Correlations of Inflammatory Biomarkers With the Onset and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss
Correlations of Inflammatory Biomarkers With the Onset and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss
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DOI：
10.1097/mao.0b013e3182635417
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发表时间：
2012-09-01
影响因子：
2.1
通讯作者：
Ogawa, Kaoru
中科院分区：
文献类型：
--
作者：
Masuda, Masatsugu;Kanzaki, Sho;Ogawa, Kaoru
假设：我们调查了炎症生物标志物和应激是否参与了特发性感音神经性听力损失（ISHL）的病理生理学。研究设计：个体队列研究。设置：两个三级中心。患者：2004年至2010年在我们的耳鼻喉科就诊的43名ISHL和10名非ISHL患者，在新症状发作后一周内就诊，并且在就诊之前未使用类固醇。干预：多项听力学评估、血液检查（包括白细胞计数、自然杀伤细胞活性（NKCA）、白细胞介素6（IL-6）、肿瘤坏死因子、高敏C反应蛋白（hCRP））和一般健康问卷被用于评估全身应激和炎症反应。主要结果测量：通过统计分析评估生物标志物与ISHL严重程度和预后的相关性。在ISHL患者中，中性粒细胞计数高于参考范围与严重听力损失和预后不良相关，并伴有低NKCA和高IL-6。在非ISHL患者中，不存在这些相关性。中性粒细胞计数异常与既存血管疾病无关。异常计数对治疗有反应，并下降到参考范围内。结论：神经细胞计数高于参考范围的设施将是一个有用的指标，ISHL预后不良。不同类型的NF-κ B活化途径的同步可能是导致严重ISHL所必需的。NKCA降低、急性中性粒细胞计数升高和IL-6升高可诱导耳蜗中NF-κ B活化并导致重度ISHL。应进行进一步的流行病学调查，以评估压力性生活事件是否会增加重度ISHL发作的风险。
Hypothesis: We investigated whether inflammatory biomarkers and stress are involved in the pathophysiology of idiopathic sensorineural hearing loss (ISHL).Study Design: Individual cohort study.Setting: Two tertiary centers.Patients: Forty-three ISHL and 10 non-ISHL patients seen in our ENT departments from 2004 to 2010 within a week from the onset of new symptoms and without steroid administration before visiting our departments.Intervention: Multiple audiologic evaluations, blood tests including leukocyte counts, natural killer cell activity (NKCA), interleukin 6 (IL-6), tumor necrosis factor, high-sensitivity CRP (hCRP), and the General Health Questionnaire were used to evaluate the systemic stress and inflammatory response.Main Outcome Measures: Correlations between biomarkers and ISHL severity and prognosis were evaluated by statistical analysis.Results: In the ISHL patients, a neutrophil count above the reference range was associated with severe hearing loss and poor prognosis, and was accompanied by low NKCA and high IL-6. In the non-ISHL patients, these associations were not present. The abnormal neutrophil count was independent of preexisting vascular diseases. The abnormal counts responded to treatment and decreased into the reference range.Conclusion: Neutrophil counts above the reference range of a facility will be a useful indicator of poor prognosis of ISHL. Synchronism of different types of NF-kappa B activation pathways could be required to cause severe ISHL. An NKCA decrease, an acute neutrophil count increase, and an IL-6 increase can induce NF-kappa B activation in the cochlea and cause severe ISHL. Further epidemiologic surveys should be conducted to evaluate whether stressful life events increase the risk of severe ISHL onset.