Gebbers J O, Altermatt H J, Arnold W, Laissue J A, Pfaltz C R
Pathologisches Institut, Kantonsspital Luzern, Basel.
HNO. 1987 Dec;35(12):487-91.
The immunopathological processes possibly involved in cryptogenic sensorineural hearing loss were investigated. In a pilot study the sera from 66 patients were tested by the indirect immunofluorescence technique for immunoglobulins which bind to normal human inner ear tissue. The reaction was positive in two thirds of all patients with sudden hearing loss, especially bilateral. This was mostly for IgG, and to the organ of Corti. Others have found that Corti's organ showed marked degenerative changes in cases of sudden hearing loss, examined by histology. The reaction was positive in half of the patients with progressive sensorineural hearing loss. It was noticeable that positive reactions for IgA were twice as frequent in sera of patients with progressive hearing loss than in those with sudden deafness. In a control study, the sera of ten patients were tested in parallel by the same method on histological sections of inner ears taken from four individuals. Similar results were found for the sera of two patients only. The sera of the remaining eight patients revealed very inconsistent reaction patterns. These preliminary results may indicate that temporary or permanent humoral (auto) immune mechanisms could have occurred in certain inner ear diseases. So far however reliable diagnostic methods have not been established, and not enough patients have been followed up.
对可能与特发性感音神经性听力损失有关的免疫病理过程进行了研究。在一项初步研究中,采用间接免疫荧光技术对66例患者的血清进行检测,以检测与正常人内耳组织结合的免疫球蛋白。在所有突发性听力损失患者中,三分之二的患者反应呈阳性,尤其是双侧性患者。这种反应主要针对IgG,且针对柯蒂氏器。其他人通过组织学检查发现,在突发性听力损失病例中,柯蒂氏器显示出明显的退行性变化。在进行性感音神经性听力损失患者中,一半患者的反应呈阳性。值得注意的是,进行性听力损失患者血清中IgA阳性反应的频率是突发性耳聋患者血清中的两倍。在一项对照研究中,采用相同方法对取自4个人的内耳组织切片,对10例患者的血清进行了平行检测。仅在2例患者的血清中发现了类似结果。其余8例患者的血清显示出非常不一致的反应模式。这些初步结果可能表明,在某些内耳疾病中可能发生了暂时或永久性的体液(自身)免疫机制。然而,到目前为止,尚未建立可靠的诊断方法,且随访的患者数量不足。