The effect of acetazolamide on the endolymphatic sac DC potential

Ion transport its regulation in the endolymphatic sac: suggestions for clinical aspects of Meniere's disease

Ion transport and its regulation in the endolymphatic sac (ES) are reviewed on the basis of recent lines of evidence. The morphological and physiological findings demonstrate that epithelial cells in the intermediate portion of the ES are more functional in ion transport than those in the other portions. Several ion channels, ion transporters, ion exchangers, and so on have been reported to be present in epithelial cells of ES intermediate portion. An imaging study has shown that mitochondria-rich cells in the ES intermediate portion have a higher activity of Na⁺, K⁺-ATPase and a higher Na⁺ permeability than other type of cells, implying that molecules related to Na⁺ transport, such as epithelial sodium channel (ENaC), Na⁺–K⁺–2Cl⁻ cotransporter 2 (NKCC2) and thiazide-sensitive Na⁺–Cl⁻ cotransporter (NCC), may be present in mitochondria-rich cells. Accumulated lines of evidence suggests that Na⁺ transport is most important in the ES, and that mitochondria-rich cells play crucial roles in Na⁺ transport in the ES. Several lines of evidence support the hypothesis that aldosterone may regulate Na⁺ transport in ES, resulting in endolymph volume regulation. The presence of molecules related to acid/base transport, such as H⁺-ATPase, Na⁺–H⁺ exchanger (NHE), pendrin (SLC26A4), Cl⁻–HCO₃⁻ exchanger (SLC4A2), and carbonic anhydrase in ES epithelial cells, suggests that acid/base transport is another important one in the ES. Recent basic and clinical studies suggest that aldosterone may be involved in the effect of salt-reduced diet treatment in Meniere’s disease.

Presence of FXYD6 in the endolymphatic sac epithelia

A homeostasis of the electrochemical properties and volume of the endolymph in the inner ear is essential for hearing and equilibrium sensing and is maintained by ion-transport across an epithelial tissue, the endolymphatic sac. One of the key proteins in the maintenance is Na(+), K(+)-ATPase. Although we previously found that the Na(+), K(+)-ATPase in the sac plays a pivotal role in the control of the endolymphatic volume, the mechanism remains unclear. Therefore, in this study, we examined the expression of FXYD6, a functional modulator of the Na(+), K(+)-ATPase, in the epithelial cells of the endolymphatic sac using various approaches. Laser capture microdissection RT-PCR was used to identify FXYD6 mRNA in the endolymphatic sac. Immunolabeling with the specific antibody showed that FXYD6 was predominantly expressed in the intermediate portion of the endolymphatic sac, and it was colocalized with the Na(+), K(+)-ATPase. Because the Na(+), K(+)-ATPase in this region is known to exhibit a high level of activity, an interaction of FXYD6 with this transporter may be critically involved in the regulation of the characteristics of the endolymph.

Endolymphatic sac is involved in the regulation of hydrostatic pressure of cochlear endolymph

To clarify the role of the endolymphatic sac (ES) in the regulation of endolymphatic pressure, the effects of isoproterenol, a beta-adrenergic receptor agonist, and acetazolamide, a potent carbonic anhydrase inhibitor, both of which decrease ES direct current potential on cochlear hydrostatic pressure, were examined in guinea pigs. When isoproterenol was applied intravenously, hydrostatic pressures of cochlear endolymph and perilymph were significantly increased with no change in endocochlear potential or the hydrostatic pressure of cerebrospinal fluid. Acetazolamide produced no marked change in the hydrostatic pressure of cochlear endolymph. In ears with an obstructed ES, the action of isoproterenol on the hydrostatic pressure of cochlear endolymph and perilymph was suppressed. These results suggest that the ES may regulate the hydrostatic pressure of the endolymphatic system via the action of the agents such as catecholamines on the ES.

Functional changes associated with experimentally induced endolymphatic hydrops

A guinea pig model with surgically induced endolymphatic hydrops of the inner ear has been developed and studied over the past thirty years. The aim of such studies is to obtain insight into physiological processes associated with endolymphatic hydrops in man and in particular in Menière's disease where endolymphatic hydrops is systematically encountered at post-mortem examination of the temporal bones. The present review attempts to draw together the data pertaining to functional modifications of inner ear function in the animal model. For simplicity the data are categorised under five main titles: electrochemical modifications, electrophysiological modifications, pressure and hydrops, sensitivity to other insults and vestibular dysfunction. One of the most striking observations that can be made is that the data originating from different authors are very variable. There is, however, some evidence suggesting that the evolution of the auditory dysfunction could be considered as consisting of a series of different phases. This kind of information could serve as a basic framework for future research on the animal model.

Effects of acetazolamide on acid-base balance in the endolymphatic sac of the guinea pig

The effects of acetazolamide, a carbonic anhydrase inhibitor, on acid-base parameters in the endolymphatic sac of the guinea pig were investigated using ion-selective microelectrodes. Bicarbonate concentration was reduced and pH shifted to being acidic immediately after administration of acetazolamide. Chloride concentration in the endolymphatic sac increased after carbonic anhydrase inhibition. These findings provide evidence of an active function of carbonic anhydrase in the endolymphatic sac and suggest that carbonic anhydrase activity is involved in the formation of endolymphatic sac fluid.