Street I, Jobanputra P, Proops D W
Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK.
J Laryngol Otol. 2006 Dec;120(12):1064-6. doi: 10.1017/S0022215106002593. Epub 2006 Aug 15.
Patients with autoimmune inner-ear disease (AIED) are treated with high doses of steroids in the short term when suffering an acute hearing loss. As a consequence, substances such as methotrexate have been employed in the role of steroid-sparing agents. Additionally, it is known that tumour necrosis factor alpha (TNFalpha) is an important mediator of the inflammatory process, inhibition of which may be of benefit in AIED. This case report illustrates the use of a TNFalpha inhibitor in combination with methotrexate, which is known to be an effective combination in rheumatoid arthritis but has yet to be described for sensorineural hearing loss. We conclude that progressive AIED may respond well to TNFalpha inhibition, whilst more difficult cases, such as this example, could benefit from combining such therapy with methotrexate.
自身免疫性内耳疾病（AIED）患者在急性听力损失时短期内接受高剂量类固醇治疗。因此，诸如甲氨蝶呤之类的物质已被用作类固醇节省剂。此外，已知肿瘤坏死因子α（TNFα）是炎症过程的重要介质，抑制它可能对AIED有益。本病例报告说明了TNFα抑制剂与甲氨蝶呤联合使用的情况，已知该组合在类风湿性关节炎中有效，但尚未用于感音神经性听力损失的治疗。我们得出结论，进行性AIED可能对TNFα抑制反应良好，而对于更棘手的病例，如此例，将这种治疗与甲氨蝶呤联合使用可能有益。
