
- Receptors, Cell Surface/immunology
- Receptors, Cell Surface/metabolism
- Spleen/immunology
- Spleen/pathology
- T-Lymphocytes/cytology
- T-Lymphocytes/immunology
Collapse
Affiliation(s)
- D R Trune
- Oregon Hearing Research Center (NRCO4), Department of Otolaryngology, Head and Neck Surgery, Oregon Health Sciences University, Portland 97201-3098, USA
| | | | | | | |
Collapse
|
39
|
Cao MY, Thonnard J, Deggouj N, Gersdorff M, Philippe M, Osselaer JC, Tomasi JP. HLA class II-associated genetic susceptibility in idiopathic progressive sensorineural hearing loss. Ann Otol Rhinol Laryngol 1996; 105:628-33. [PMID: 8712634 DOI: 10.1177/000348949610500808] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To investigate the association between genes in the major histocompatibility complex and inner ear disease susceptibility at the DNA level, high-resolution genotyping for HLA class II (HLA-DR, -DQ, -DP) was performed by polymerase chain reaction-sequence-specific oligonucleotide reverse dot blot and polymerase chain reaction-restriction fragment length polymorphism analysis in 34 patients with idiopathic progressive sensorineural hearing loss (PSHL) and in 214 controls. The frequencies of DRB1*0301, DRB3*0101, DQB1*0201, and DPB1*0401 were significantly increased in patients with idiopathic PSHL compared with controls. The DQB1*0301 allele was significantly decreased in the patients. A linkage disequilibrium was probably responsible for the concomitant increase of both DRB1*0301 and DRB3*0101 alleles in patients. The increase of DQB1*0201 in patients was associated with the DRB1*0301 allele. In addition, the telomeric DPB1*0401 allele may act as an independent risk factor. The DQB1*0301 allele may have a protective role in the pathogenesis of idiopathic PSHL. These results suggest that the specific HLA class II gene products may confer susceptibility or resistance to idiopathic PSHL.
Collapse
Affiliation(s)
- M Y Cao
- Department of Otolaryngology, Laboratory of Clinical Molecular Biology, University Hospital of St-Luc, Brussels
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
To better understand autoimmune-related inner ear disease, cochlear structure and function were evaluated in the C3H/lpr autoimmune strain mouse, a model for systemic lupus erythematosus. C3H/lpr mice were examined at ages from 2 to 12 months along with age-matched C3H/HeJ controls. Autoimmune disease onset occurred at 3-4 months of age as serum immune complexes, antinuclear antibodies, and spleen weights were significantly elevated. Auditory brainstem response (ABR) audiometry showed normal auditory thresholds in C3H/lpr mice at 4 months of age, but elevated thresholds by 6 months, particularly in the high frequencies. Examination of the cochleas revealed no apparent loss of hair cells or spiral ganglion neurons, even in those mice with 50 dB SPL threshold shifts. However, changes were observed in the stria vascularis, including edematous spaces, enlarged capillaries, and thickened vessel linings. These findings imply that cochlear dysfunction in the autoimmune disease mice is the result of stria vascularis pathology.
Collapse
Affiliation(s)
- D R Trune
- Oregon Hearing Research Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland 97201-3098, USA
| | | | | |
Collapse
|
41
|
Kimura Y, Miwa H, Furukawa M, Mizukami Y. Relapsing polychondritis presented as inner ear involvement. J Laryngol Otol 1996; 110:154-7. [PMID: 8729501 DOI: 10.1017/s002221510013302x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report a rare case of relapsing polychondritis with an initial symptom of inner ear involvement. This 53-year-old Japanese man experienced a hearing difficulty, tinnitus in both ears, and dizziness of sudden onset, but lacked auricular chondritis at that time, which is the most frequent finding in relapsing polychondritis. Thus it was difficult to reach a correct diagnosis. Steroid therapy, with oral prednisolone 15 mg daily, was effective. Almost two months after we began the steroid therapy, the patient complained of losing interest in his work and reported a hallucination vision on the TV screen, so the dose of prednisolone was decreased to 10 mg. The hallucinations then disappeared, but the serum level of C-reactive protein increased highly. To reduce the dose of prednisolone, we tried low-dose oral methotrexate. However, we had to discontinue it when the patient experienced severe vomiting and diarrhoea. As adjuvant therapy, we then administered Sho-saiko-to, Chinese herbal medicines with few side effects. Symptoms and laboratory abnormalities then improved markedly.
