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The Role of Autoimmunity in the Pathogenesis of Sudden Sensorineural Hearing Loss. Neural Plast 2018; 2018:7691473. [PMID: 30008743 PMCID: PMC6020465 DOI: 10.1155/2018/7691473] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/10/2018] [Indexed: 12/20/2022] Open
Abstract
Sudden sensorineural hearing loss (SSHL) is a clinically common acute symptom in otolaryngology. Although the incidence of SSHL has increased around the world in recent years, the etiology of the disease is still unclear. It has been reported that infections, ototoxic drugs, membrane labyrinth rupture, carcinomas, circulatory system diseases, autoimmune diseases, brain lesions, mental diseases, congenital or inherited diseases, and so on, are all risk factors for SSHL. Here, we discuss the autoimmune mechanisms behind SSHL, which might be induced by type II–IV allergic reactions. We also introduce the main immunosuppressive medications that have been used to treat SSHL, which will help us to identify potential targets for immune therapy.
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Vethanayagam RR, Yang W, Dong Y, Hu BH. Toll-like receptor 4 modulates the cochlear immune response to acoustic injury. Cell Death Dis 2016; 7:e2245. [PMID: 27253409 PMCID: PMC5143385 DOI: 10.1038/cddis.2016.156] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/29/2016] [Accepted: 05/03/2016] [Indexed: 12/13/2022]
Abstract
Acoustic overstimulation traumatizes the cochlea, resulting in auditory dysfunction. As a consequence of acoustic injury, the immune system in the cochlea is activated, leading to the production of inflammatory mediators and the infiltration of immune cells. However, the molecular mechanisms responsible for initiating these immune responses remain unclear. Here, we investigate the functional role of Toll-like receptor 4 (Tlr4), a cellular receptor that activates the innate immune system, in the regulation of cochlear responses to acoustic overstimulation. Using a Tlr4 knockout mouse model, we examined how Tlr4 deficiency affects sensory cell pathogenesis, auditory dysfunction and cochlear immune activity. We demonstrate that Tlr4 knockout does not affect sensory cell viability under physiological conditions, but reduces the level of sensory cell damage and cochlear dysfunction after acoustic injury. Together, these findings suggest that Tlr4 promotes sensory cell degeneration and cochlear dysfunction after acoustic injury. Acoustic injury provokes a site-dependent inflammatory response in both the organ of Corti and the tissues of the lateral wall and basilar membrane. Tlr4 deficiency affects these inflammatory responses in a site-dependent manner. In the organ of Corti, loss of Tlr4 function suppresses the production of interleukin 6 (Il6), a pro-inflammatory molecule, after acoustic injury. By contrast, the production of inflammatory mediators, including Il6, persists in the lateral wall and basilar membrane. In addition to immune molecules, Tlr4 knockout inhibits the expression of major histocompatibility complex class II, an antigen-presenting molecule, in macrophages, suggesting that Tlr4 participates in the antigen-presenting function of macrophages after acoustic trauma. Together, these results suggest that Tlr4 regulates multiple aspects of the immune response in the cochlea and contributes to cochlear pathogenesis after acoustic injury.
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Affiliation(s)
- R R Vethanayagam
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - W Yang
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Y Dong
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - B H Hu
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
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Hervier B, Bordure P, Masseau A, Calais C, Agard C, Hamidou M. [Auto-immune sensorineural deafness: physiopathology and therapeutic approach]. Rev Med Interne 2009; 31:222-8. [PMID: 19233519 DOI: 10.1016/j.revmed.2008.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Revised: 11/29/2008] [Accepted: 12/10/2008] [Indexed: 12/17/2022]
Abstract
Sensorineural hearing loss may be due to an autoimmune mechanism. The mechanisms that could induce autoimmune inner ear damage are now better understood, but are not exclusive. Moreover, there is no specific immunologic test available for the diagnosis of autoimmune sensorineural hearing loss, which could also complicate the disease course of other autoimmune systemic diseases. Thus, the incidence of sensorineural autoimmune hearing loss is probably underestimated. The aim of this study was to review the experimental immunologic data in favour of an autoimmune mechanism in this subgroup of sensorineural hearing loss: humoral specific response against inner ear (autoantibodies against a transmembrane transporter) and also cellular response (against cochlin: one of the major proteins expressed in the inner ear). The aim of this review was also to focus on clinical and epidemiological human data that provide evidence for an autoimmune etiopathogeny of some sensorineural hearing loss. Therapeutic options such as immunosuppressive treatments (oral corticosteroids and other immunosuppressive drugs, such as methotrexate and anti-TNFalpha) are also discussed.
