Department of Otolaryngology, Zucker School of Medicine at Hofstra/Northwell, Feinstein Institute for Medical Research, Manhasset, New York.
Department of Otorhinolaryngology, Albert Einstein College of Medicine, Bronx, New York.
Otol Neurotol. 2021 Oct 1;42(9):1422-1428. doi: 10.1097/MAO.0000000000003196.
Autoimmune inner ear disease (AIED) patients will differentially express interleukin (IL)-6 based on corticosteroid responsiveness.
AIED is characterized by periods of acute sensorineural hearing loss (SNHL). In a majority of patients corticosteroid responsiveness is lost over time. The mechanisms that control corticosteroid responsiveness have not been fully elucidated.
Thirty-five AIED patients and 13 age-matched control subjects were enrolled in this study. Steroid responsive (n = 15) and steroid nonresponsive AIED patients (n = 20) were characterized based on audiometry before and after treatment for acute SNHL. Plasma and peripheral blood mononuclear cells (PBMC) were obtained at the time of acute SNHL to quantify plasma IL-6, soluble IL-6 receptor (sIL-6R), and C-C Motif Chemokine Ligand 3 (CCL3). PBMCs were stimulated with dexamethasone and release of soluble IL-6, sIL-6R, and CCL3 protein into conditioned supernatants was measured. Plasma IL-6 was also correlated to serum c-reactive protein (CRP), cardiac CRP, erythrocyte sedimentation rate.
Statistically significant differences were observed in the plasma IL-6 between AIED patients and controls (2.37 versus 2.03 pg/ml, p < 0.01), plasma IL-6, and CCL3 between responders and nonresponders (0.136 versus 3.84 pg/ml, p < 0.005; 30.5 versus 32.4, p < 0.05) and released IL-6 from dexamethasone stimulated PBMC in AIED patients compared with controls (0.54 versus 1.12 pg/ml, p < 0.001). There was a correlation between plasma IL-6 levels of AIED patients to both serum CRP and cardiac CRP (R2 = 0.83, R2 = 0.88).
We observed AIED patients, specifically nonresponders expressed greater levels of IL-6. Elevated IL-6 levels in AIED patients correlated with CRP levels, providing a commonly available laboratory test that may aid in rapid clinical decision-making in these patients.
自身免疫性内耳疾病（AIED）患者根据皮质类固醇反应性表现出不同的白细胞介素（IL）-6 表达。
AIED 的特征是急性感音神经性听力损失（SNHL）期。在大多数患者中，皮质类固醇反应性随时间丧失。控制皮质类固醇反应性的机制尚未完全阐明。
本研究纳入 35 名 AIED 患者和 13 名年龄匹配的对照者。根据急性 SNHL 治疗前后的听力测定，将类固醇反应性（n=15）和类固醇非反应性 AIED 患者（n=20）进行特征描述。在急性 SNHL 时获得血浆和外周血单核细胞（PBMC）以定量血浆白细胞介素（IL）-6、可溶性 IL-6 受体（sIL-6R）和 C-C 基序趋化因子配体 3（CCL3）。用地塞米松刺激 PBMC，测量条件培养基中可溶性 IL-6、sIL-6R 和 CCL3 蛋白的释放。还将血浆 IL-6 与血清 C 反应蛋白（CRP）、心脏 CRP、红细胞沉降率进行相关性分析。
AIED 患者与对照组之间的血浆 IL-6 存在统计学差异（2.37 对 2.03 pg/ml，p<0.01），反应者与非反应者之间的血浆 IL-6 和 CCL3 也存在统计学差异（0.136 对 3.84 pg/ml，p<0.005；30.5 对 32.4，p<0.05），AIED 患者与对照组相比，用地塞米松刺激 PBMC 释放的 IL-6 也更多（0.54 对 1.12 pg/ml，p<0.001）。AIED 患者的血浆 IL-6 水平与血清 CRP 和心脏 CRP 之间存在相关性（R2=0.83，R2=0.88）。
我们观察到 AIED 患者，尤其是非反应者表达了更高水平的 IL-6。AIED 患者的 IL-6 水平升高与 CRP 水平相关，提供了一种常用的实验室检测，可能有助于这些患者的快速临床决策。