Collapse
Affiliation(s)
- Y Kimura
- Department of Otolaryngology, Kanazawa University School of Medicine, Japan
| | | | | | | |
Collapse
|
42
|
Cao MY, Deggouj N, Gersdorff M, Tomasi JP. Guinea pig inner ear antigens: extraction and application to the study of human autoimmune inner ear disease. Laryngoscope 1996; 106:207-12. [PMID: 8583855 DOI: 10.1097/00005537-199602000-00019] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In this study, the authors attempted to develop a method of extracting guinea pig inner ear antigens for otoimmunological research, and to investigate the distribution of the antigens in the various structures of the inner ear. The antigens were extracted either from the entire or from various parts of the guinea pig inner ear. These antigens were separated on sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gels. Western blot techniques were used to test sera from patients with inner ear disease against guinea pig inner ear protein extracts. It found that the various molecular weight antigens in the inner ear were associated with the different structures of the inner ear. The sera of 37.5% (N = 80) of patients reacted with two bands (30 and 58 kd) of the guinea pig inner ear immunoblots. The 58 kd band was not specific to the inner ear, but instead was also found in the immunoblots of other guinea pig tissues (brain, lung, and liver). This study suggests that the various antigens of interest could be further extracted and purified from the corresponding locations of the inner ear.
Collapse
Affiliation(s)
- M Y Cao
- Department of Otorhinolaryngology, Catholic University of Louvain, University Hospital of St-Luc, Brussels, Belgium
| | | | | | | |
Collapse
|
43
|
Cao MY, Gersdorff M, Deggouj N, Warny M, Tomasi JP. Detection of inner ear disease autoantibodies by immunoblotting. Mol Cell Biochem 1995; 146:157-63. [PMID: 7565645 DOI: 10.1007/bf00944608] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To define further the character of autoantibodies against the inner ear in patients with inner ear disease, Autoantibodies in sera from 82 patients with inner ear disease were investigated by immunoblotting. The inner ear antigens were extracted from Hartley guinea pigs. Brain, kidney, lung, heart and liver extracts were also prepared. Antibodies against the inner ear were found in 32 of 82 (39%) patients with inner ear disease. These sera reacted with the 30 and 58 kDa bands of the inner ear extracts. The 30 kDa band was detected in sera from patients with various inner ear diseases, while the 58 kDa band reacted with sera of patients with idiopathic progressive sensorineural hearing loss. Only two of the 52 normal control sera had a very faint band at 30 kDa. Sixteen of 32 positive sera were then used to probe Western blots of the brain, kidney, lung heart and liver extracts. The 58 kDa band was also found in the protein extracts of the brain, the lung, and the liver. On the other hand, preliminary purification of the 30 and 58 kDa proteins from the inner ear extracts were achieved by anion exchange chromatography. These results show that antibodies in sera from patients with inner ear disease reacted with at least two polypeptide bands (30 and 58 kDa) of guinea pig inner ear extracts, and the 58 kDa antigenic epitope was not cochlea specific.
Collapse
Affiliation(s)
- M Y Cao
- Department of Otolaryngology, Catholic University of Louvain, University Hospital of St-Luc, Brussels, Belgium
| | | | | | | | | |
Collapse
|
44
|
Nair TS, Raphael Y, Dolan DF, Parrett TJ, Perlman LS, Brahmbhatt VR, Wang Y, Hou X, Ganjei G, Nuttall AL. Monoclonal antibody induced hearing loss. Hear Res 1995; 83:101-13. [PMID: 7607976 DOI: 10.1016/0378-5955(94)00194-u] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Monoclonal antibodies KHRI-3 and KHRI-5 identify antigens expressed on inner ear supporting cells and auditory hair cells respectively. To determine if these antibodies affect inner ear function groups of syngeneic Balb/c mice were inoculated with hybridomas KHRI-3, KHRI-5 and other Ig-secreting hybridomas. Hybridomas UM-A9, UM-7F11, the non-secreting SP2/0 myeloma and mice with no hybridoma were used as controls. Animals were tested for auditory brainstem responses (ABR) for frequencies of 4, 8, 16 and 24 kHz, before the inoculation of the hybridomas and at intervals of 6 to 10 days thereafter or daily once tumors became palpable. In normal mice there were no changes in ABR thresholds over the course of the experiment. Other control animals showed little change in ABR even when the growth of the hybridoma or myeloma tumors were far advanced. Of the KHRI-5 hybridoma bearing animals only one of seven animals exhibited threshold shifts greater than 15 dB. In contrast, most mice bearing the KHRI-3 hybridoma exhibited high frequency threshold shifts of 40-50 dB that coincided temporally with the growth of the hybridoma, the presence of circulating KHRI-3 antibody, and greatly increased immunoglobulin titers. Ears from KHRI-3-bearing mice that developed high frequency hearing loss also had a novel type of lesion in the basal turn of the cochlea that was characterized by loss of outer hair cells and absence of typical supporting cell scars. Such changes were not found in control hybridoma-bearing mice. These findings suggest that KHRI-3 antibody has an effect on hearing that is secondary to damage to the organ of Corti and loss of outer hair cells. Our results have important implications for antibody-mediated mechanisms of hearing loss and provide an animal model in which to study this phenomenon.