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Abstract
The incidence of autoimmune inner ear disease (AIED) is difficult to determine: probably it is a rare disease, accounting for <1% of all cases of hearing impairment or dizziness. Nevertheless, the diagnosis of AIED might be overlooked because of the lack of a specific diagnostic test. The hallmark of this clinically diagnosed condition is the presence of a rapidly progressive, often fluctuating, bilateral sensorineural hearing loss (SNHL) over a period of weeks to months. The progression of hearing loss is too rapid to be diagnostic for presbycusis and too slow to conclude a diagnosis of sudden SNHL. Vestibular symptoms, such as generalized imbalance, ataxia, positional vertigo and episodic vertigo may be present in almost 50% of patients. Occasionally only one ear is affected initially, but bilateral hearing loss occurs in most patients, with symmetric or asymmetric audiometric thresholds. Almost 25-50% of patients also have tinnitus and aural fullness, which can fluctuate. Systemic autoimmune diseases coexist in 15-30% of patients.
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Affiliation(s)
- R Bovo
- Department of Audiology, University of Ferrara, Ferrara, Italy.
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Barkdull GC, Vu C, Keithley EM, Harris JP. Cochlear microperfusion: experimental evaluation of a potential new therapy for severe hearing loss caused by inflammation. Otol Neurotol 2005; 26:19-26. [PMID: 15699715 DOI: 10.1097/00129492-200501000-00005] [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: 12/27/2022]
Abstract
HYPOTHESIS Cochlear microperfusion will be a useful treatment of severe sensorineural hearing loss caused by inflammation. BACKGROUND Viruses, bacteria, and autoimmunity can initiate inflammation in the inner ear. The acute phase is associated with elevations in cytokines, nitrous oxide, and cellular infiltrates and the breakdown of the blood-labyrinthine barrier. The chronic phase leads to irreversible ossification of the labyrinth. METHODS The authors developed cochlear microperfusion to facilitate removal of inflammatory cells and their byproducts during the acute phase of inflammation. Using a ventral approach to the guinea pig cochlea, the authors displaced resident perilymph by delivering perfusate into the scala vestibuli and collecting the effluent from the scala tympani. The authors evaluated the benefit of the procedure in an animal model of severe hearing loss caused by inflammation. RESULTS Healthy controls undergoing cochlear microperfusion with phosphate-buffered saline incurred a mean hearing loss of 16 dB (n=4). This hearing loss was associated with the creation of two cochleostomies and not the perfusion itself. Sterile labyrinthitis (n=5) generated by perfusion of the cochlea with antigen consistently produced severe hearing loss over the initial 48 hours, and this hearing loss persisted for the subsequent 7 days. Therapeutic cochlear microperfusion, performed within the first 24 hours of developing severe hearing loss (n=9), immediately restored on average 24 dB (p <0.007) of hearing. CONCLUSION Cochlear microperfusion is a promising new technique for treating severe deafness caused by inflammation. The benefit may be sustained when combined with local delivery of immunosuppressive agents to the inner ear.
