Blood levels of TNF-, IL-10, and IL-12 in idiopathic sudden sensorineural hearing loss
Department of Otorhinolaryngology, Eregli State Hospital, Zonguldak. The Laryngoscope
(Impact Factor: 2.14).
07/2013; 123(7). DOI: 10.1002/lary.23907
To investigate the blood levels of TNF-α, IL-10, and IL-12 in the idiopathic sudden sensorineural hearing loss patients, and the change of these cytokine levels after treatment.
Prospective clinical trial.
Twenty-three patients with idiopathic sudden sensorineural hearing loss and 20 healthy people were selected as study and control groups. Blood samples for TNF-α, IL-10, and IL-12 were taken before treatment and 6 weeks after treatment. The study group was given combined treatment including dexamethasone, heparin, pentoxifyline, vitamin B1, and B6 for 10 days, and was divided into two groups: treatment responders and treatment nonresponders. The treatment responders group was also divided into three groups according to most accepted criteria for improvement in the literature. Audiograms were taken before treatment and 6 weeks after treatment to determine the response to the treatment.
There was no significant difference between pre- and posttreatment values of IL-10 and IL-12 in all study groups (P > 0.05). There was also no significant difference between pre- and posttreatment values of TNF-α in treatment responders (P > 0.05). Treatment nonresponders had more elevated posttreatment values of TNF-α than pretreatment values (P < 0.05).
IL-10 and IL-12 may not play a critical role in idiopathic sudden sensorineural hearing loss. But our data supports the role of TNF-α in the pathophysiology of idiopathic sudden sensorineural hearing loss, and TNF-α receptor blockers may have benefits in these patients.
3B. Laryngoscope, 2013
Available from: Su-Hua Sha
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ABSTRACT: Exogenous tumor necrosis factor-alpha (TNF-α) plays a role in auditory hair cell death by altering the expression of apoptosis-related genes in response to noxious stimuli. Little is known, however, about the function of TNF-α in normal hair cell physiology. We, therefore, investigated the cochlear morphology and auditory function of TNF-α-deficient mice. Auditory evoked brainstem response showed significantly higher thresholds, especially at higher frequencies, in 1-month-old TNF-α(-/-) mice as compared to TNF-α(+/-) and wild type (WT); hearing loss did not progress further from 1 to 4 months of age. There was no difference in the gross morphology of the organ of Corti, lateral wall, and spiral ganglion cells in TNF-α(-/-) mice compared to WT mice at 4 months of age, nor were there differences in the anatomy of the auditory ossicles. Outer hair cells were completely intact in surface preparations of the organ of Corti of TNF-α(-/-) mice, and synaptic ribbon counts of TNF-α(-/-) and WT mice at 4 months of age were similar. Reduced amplitudes of distortion product otoacoustic emissions, however, indicated dysfunction of outer hair cells in TNF-α(-/-) mice. Scanning electron microscopy revealed that stereocilia were sporadically absent in the basal turn and distorted in the middle turn. In summary, our results demonstrate that TNF-α-mutant mice exhibit early hearing loss, especially at higher frequencies, and that loss or malformation of the stereocilia of outer hair cells appears to be a contributing factor.
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ABSTRACT: Higher levels of fibrinogen or cholesterol were associated with improved hearing recovery in SSHL patients after treatment with HELP-apheresis (Heparin-induced extracorporeal LDL precipitation apheresis). The present trial was performed to demonstrate HELP-related effects on relevant metabolic and inflammatory parameters in the context of SSHL treatment. In the framework of a single arm non-controlled trial, we investigated the variation of metabolic and inflammatory parameters using HELP-apheresis for a defined group of 100 patients with SSHL. Based on cut off inclusion criteria (Serum LDL-cholesterol >1.6 g/l and/or fibrinogen >2.0 g/l, SSHL in minimum three frequencies more than 30 dB, time after event not longer than 6 days), the protocol followed a strict time line with one single shot HELP-apheresis and follow-up monitoring including laboratory parameters at six defined time points. If HELP-apheresis could not effect improvement of hearing on day 5, additional corticosteroid treatment was applied. Concentration of anti-inflammatory IL-10 increased while other proinflammatory parameters declined. Serum levels of all measured sterols and apolipoproteins decreased significantly. None of the investigated parameters were suitable to predict hearing improvement of the patients. Levels of fibrinogen and LDL-cholesterol were not prognostic for outcome after HELP-apheresis. A significant (p < 0.001) increase of anti-inflammatory IL-10 after apheresis was notable, while most of the proinflammatory parameters declined. Despite the limited validity of a single arm non-controlled trial, these alterations on immune modulating factors indicate possible secondary pleiotropic effects caused by HELP-apheresis.
Available from: Sabri Koseoglu
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ABSTRACT: OBJECTIVE: The etiopathogenesis of sudden sensorineural hearing loss (SSNHL) is not clearly defined. Inflammation is being emphasized in its etiology. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are the parameters that show inflammation that can be obtained easily without additional cost. In this study, we aimed at delineating the relationship between SSNHL and the inflammation markers NLR and PLR. MATERIALS and METHODS: This study was performed with 102 patients diagnosed with SSNHL and 119 sex-and age-matched controls. All subjects in the study and the control group had their complete blood count (CBC) results, which were evaluated retrospectively to calculate NLR and PLR values. All patients underwent an audiological examination on the 1st, 3rd, 10th, and 30th days of the hearing loss. All patients received 1 mg/kg IV prednisolone treatment in tapered amounts to be completed in 15 days. Based on the improvements seen in the audiograms, the patients were divided into two groups: responders and non-responders to treatment. RESULTS: PLR and NLR values of the patient group were significantly higher than in the control group (p<0.001, p<0.001). Furthermore, patients who responded to treatment had significantly higher NLR values than those who did not respond (p=0.010). CONCLUSION: In this study, NLR and PLR values were found to be significantly high in SSNHL patients. PLR value was investigated for the first time in the literature in SSNHL patients. NLR and PLR values are parameters that aid in the diagnosis of SSNHL. Moreover, SSNHL patients who had higher NLR values responded to the treatment better.
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