Yazawa Yoshiro, Suzuki Mikio, Hanamitsu Masakazu, Kimura Hiroshi, Tooyama Ikuo
Department of Otolaryngology, Shiga University of Medical Science, Seta, Otsu, Shiga 520-2192, Japan.
ORL J Otorhinolaryngol Relat Spec. 2003 May-Jun;65(3):162-8. doi: 10.1159/000072254.
The main purpose of this study is to search for a viral etiology in Ménière's disease by examining the presence or absence of herpes family virus DNA in the endolymphatic sac (ES) using the in situ hybridization method. This was a prospective study with the ES from 10 patients with Ménière's disease and from 7 control cases without any pre-mortem ear diseases except a case of acoustic tumor. These 10 patients underwent the ES surgery. The presence of herpes family virus DNA, such as herpes simplex virus types 1 and 2 (HSV1&2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV) and human cytomegalovirus (CMV), was examined using the in situ hybridization method. Serum antibody titers against these viruses just before the ES surgery were studied in these patients. Of the 10 specimens from the patients with Ménière's disease, 7 were positive for VZV, 4 for EBV, 1 for CMV and none for HSV1&2, although the serum antibody titers against these viruses did not show any significant elevation in these patients just before the ES surgery. This result suggests that the viral DNA in the ES is inactive and is present in a latent form. From the statistical analysis, it can be postulated that VZV infection in early childhood may reach the ES and play a role in the pathogenesis of Ménière's disease (p = 0.0235). The double infection with both VZV and EBV tended to be another candidate for the pathogenesis of Ménière's disease (p = 0.0557).
本研究的主要目的是通过使用原位杂交方法检测内淋巴囊（ES）中疱疹家族病毒DNA的有无，来寻找梅尼埃病的病毒病因。这是一项前瞻性研究，研究对象为10例梅尼埃病患者的ES以及7例对照病例的ES，对照病例除1例听神经瘤外无任何生前耳部疾病。这10例患者接受了ES手术。使用原位杂交方法检测疱疹家族病毒DNA的存在情况，如单纯疱疹病毒1型和2型（HSV1&2）、水痘-带状疱疹病毒（VZV）、爱泼斯坦-巴尔病毒（EBV）和人巨细胞病毒（CMV）。研究了这些患者在ES手术前针对这些病毒的血清抗体滴度。在10例梅尼埃病患者的标本中，7例VZV呈阳性，4例EBV呈阳性，1例CMV呈阳性，HSV1&2均为阴性，尽管这些患者在ES手术前针对这些病毒的血清抗体滴度没有任何显著升高。这一结果表明，ES中的病毒DNA是无活性的，以潜伏形式存在。通过统计分析，可以推测儿童早期的VZV感染可能到达ES并在梅尼埃病的发病机制中起作用（p = 0.0235）。VZV和EBV的双重感染倾向于成为梅尼埃病发病机制的另一个候选因素（p = 0.0557）。