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Affiliation(s)
- Gregory C Barkdull
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, School of Medicine, 92103-8895, USA
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Abstract
Autoimmune sensorineural hearing loss (ASNHL) typically produces a bilateral rapidly progressive loss of hearing that may occur suddenly. The diagnosis is made by excluding ototoxicity, systemic disease, and other factors that mimic ASNHL and by showing a therapeutic response to corticosteroid treatment. Although autoantibodies and autoreactive T cells have been implicated in the etiopathogenesis of ASNHL, several central issues remain unresolved, including the relative prominence of B cell or T cell autoimmunity in the initiation and progression of ASNHL, the identity of the putative inner ear self-antigen(s) that target ASNHL, and the development and application of immunosuppressive therapies for preventing the progressive hearing loss which may be profound and require cochlear implantation. In this review, we will examine the seminal human and animal studies that have led to our current views regarding the autoimmune etiopathogenesis of ASNHL. In addition, we will address the need for developing an inner ear-specific mouse model for ASNHL that may define the stages leading to the development of ASNHL and may also provide new diagnostic markers and help develop novel and effective treatments for preventing progressive hearing loss in ASNHL.
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Affiliation(s)
- C Arturo Solares
- Department of Immunology, NB30, Lerner Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Abstract
Otolaryngologists have long sought to identify causes of sensorineural hearing loss that could be reversed by medical treatment. An increasing amount of clinical and experimental evidence indicates that this postulated entity is related to autoimmune inner ear disease. Because of the lack of well-defined detection methods for identifying autoimmune processes within the human inner ear and the fact that it is one of the few organs of the body not amenable to diagnostic biopsy there has been great interest in developing animal models that mimic clinical entities. Different models will be presented in this paper. The results of these studies should provide sufficient evidence to establish a clear position in mainstream immunology for the entity of autoimmune inner ear disease.
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Affiliation(s)
- Bertrand Gloddek
- Department of Otolaryngology/Head & Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Germany,.
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Satoh H, Firestein GS, Billings PB, Harris JP, Keithley EM. Tumor necrosis factor-alpha, an initiator, and etanercept, an inhibitor of cochlear inflammation. Laryngoscope 2002; 112:1627-34. [PMID: 12352677 DOI: 10.1097/00005537-200209000-00019] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES/HYPOTHESIS The inner ear rapidly mounts an immune response that can lead to cochlear degeneration and permanent hearing loss. Identification of proinflammatory cytokine expression during the initiation of the response should lead to rational therapeutic strategies that block the response, reducing damaging sequelae. STUDY DESIGN A cochlear immune response to keyhole limpet hemocyanin (KLH) injected into the inner ear or subarachnoid space of sensitized animals was created. Etanercept was administered to a group of animals to blunt the immune response. METHODS Cochleae were immunoassayed for expression of interleukin-1beta, tumor necrosis factor-alpha, and interleukin-6 and evaluated for the amount of cochlear-infiltrated cells. RESULTS Tumor necrosis factor-alpha and interleukin-1beta were expressed by infiltrated cells shortly after KLH injection. Tumor necrosis factor-alpha was expressed whether the antigen was introduced with or without surgical trauma. Interleukin-1beta was also expressed by the cochlear fibrocytes during the immune response and in surgical control animals, but not after intrathecal injection of antigen. Interleukin-6 expression was minimal during the response. Based on this observation, animals were treated with systemic injection of Etanercept, which reduced cochlear infiltrating cell number and cochlear fibrosis. CONCLUSION Interleukin-1beta expression is a general cochlear response to trauma, whereas tumor necrosis factor-alpha expression in the infiltrated immunocompetent cells is the cytokine that induces amplification of the response that leads to cochlear disease.
