IMMUNOLOGICAL ROLE OF ENDOLYMPHATIC SAC IN THE OCCURRENCE OF ENDOLYMPHATIC HYDROPS AND RELATION TO THE PERILYMPHATIC FISTULA

我们研究了内淋巴囊在内淋巴积水发生中的免疫学作用，内淋巴积水是梅尼埃病的主要病理。在内淋巴管阻断后的功能和免疫病理改变的研究中，囊内Na~+、K~+浓度和DC电位明显降低。囊腔内可染物质的数量在几周内增加。这些结果表明，在被切断的囊中，离子跨囊上皮的主动转运和/或被动扩散将受到干扰，可染色物质的增加可能在调节内淋巴系统的压力/容量动态平衡中发挥重要作用。用已阻断内淋巴管的致敏豚鼠进行的免疫病理研究表明，经KLH或HRP二次免疫囊内后，外淋巴液中的抗体无明显增加。而在非INT…的动物中在相同的二次免疫后，外淋巴抗体水平显著升高。这一发现表明，内淋巴囊是内耳免疫反应中的一个重要部位。此外，利用骨髓移植后移植物抗宿主病模型，分布在内淋巴囊中的免疫活性细胞可能来源于体循环。另一方面，有报道称内淋巴积水似乎是由于淋巴瘘的继发性损伤所致。我们对实验性外淋巴瘘豚鼠的颞骨病理进行了研究。在实验早期，由于外淋巴压力的迅速降低，耳蜗会出现积水，而前庭则会因为小梁网状结构的破坏而出现塌陷。在实验的后期(2周)，前庭出现积水，并伴有椭圆形皱褶的闭塞。提示外淋巴瘘引起的结构异常可能导致继发性积液，可能是梅尼埃病的病因之一。较少

We have investigated the immunological role of endolymphatic sac in the occurrence of endolymphatic hydrops which is the main pathology of Meniere's disease. On the study of functional and immunopathological alterations after interruption of endolymphatic duct, Na^+ and K^+ concentration and DC potential in the sac showed significant reduction. The amount of stainable substance in the sac lumen was increased for a few week. These findings suggested that an active transport and/or passive diffusion of ions across sac epithelium would be disturbed in the interrupted sac, and the stainable substance increased may play an important role in the regulation of pressure/volume homeostasis in the endolymphatic system. Immunopathological study using sensitized guinea pigs which were already interrupted endolymphatic duct revealed that after secondary immunization of KLH or HRP into the sac, there were no significant increase of antibodies in the perilymph. While in the animals which were not int … More errupted duct, the perilymphatic antibody levels were significantly increased following same secondary immunization. This finding suggests that the endolymphatic sac is an important site in the inner ear immune response. Furthermore, using graft versus host disease model after bone marrow transplantation, the immunocompetent cells distributed in the endolymphatic sac may be derived from systemic circulation. On the other hand, it has been reported that the endolymphatic hydrops appear to be due to the secondary injury of perilymphatic fistula. We have investigated the temporal bone pathology of the guinea pigs with experimentally induced perilymphatic fistula. In the early stage of experiment, the cochlea showed hydrops due to the rapid reduction of perilymphatic pressure while the vestibule showed collapse due to the damage of trabecular mesh. In the late stage (2 weeks) of experiment, the vestibule showed hydrops in association with the obliteration of utricular-fold. This model suggests that the structural abnormality induced by the perilymphatic fistula may produce secondary hydrops and may possibly be one of etiology of Meniere's disease. Less