Lassa fever-induced sensorineural hearing loss: A neglected public health and social burden.
Lassa fever-induced sensorineural hearing loss: A neglected public health and social burden.
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DOI：
10.1371/journal.pntd.0006187
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发表时间：
2018-03
影响因子：
3.8
通讯作者：
Paessler S
中科院分区：
文献类型：
--
作者：
Mateer EJ;Huang C;Shehu NY;Paessler S
虽然Lassa热(LF)与突发性感音神经性耳聋(SNHL)之间的关系在1990年已被临床证实，但在流行国家，由LF引起的SNHL的流行率仍然被低估。LF是一种由拉萨病毒(LASV)引起的病毒性出血热疾病，在西非流行，每年造成约50万例病例和5000人死亡。突发性SNHL是LF的并发症之一，发生在约三分之一的幸存者身上，构成了被忽视的公共卫生和社会负担。在获得助听器的机会有限的流行国家，SNHL导致受影响者的生活质量下降。此外，听力损失每年给尼日利亚造成的损失约为4300万美元。LF诱导的SNHL的流行病学尚未得到很好的描述。SNHL所致的LF并发症也是疫苗开发和治疗的重要考虑因素。然而，由于缺乏尸检样本和相关的小动物模型，对这一机制的研究一直受到阻碍。最近，第一个模拟SNHL与LF相关症状的动物模型被开发出来。来自新动物模型的初步数据以及临床病例研究支持免疫介导的损伤导致LF患者SNHL的机制。本文综述了LF患者听力损失的临床表现，重点介绍了LASV感染与SNHL的关系以及LF诱发SNHL的可能机制(S)。需要进一步的研究来确定LF诱导SNHL的机制和流行病学。
Although an association between Lassa fever (LF) and sudden-onset sensorineural hearing loss (SNHL) was confirmed clinically in 1990, the prevalence of LF-induced SNHL in endemic countries is still underestimated. LF, a viral hemorrhagic fever disease caused by Lassa virus (LASV), is endemic in West Africa, causing an estimated 500,000 cases and 5,000 deaths per year. Sudden-onset SNHL, one complication of LF, occurs in approximately one-third of survivors and constitutes a neglected public health and social burden. In the endemic countries, where access to hearing aids is limited, SNHL results in a decline of the quality of life for those affected. In addition, hearing loss costs Nigeria approximately 43 million dollars per year. The epidemiology of LF-induced SNHL has not been characterized well. The complication of LF induced by SNHL is also an important consideration for vaccine development and treatments. However, research into the mechanism has been hindered by the lack of autopsy samples and relevant small animal models. Recently, the first animal model that mimics the symptoms of SNHL associated with LF was developed. Preliminary data from the new animal model as well as the clinical case studies support the mechanism of immune-mediated injury that causes SNHL in LF patients. This article summarizes clinical findings of hearing loss in LF patients highlighting the association between LASV infection and SNHL as well as the potential mechanism(s) for LF-induced SNHL. Further research is necessary to identify the mechanism and the epidemiology of LF-induced SNHL.