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Affiliation(s)
- Hitoshi Satoh
- Division of Otolaryngology--Head and Neck Surgery, University of California, San Diego, La Jolla 92093-0666, USA
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Gloddek B, Lassmann S, Gloddek J, Arnold W. Role of S-100beta as potential autoantigen in an autoimmune disease of the inner ear. J Neuroimmunol 1999; 101:39-46. [PMID: 10580812 DOI: 10.1016/s0165-5728(99)00131-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In Lewis rats, adoptive transfer of T cells specific for the calcium-binding protein S-100beta mediates experimental autoimmune encephalomyelitis, but surprisingly also induced a marked labyrinthitis associated with impairment of hearing. This suggests that transfer of S-100beta-specific T cells into susceptible animals could be a novel model to study autoimmunity of inner ear diseases. The investigation demonstrated in detail an inner ear involving, central nervous system (CNS)-specific autoimmune disease in order to identify a putatively shared autoantigen(s) in these pathologies. In fact, the model will be a useful tool to investigate in detail, the pathological mechanisms of the human inner ear disease associated with Vogt-Koyanagi-Harada disease.
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Affiliation(s)
- B Gloddek
- Department of Otolaryngology/Head and Neck Surgery, Klinicum rechts der Isar der, Technical University München, Munich, Germany.
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Gloddek B, Arnold W. The endolymphatic sac receives antigenetic information from the organs of the mucosa-associated lymphatic system. Acta Otolaryngol 1998; 118:333-6. [PMID: 9655206 DOI: 10.1080/00016489850183403] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The endolymphatic sac holds the entire arrangement of immunocompetent cells and functions as an immunological potent control organ for the inner ear. The evidence of secretory immunoglobulin A and other features of lymphocyte subtypes characterizes the endolymphatic sac as an organ of the mucosa-associated lymphatic system (MALT). In this system a permanent recirculation of sensitized memory lymphocytes from one organ to the other has been demonstrated experimentally as serving to dispose memory lymphocytes after renewed antigenetic stimulus. The aim of this study was to prove the possible recirculation of antigen-sensitized lymphocytes to the endolymphatic sac after antigenic stimulus of another part of the mucosa-associated lymphatic system. The results are evidence that the endolymphatic sac is provided with immunocompetent cells which derive from the lymphatic tissue of the nasopharynx. While the origin of immunocompetent cells in the endolymphatic sac still remains uncertain, this study underlines the role of lympho-epithelial tissue of the nasopharynx as a possible cell source for the endolymphatic sac. The results might explain the altered or disturbed function of the endolymphatic sac as a possible cause of certain inner ear diseases.
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Affiliation(s)
- B Gloddek
- Department of Otolaryngology and Head- and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, München, Germany
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Chen MC, Harris JP, Keithley EM. Immunohistochemical analysis of proliferating cells in a sterile labyrinthitis animal model. Laryngoscope 1998; 108:651-6. [PMID: 9591540 DOI: 10.1097/00005537-199805000-00005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Inflammatory reactions within the cochlea lead to the formation of fibrotic tissue and bone. To determine which cells are involved in the proliferation of the inflammatory response within the cochlea, sterile labyrinthitis was created by inoculating keyhole limpet hemocyanin (KLH) into the scala tympani of systemically sensitized animals. Cellular proliferation was assessed immunohistochemically using the monoclonal antibody Ki-67. Proliferating cells were identified among inflammatory cells and fibroblasts within the matrix, as well as in endosteal cells lining the scala tympani. Inflammatory and potential osteoprogenitor cells were labeled as late as 6 weeks after inoculation, suggesting the absence of a strong immunosuppressive mechanism. Endosteal cells may proliferate and secrete the extracellular matrix used by the inflammatory cells to move within the cochlear scalae. They may also participate in the ossification of the inflammatory matrix.
