Serum Fibrinogen Level and Cytokine Production as Prognostic Biomarkers for Idiopathic Sudden Sensorineural Hearing Loss
Serum Fibrinogen Level and Cytokine Production as Prognostic Biomarkers for Idiopathic Sudden Sensorineural Hearing Loss
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DOI：
10.1097/mao.0000000000003552
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发表时间：
2022-08-01
影响因子：
2.1
通讯作者：
Ogawa, Takenori
中科院分区：
文献类型：
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作者：
Okuda, Hiroshi;Aoki, Mitsuhiro;Ogawa, Takenori
目的：尚未确定特发性突发感音神经性听力损失（ISSNHL）具有临床意义的预后因素。因此，本研究试图从血液生物标志物中确定特发性突发感音神经性听力损失的有用预后因素，同时尝试对致病机制进行分类，并根据这些结果制定治疗策略。研究设计：前瞻性队列研究。地点：三级转诊中心。方法：总共 47 名急性期 ISSNI1L 患者接受初始剂量为 1 mg/kg/天的类固醇治疗 和高压氧治疗并随访6个月。测量血清纤维蛋白原水平、外周血单核细胞 (PBMC) 以及 PBMC 产生的白细胞介素 (IL)-1β、IL-6 和肿瘤坏死因子 (TNF)-α 水平，然后比较患者治疗前和治疗后的听力。 结果：在整个队列中，平均改善水平、平均恢复率和平均纤维蛋白原水平为 分别为 20.3 dB、46.2%、292.0 mg/mL。脂多糖刺激下培养的外周血单核细胞产生的IL-1β、IL-6和TNF-α的平均水平分别为318.4、498.1和857.6pg/mL。高纤维蛋白原水平与听力预后不良相关。 PBMC 脂多糖刺激的细胞因子产生与听力变化无关；然而，纤维蛋白原水平低且 PBMC 产生的 IL-1β 水平高的患者的预后明显好于其他患者。结论：我们的结果表明，单纯炎症型 ISSNHL 患者对标准治疗反应良好。因此，血清纤维蛋白原水平和 PBMC 细胞因子产生可能有助于根据 ISSNHL 的致病机制确定其治疗方法。
Objectives: No clinically useful prognostic factors have been identified for idiopathic sudden sensorineural hearing loss (ISSNHL). The current study therefore sought to identify useful prognostic factors for idiopathic sudden sensorineural hearing loss from blood biomarkers while attempting to classify the pathogenic mechanism and formulate treatment strategies based on these results.Study Design: Prospective cohort study.Setting: Tertiary referral center.Methods: A total of 47 patients with acute phase ISSNI1L were treated with steroid at an initial dose of 1 mg/kg/day and hyperbaric oxygen therapy and followed up for 6 months. Serum fibrinogen levels, peripheral blood mononu- clear cells (PBMCs), and interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha production levels from PBMCs were measured, after which patient's pre- and post- treatment hearing was compared.Results: In the overall cohort, the mean improvement level, mean recovery rate, and mean fibrinogen level was 20.3 dB, 46.2%, 292.0 mg/mL, respectively. The mean levels of IL-1 beta, IL-6, and TNF-alpha produced by peripheral blood mononuclear cells cultured under lipopolysaccharide stimulation were 318.4, 498.1, and 857.6 pg/mL, respectively. High fibrinogen levels were associated with poor hearing prognosis. Lipopolysaccharide-stimulated cytokine production by PBMCs did not correlate with hearing changes; however, the prognosis was significantly better in patients with low fibrinogen levels and high IL-1 beta levels produced by PBMCs than in other patients.Conclusions: Our results suggest that patients with simple inflammatory-type ISSNHL responded well to standard therapy. Therefore, serum fibrinogen levels and PBMCs cytokine production may help determine the management of ISSNHL based on its pathogenic mechanism.