Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss - PubMed (original) (raw)
Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss
Masatsugu Masuda et al. Otol Neurotol. 2012 Sep.
Abstract
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-κB 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-κB 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.
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