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Affiliation(s)
- M C Chen
- Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, and the Research Services of Veterans Affairs, La Jolla 92093, USA
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Gong S, Zeng X, Yan Z, Wang J. Expression of intercellular adhesion molecule-1 in immune response of inner ear. Curr Med Sci 1998; 18:208-11. [PMID: 10806847 DOI: 10.1007/bf02886474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/1998] [Indexed: 10/19/2022]
Abstract
To understand the role of intercellular adhesion molecule-1 (ICAM-1) in immune response of the inner ear, inner ear immune response was induced in rats by inoculation of keyhole limpet hemocyanine (KLH) into the scala tympani of the animals who had been systemically sensitized. The expression of ICAM-1 in the inner ear was immunohistochemically examined. ICAM-1 was found in the epithelium of the spiral modiolar vein (SMV) with its collecting venules (CVs) as early as 6 h after challenge. Expression of ICAM-1 was observed on the epithelium of the endolymphatic sac (ES) and perisaccular region at 12 h. The intensity of ICAM-1 staining reached its peak within 24-48 h in these sites of the inner ear. By day 28, most specimens were devoid of appreciable staining for ICAM-1. Our study demonstrates that adhesion molecules play an important role in extravasation of inflammatory cells from the systemic circulation in the process of inner ear immune response. It also shows that cytokines that control expression of adhesion molecules may be released by cells outside ES, besides those cells in the ES.
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Affiliation(s)
- S Gong
- Department of Otorhinolaryngology, Xiehe Hospital, Tongji Medical University, Wuhan
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Abstract
We have reviewed the events of an inner-ear immune response. The perilymph contains antibody, presumably derived from the systemic circulation and CSF, which would allow for neutralization and help with opsonization and complement fixation. The endolymphatic sac contains immunocompetent cells capable of processing and presenting viral or bacterial antigen, potentiating the immune response, attacking the invaders directly or attacking infected cells, and developing immunoglobulin responses in situ. The early release of mediators such as IL-2 likely emanate from the endolymphatic sac and result in potentiation and regulation of the response and may assist in changes in the SMV, including expression of ICAM-1, which aid in the egress of immune cells from the systemic circulation. PMNs arrive first, followed by T cells and B cells, with secretion of specific antibody a relatively late event. Concomitant with the increase in cellular constituents is the formation of a dense extracellular matrix. The inner ear appears to have remarkable difficulty in clearing this matrix, ultimately resulting in ossification. The immune response is unfortunately deleterious to the inner ear, resulting in degeneration of the organ of Corti, stria vascularis, and spiral ganglion. Hearing loss is consistently seen following sterile and virally induced labyrinthitis. The inner ear also appears to be a target for autoimmune disease. While inner-ear damage has been described as part of non-organ-specific autoimmune disease, specific disease against the hearing apparatus is also likely. Experimental paradigms have allowed alterations of both the afferent and efferent limbs of this response; ultimately, with the hope that we can alter the course of the response and the subsequent damage in patients.
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Affiliation(s)
- J P Harris
- Department of Surgery, University of California, San Diego, La Jolla, California 92037, USA.
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Takasu T, Harris JP. Reduction of inner ear inflammation by treatment with anti-ICAM-1 antibody. Ann Otol Rhinol Laryngol 1997; 106:1070-5. [PMID: 9415603 DOI: 10.1177/000348949710601211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The in vivo effect of systemic administration of monoclonal antibody (mAb) against ICAM-1 (alphaICAM-1) in experimental immune-mediated labyrinthitis was evaluated. The alphaICAM-1-treated rats showed reduced inflammatory cell infiltration in the scala tympani and the perisaccular tissue of the endolymphatic sac. However, with this experimental paradigm, labyrinthitis could not be completely abolished. These findings suggest that ICAM-1-dependent pathways play an important role in the series of immunologic events occurring in the inner ear, and that the use of ICAM-1 antagonist may be a possible therapeutic approach to labyrinthitis.
