Plasma Vasopressin and V2 Receptor in the Endolymphatic Sac in Patients With Delayed Endolymphatic Hydrops
Plasma Vasopressin and V2 Receptor in the Endolymphatic Sac in Patients With Delayed Endolymphatic Hydrops
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DOI：
10.1097/mao.0b013e3181b11db5
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发表时间：
2009-09-01
影响因子：
2.1
通讯作者：
Doi, Katsumi
中科院分区：
文献类型：
--
作者：
Kitahara, Tadashi;Maekawa, Chie;Doi, Katsumi
目的：有些疾病是由于对日常生活中的身体和/或心理压力适应不足而引起的。迟发性内淋巴积水 (DEH) 是一种内耳疾病，类似于梅尼埃病 (MD)，其特征是在既往存在单侧耳聋的情况下出现阵发性眩晕，尤其发生在生活压力大的文明人群中。 1976 年的一项颞骨研究证实其耳病理学结果为内耳内淋巴积水，就像 1938 年 MD 的情况一样。为了阐明压力与内耳之间的关系，我们检查了 DEH 患者内淋巴囊中血浆抗利尿应激激素加压素 (pAVP) 及其 2 型受体 (V2R) 的表达。研究设计：一项前瞻性分子生物学研究研究方法：1998 年至 2007 年间，我们招募了 20 名同侧 DEH 患者，检查他们眩晕发作缓解期间的 pAVP。还对 87 名单侧 MD 患者和 30 名慢性中耳炎对照患者进行了血浆加压素检测。采用实时聚合酶链反应方法，对手术期间获得的组织样本进行检测，检测 6 例同侧 DEH 患者、9 例单侧 MD 患者和 6 例对照听神经瘤患者的内淋巴囊中 V2R mRNA 的表达。 结果：血浆加压素（相对于对照的 1.5 倍；非配对 t 检验，p = 0.140）和内淋巴囊中 V2R mRNA 的表达与听神经瘤患者相比，DEH 患者的这一比率（与对照组相比为 35.8 倍；非配对 t 检验，p = 0.002）更高。 DEH和MD内淋巴囊中pAVP或V2R表达没有显着差异。 DEH患者的pAVP与V2R呈显着负相关（Pearson检验，r = -0.92，p = 0.009），与MD患者一样（Pearson检验，r = -0.68，p = 0.043）。结论：文明人在日常生活中经常承受压力，pAVP随时容易升高。因此，内淋巴囊中 pAVP 和 V2R 之间的负反馈系统可能有助于内耳液体稳态，防止应激引起的 pAVP 增加。对于导致 DEH 和 MD 患者眩晕发作的内淋巴积水的发病机制，pAVP 可能代表一个后果，但内淋巴囊中 V2R 的过度表达可能是这些疾病的基础。
Objective: There are some kinds of sicknesses provoked by inadequate adaptation to physical and/or psychogenic stress in daily life. Delayed endolymphatic hydrops (DEH) is an inner ear disease like Meniere's disease (MD) characterized by episodic vertigo in the setting of preexisting unilateral deafness that especially occurs in civilized people with a stressful lifestyle. Its otopathologic finding was demonstrated to be inner ear endolymphatic hydrops through a temporal bone study in 1976, as in the case with MD in 1938. To elucidate the relationship between stress and the inner ear, we examined the plasma antidiuretic stress hormone vasopressin (pAVP) and its type 2 receptor (V2R) expression in the endolymphatic sac in patients with DEH.Study Design: A prospective molecular biological study.Methods: Between 1998 and 2007, we enrolled 20 patients with ipsilateral DEH to examine their pAVP during remission from vertigo attacks. Plasma vasopressin was also examined in 87 patients with unilateral MD and 30 control patients with chronic otitis media. Using the real-time polymerase chain reaction method with tissue samples obtained during surgery, we examined V2R mRNA expression in the endolymphatic sac in 6 patients with ipsilateral DEH, 9 patients with unilateral MD, and 6 control patients with acoustic neuroma.Results: Plasma vasopressin (1.5 times versus controls; unpaired t test, p = 0.140) and V2R mRNA expression in the endolymphatic sac (35.8 times versus controls; unpaired t test, p = 0.002) were higher in patients with DEH compared with those with acoustic neuroma. There were no significant differences in pAVP or V2R expression in the endolymphatic sac between DEH and MD. Patients with DEH showed a significantly negative correlation between pAVP and V2R (Pearson test, r = -0.92, p = 0.009) as in those with MD (Pearson test, r = -0.68, p = 0.043).Conclusion: Civilized people are frequently exposed to stress in their daily life, and pAVP can easily become elevated at any time. Therefore, a negative feedback system between pAVP and V2R in the endolymphatic sac may function for inner ear fluid homeostasis against stress-induced increases in pAVP. For the pathogenesis of endolymphatic hydrops resulting in vertigo attacks in patients with DEH as well as MD, pAVP may represent a matter of consequence, but V2R overexpression in the endolymphatic sac could be much more essential as a basis for these diseases.