Fuse Takeo, Hayashi Tomohiro, Oota Nobuo, Fukase Shigeru, Asano Shinichirou, Kato Takeo, Aoyagi Masaru
Department of Otolaryngology, Yamagata University School of Medicine, Yamagata, Japan.
Acta Otolaryngol. 2003 Jan;123(1):26-31. doi: 10.1080/0036554021000028074.
The autoimmune response appears to play an important role in some types of acute sensorineural hearing loss. Endolymphatic hydrops associated with fluctuating hearing loss has also been suggested to be caused by an immunological mechanism. Acute low-tone hearing loss (ALHL) associated with Ménière's disease (MD) is characterized by fluctuating hearing loss, and its etiology is thought to involve endolymphatic hydrops. The aim of this study was to attempt to determine the etiology of ALHL in MD.
A flow cytometer was used to analyze intracellular cytokine levels in peripheral blood from 19 patients with ALHL and 26 patients with MD and the data compared to those obtained from age- and gender-matched healthy volunteers.
The patients with ALHL showed significantly increased levels of Th1 subsets (interferon-gamma-producing helper T cells) as compared to those in normal controls. The levels of Th2 (IL-4-producing helper T cells) subsets did not differ from those in the control group and thus Th1 predominated in ALHL patients. The patients with MD showed significantly increased natural killer cell activity but no Th1 dominance. These patients had no obvious systemic or local disease except in the inner ear.
An abnormality of the Th1/Th2 balance in ALHL and increased natural killer cell activity in MD are thought to relate to inner ear disorder. These results are consistent with the possibility that the etiology of ALHL and MD involves an immune response.
自身免疫反应似乎在某些类型的急性感音神经性听力损失中起重要作用。与波动性听力损失相关的内淋巴积水也被认为是由免疫机制引起的。梅尼埃病（MD）相关的急性低频听力损失（ALHL）的特征是波动性听力损失，其病因被认为与内淋巴积水有关。本研究的目的是试图确定MD中ALHL的病因。
使用流式细胞仪分析19例ALHL患者和26例MD患者外周血中的细胞内细胞因子水平，并将数据与年龄和性别匹配的健康志愿者的数据进行比较。
与正常对照组相比，ALHL患者的Th1亚群（产生干扰素-γ的辅助性T细胞）水平显著升高。Th2（产生IL-4的辅助性T细胞）亚群的水平与对照组无差异，因此ALHL患者中Th1占主导。MD患者的自然杀伤细胞活性显著增加，但不存在Th1优势。除内耳外，这些患者没有明显的全身性或局部疾病。
ALHL中Th1/Th2平衡异常以及MD中自然杀伤细胞活性增加被认为与内耳疾病有关。这些结果与ALHL和MD的病因涉及免疫反应的可能性一致。