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Affiliation(s)
- T Takasu
- Department of Surgery, University of California, San Diego, La Jolla 92093-0970, USA
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Paleri V. Inner Ear Immunology and Allergy: An Overview of Current Day Concepts. EAR, NOSE & THROAT JOURNAL 1997. [DOI: 10.1177/014556139707601108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Takahashi M, Tomiyama S. Cell proliferation in the endolymphatic sac in situ after inner ear immunostimulation. Acta Otolaryngol 1995; 115:396-9. [PMID: 7653260 DOI: 10.3109/00016489509139336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Cell proliferation in the endolymphatic sac (ES) after immunostimulation was assessed immunohistochemically. Guinea pigs were employed as experimental animals and keyhole limpet hemocyanin was used as the antigen. After i.p. injection of 5-bromo-2'-deoxyuridine (BrdUrd), the BrdUrd+ cells were counted to assess the number of proliferating cells. In the secondary immune reaction of the ES, the IgG+ cell count in the perisaccular region was markedly increased on days 7-14. An increased number of BrdUrd+ cells was detected, peaking on day 3, and the localization of these cells in the ES was similar to that of the IgG+ cells. This suggests that some BrdUrd+ cells may differentiate into IgG- cells within the ES.
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Affiliation(s)
- M Takahashi
- Department of Otolaryngology, Asahikawa Medical School, Japan
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Suzuki M, Harris JP. Expression of intercellular adhesion molecule-1 during inner ear inflammation. Ann Otol Rhinol Laryngol 1995; 104:69-75. [PMID: 7530436 DOI: 10.1177/000348949510400111] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study was designed to investigate the expression of intercellular adhesion molecule-1 (ICAM-1) on the spiral modiolar vein (SMV) with its collecting venules (CVs) and the venules of the endolymphatic sac during inner ear inflammation. These data will further elucidate the role of adhesion molecules in extravasation of inflammatory cells from blood vessels during an inner ear immune response. Labyrinthitis was induced in rats by inoculation of keyhole limpet hemocyanin into the scala tympani of animals who had been systemically sensitized to it. Expression of ICAM-1 was examined with a mouse monoclonal antibody to rat ICAM-1 by immunohistochemistry. ICAM-1 was found weakly on the epithelium of SMVs and CVs as early as 6 hours postchallenge, reaching a maximum by day 2 and then fading away gradually. The maximum influx of immunocompetent cells into the cochlea was seen between days 3 and 7. Staining for ICAM-1 was observed on the epithelium of the endolymphatic sac and perisaccular region at 12 and 24 hours, respectively, and this was associated with infiltration of cells into these areas 3 days postchallenge. By day 28, the inner ear had developed endolymphatic hydrops, but at this time it showed almost no significant staining with anti-ICAM-1. The molecule was also expressed in the mesothelium of perilymph, the perineurium of cochlear nerves, the spiral ligament, and the basal cells of the stria vascularis following immunization. Our data provide evidence that endothelial cells of the SMV and its CVs, as well as other inner sites, have the potential to express ICAM-1. This expression precedes the influx of immune cells; therefore, it is possible that this ligand plays a pivotal role in the onset of inflammation in the inner ear. This study also confirmed that the immune response results in endolymphatic hydrops as a long-term consequence.
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Affiliation(s)
- M Suzuki
- Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego
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Gloddek B, Rogowski M, Reiss G, Arnold W. Adoptive transfer of an autoimmunological labyrinthitis in the guinea pig; animal model for a sympathetic cochleolabyrinthitis. Clin Exp Immunol 1994; 97:133-7. [PMID: 8033410 PMCID: PMC1534794 DOI: 10.1111/j.1365-2249.1994.tb06591.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Sensorineural hearing loss is a common problem in the otolaryngologist's practice, with autoimmune disease of the inner ear being one possible cause. The restoration of auditory function in some patients following immunosuppressive therapy has created a desire to define and understand this disease better. Because of the lack of a well defined detection method to identify this entity clinically, this study was undertaken in order to provide an animal model for autoimmune disease of the inner ear. Previous studies with guinea pigs have demonstrated that sensitized lymphocytes from the systemic circulation migrate to the labyrinth during an immune response in the inner ear. The aim of this study was to prove the capacity of sensitized lymphocytes to transfer autoimmune inner ear disease, and to describe the resulting morphological and physiological changes. Therefore two groups of sensitized lymphocytes partially labelled with a radioactive marker from inbred guinea pigs with an immune response within the inner ear were injected into the bloodstream of naive recipient animals. Most of the labelled cells were observed in the apical turn of the experimental cochlea, while only few cells were detectable in the control cochleas. In addition, the absence of otoacoustic emissions and the loss of outer hair cells observed by electron microscopy were interpreted as a sign of damage caused by the provoked immunopathologic mechanism. The results are discussed as a possible model for a sympathetic cochleolabyrinthitis.
