FUNDAMENTAL IMMUNE-MECHANISMS OF THE BRAIN AND INNER-EAR
FUNDAMENTAL IMMUNE-MECHANISMS OF THE BRAIN AND INNER-EAR
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DOI：
10.1016/s0194-5998(95)70170-2
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发表时间：
1995-06-01
影响因子：
3.4
通讯作者：
RYAN, AF
中科院分区：
文献类型：
--
作者：
HARRIS, JP;RYAN, AF
由于血-脑和血-迷路的屏障，大脑和内耳曾被认为是免疫屏障。尽管这些屏障提供了保护，使其免受器官微妙结构的炎症损害，但自那以来，这两个部位都被证明能够在适当的刺激下产生积极的免疫反应。在内耳，内淋巴囊周围的囊周组织是常驻淋巴细胞的宿主，是免疫监视的场所。淋巴细胞也从循环进入内耳，在耳蜗处通过螺旋耳缘静脉进入内耳。免疫反应可以保护迷宫免受感染，但也可能导致旁观者受伤。此外，耳蜗会成为免疫反应的目标，从而损害听力。这种自身免疫性感音神经性听力损失可以是部位特异性的，其主要表现是听力损失和平衡失调。其中一些病例可以通过抗体或淋巴细胞对内耳抗原的反应来诊断。或者，全身性自身免疫性疾病可以导致内耳功能障碍，作为更广泛疾病的一部分。免疫介导的内耳功能障碍的两种形式都可能对免疫抑制治疗产生反应，包括类固醇、细胞毒剂和血浆置换。
Because of the blood-brain and blood-labyrinthine barriers, the brain and inner ear were once thought to be immunoprivileged sites. Although these barriers provide protection from inflammatory damage to the delicate structures of the organs, both sites have since been shown to be capable of active immune responses when appropriately stimulated. In the inner ear, perisacular tissue around the endolymphatic sac hosts resident lymphocytes and serves as a site of immunosurveillance. Lymphocytes also enter the inner ear from the circulation, and in the cochlea this occurs via the spiral modiolar vein. immune responses can protect the labyrinth from infection, but they can also cause bystander injury. Moreover, the cochlea can itself become the target of immune responses that damage hearing. Such autoimmune sensorineural hearing loss can be site specific, with the primary manifestation of the disorder being hearing loss and dysequilibrium. Some of these cases can be diagnosed by antibody or lymphocyte responses to inner ear antigens. Alternately, systemic autoimmune disorders can result in inner ear dysfunction as part of a broader spectrum of disease. Both forms of immune-mediated inner ear dysfunction may respond to immunosuppressive therapies, including steroids, cytotoxic agents, and plasmapheresis.