Yuan Vincent G, Xia Anping, Santa Maria Peter L
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburg, PA, United States.
Front Immunol. 2025 Aug 27;16:1639916. doi: 10.3389/fimmu.2025.1639916. eCollection 2025.
Meniere's disease (MD) is a chronic, relapsing inner ear disorder characterized by episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Although its etiology has long remained elusive, accumulating evidence implicates immune dysregulation as a central contributor to disease pathogenesis, particularly in patients who do not respond to standard therapies. This review synthesizes current insights into the immunopathological mechanisms underlying MD, focusing on the roles of both innate and adaptive immune cells-including macrophages, dendritic cells, T cells, and B cells-in promoting inflammation, endolymphatic hydrops, and sensory dysfunction. We examine the contribution of these immune cells to tissue damage, along with the roles of cytokine signaling and immune complex deposition. Emerging immunotherapies, including corticosteroids, biologics, and inflammasome inhibitors, are evaluated for their therapeutic potential. The review also highlights promising directions in precision medicine, such as immune profiling, biomarker discovery, and stratified clinical trials aimed at personalizing treatment. By integrating recent immunological advances with clinical management strategies, we underscore the potential of immune guided approaches to transform the diagnosis, treatment, and long-term care of patients with MD.
梅尼埃病（MD）是一种慢性复发性内耳疾病，其特征为眩晕发作、波动性感音神经性听力损失、耳鸣和耳胀满感。尽管其病因长期以来一直难以捉摸，但越来越多的证据表明免疫失调是疾病发病机制的核心因素，尤其是在对标准治疗无反应的患者中。本综述综合了目前对MD潜在免疫病理机制的见解，重点关注先天免疫细胞和适应性免疫细胞（包括巨噬细胞、树突状细胞、T细胞和B细胞）在促进炎症、内淋巴积水和感觉功能障碍方面的作用。我们研究了这些免疫细胞对组织损伤的作用，以及细胞因子信号传导和免疫复合物沉积的作用。对包括皮质类固醇、生物制剂和炎性小体抑制剂在内的新兴免疫疗法的治疗潜力进行了评估。本综述还强调了精准医学中的有前景方向，如免疫分析、生物标志物发现以及旨在实现个性化治疗的分层临床试验。通过将近期的免疫学进展与临床管理策略相结合，我们强调了免疫导向方法在改变MD患者的诊断、治疗和长期护理方面的潜力。