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Affiliation(s)
- B Gloddek
- Hals-Nasen-Ohrenklinik und Poliklinik, Technische Universität, München, Germany
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Tomiyama S. Development of endolymphatic hydrops following immune response in the endolymphatic sac of the guinea pig. Acta Otolaryngol 1992; 112:470-8. [PMID: 1441988 DOI: 10.3109/00016489209137428] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The present study investigated immune injury associated with endolymphatic hydrops (e.hydrops) following locally mounted immune reaction in the endolymphatic sac (e.sac) of guinea pigs. E.hydrops occurred, progressing rapidly within the first week post secondary Keyhole limpet hemocyanin (KLH) challenge in the e.sac and developed into two phases, acute and chronic. On the other hand, primary KLH challenge of the e.sac, PBS inoculation into the e.sac or intradural secondary KLH challenge were incapable of inducing e.hydrops. These results indicate that reversible and irreversible e.hydrops are induced by the immune response of the e.sac, suggesting that local immunological events of the e.sac may provide an animal model of Meniere's disease.
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Affiliation(s)
- S Tomiyama
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
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Abstract
The inner ear responds immunologically to foreign proteins and pathogens introduced into the cochlea. The route of entry of the cells participating in the inner ear inflammatory process is the spiral modiolar vein with its collecting venules. Since this vein is located adjacent to the scala tympani, the end result of cellular infiltration is fibro-osseous obliteration of this scala preferentially. This observation has implications for the placement of cochlear implant electrodes of patients with labyrinthitis as the cause of hearing loss.
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Affiliation(s)
- J P Harris
- Department of Surgery, UCSD Medical School
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Abstract
The migration of lymphocytes to the inner ear was studied during an immune response in the cochlea. Sensitized lymphocytes from peripheral blood, neck lymph nodes and spleen from strain 13 inbred guinea pigs were labelled with 51Cr and injected intravenously into strain 13 recipients undergoing an inner ear immune response. Eighteen hours later the temporal bones and immune organs of the recipients were assayed for radioactivity to detect the infiltration of labelled cells. In addition autoradiography was performed to localize labelled cells in the inner ear. More lymphocytes from the peripheral blood entered the inner ear during the immune response than spleen or lymph node cells. This indicates that the inner ear comes under the immuno-surveillance of the peripheral circulation in response to antigenic stimulation. Most labelled lymphocytes were observed in the basal turn of the scala tympani and in and around the spiral modiolar vein of the challenged cochlea. A few cells were seen also in the control cochleas but almost all where inside the blood vessels. This pattern suggests that the blood vessels of the spiral modiolar vein are the initial site through which lymphocytes entered the inner ear.
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Affiliation(s)
- B Gloddek
- Department of ENT, Medizinische Hochschule, Hannover, Germany
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Harris JP, Fukuda S, Keithley EM. Spiral modiolar vein: its importance in inner ear inflammation. Acta Otolaryngol 1990; 110:357-65. [PMID: 2284910 DOI: 10.3109/00016489009107455] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The inner ear responds immunologically to foreign proteins and pathogens introduced into the cochlea. The route of entry of the cells participating in the inner ear inflammatory process is the spiral modiolar vein with its collecting venules. Since this vein is located adjacent to the scala tympani, the end result of cellular infiltration is fibro-osseous obliteration of this scala preferentially. This observation has implications for the placement of cochlear implant electrodes of patients with labyrinthitis as the cause of hearing loss.
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Affiliation(s)
- J P Harris
- Department of Surgery, UCSD Medical School
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