Collapse
Affiliation(s)
- T S Nair
- Cell Biology Laboratory, Kresge Hearing Research Institute, University of Michigan, Ann Arbor 48109-0506, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
A substrain of an autoimmune-prone mouse, NZB/kl, was found to show spontaneous elevation of the auditory brainstem response (ABR) threshold with age. Morphological examination of the inner ear in NZB/kl mice with high ABR thresholds revealed pathological changes confined to the stria vascularis, including marked thickening of the capillary basement membrane which contained many foamy structures, and vacuolar degeneration of the intermediate cells. Circular or granular IgM deposits and some IgG deposits were found in the stria vascularis in the mice with high ABR thresholds, suggesting that deposits of immune complexes (mainly IgM antibodies) could cause strial damage that resulted in the ABR threshold elevation. Another substrain of NZB mice, NZB/san, showed lower levels of IgM immune complexes and anti-ss DNA antibodies, and did not develop either inner ear morphological changes or a high ABR threshold. NZB/kl mice may provide a useful animal model for studying the mechanism of autoimmune inner ear disease.
Collapse
Affiliation(s)
- M Sone
- Department of Otorhinolaryngology, School of Medicine, University of Nagoya, Japan
| | | | | | | |
Collapse
|
46
|
Cao MY, Gersdorff M, Deggouj N, Tomasi JP. The localization and specificity of guinea pig inner ear antigenic epitopes. J Laryngol Otol 1995; 109:19-23. [PMID: 7533202 DOI: 10.1017/s0022215100129147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In this study, we investigated the relative localization of some antigenic epitopes in the inner ear. The inner ear protein antigens were extracted from various parts of the guinea pig inner ear. Brain, kidney, lung, heart and liver extracts were also obtained. We found by SDS-polyacrylamide gel electrophoresis that total inner ear extracts separated into three high concentration polypeptide bands with molecular weights of approximately 30, 42, 58 kd and three low density bands of 20, 25 and 35 kd. The 30 kd band was found mainly in the extract of the spiral ganglion and the acoustic nerve in the modiolus. The 42 and 58 kd bands were detected in the extract of the spiral ligament and the stria vascularis. The Organ of Corti and the basilar membrane extract gave rise to three bands of 30, 42 and 58 kd. Twenty-eight of the 75 sera from patients with inner ear disease reacted with the 30 and 58 kd bands of the inner ear protein extracts by immunoblotting. Sixteen of these 28 positive sera were then used to probe immunoblots of the brain, kidney, lung, heart and liver extracts. The 58 kd band was also found in protein extracts of the brain, the lung and the liver. This study suggests that the 30 kd antigenic epitope may be mainly related to the acoustic nerve and that the 58 kd antigenic epitope is not cochlear specific.
Collapse
Affiliation(s)
- M Y Cao
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium
| | | | | | | |
Collapse
|
47
|
Herdman RC, Morgan K, Holt PJ, Ramsden RT. Type II collagen autoimmunity and Ménière's disease. J Laryngol Otol 1993; 107:994-8. [PMID: 8288993 DOI: 10.1017/s0022215100125083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Antibodies to type II collagen have been reported by some authors to be raised in patients with Ménière's disease. In this study the antibody levels to type I and II collagen have been measured in 37 patients with Ménière's disease and 20 controls, using a solid-phase, double-antibody, enzyme-linked, immunoassay. No significant difference in antibody levels between the two groups was found. These findings do not support previously reported work which suggests that some cases of Ménière's disease are due to type II collagen autoimmunity.
Collapse
Affiliation(s)
- R C Herdman
- University Department of Otolaryngology, Manchester
| | | | | | | |
Collapse
|