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Deficiency of Naive T Cells in Patients With Sudden Deafness

Deficiency of Naive T Cells in Patients With Sudden Deafness Abstract Background: Although there are a number of reports concerned with the role of immunity in the sudden onset of progressive sensorineural hearing loss, there are few references dealing with the involvement of immunemediated mechanisms in sudden deafness. Objective: To study the phenotype of peripheral blood lymphocytes in a group of patients with sudden deafness by use of 3-color flow cytometry. Design: The study was carried out prior to the start of steroid therapy. Fourteen patients underwent a follow-up study once steroid therapy had been completed. Prospective analysis, case-control. Setting: Tertiary case referral center, ambulatory and hospitalized care. Patients: Twenty-two patients (13 men and 9 women; mean age, 45.3 years) were compared with 14 healthy control subjects (9 men and 5 women; mean age, 36 years). Patients were divided in 2 groups according to their response to steroid therapy. Results: Decreased numbers of both CD4+ helper cells (38.4% vs 45.5%; P=.04) and CD8+ cytotoxic cells (17.5% vs 22.3%; P=.02) were observed in patients and compared with those in the control subjects, as well as reduced numbers of CD4+CD45RA+ cells (14.4% vs 29.3%; P=.01) and CD8+CD45RA+ naive cells (18.2% vs 25.4%; P=.04). In the group of patients with a good response to steroid therapy (group 1), a tendency toward normalization of the CD4+ (pretreatment, 38.6%; posttreatment, 44.6%), CD4+CD45RA+ (pretreatment, 15.2%; posttreatment, 21.7%), and CD4+CD45RO+ (pretreatment, 21.1%; posttreatment, 18.2%) cell counts was observed, with a slight decrease in the CD8+ population (pretreatment, 18%; posttreatment, 15.7%). However, in patients with a poorer response (group 2), while there were increases in the CD4+ (pretreatment, 38%; posttreatment, 50%) and CD4+CD45RA+ (pretreatment, 12.8%; posttreatment, 16.7%) cell counts after steroid therapy, there was a significant increment in the CD4+CD45RO+ memory cell count (pretreatment, 14,1%; posttreatment, 28.5%) and low CD8+CD45RA+ counts (pretreatment, 14.6%; posttreatment, 15.5%). No differences were observed in the numbers of B or natural killer cells or in the presence of activation antigens CD25 and HLA-DR when pretreatment and posttreatment levels were compared. Conclusion: These results demonstrate significant abnormalities in the subpopulations of lymphocytes in patients with sudden hearing loss, suggesting the existence of immune-mediated responses in the inner ear as possible etiopathogenic factors in this entity.Arch Otolaryngol Head Neck Surg. 1997;123:712-717 References 1. Wilson RB, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss . Arch Otolaryngol Head Neck Surg . 1980;106:772-776.Crossref 2. McCabe BF. Autoimmune sensorineural hearing loss . Ann Otol Rhinol Laryngol . 1979;88:585-589. 3. Yoon TH, Paparella MM. Systemic vasculitis: a temporal bone histopathologic study . Laryngoscope . 1989;99:600-609.Crossref 4. Rowe-Jones JM, Macallan DC, Sorooshian M. Polyarteritis nodosa presenting as bilateral sudden onset cochleo-vestibular failure in a young woman . J Laryngol Otol . 1990;104:562-564.Crossref 5. Schuknecht HF, Nadol JB. Temporal bone pathology in a case of Cogan's syndrome . Laryngoscope . 1994;104:1135-1142.Crossref 6. Hughes GB, Barna BP, Tomsak RL, Calabrese LH. Autoimmune reactivity in Cogan's syndrome: a preliminary report . Arch Otolaryngol Head Neck Surg . 1983; 91:24-32. 7. Cole RR, Jahrsdoerfer RA. Sudden hearing loss: an update . Am J Otol . 1988;9: 211-215. 8. Hughes GB, Kinney SE, Barna BP, Calabrese LH. Autoimmune reactivity in Meniere's disease: a preliminary report . Laryngoscope . 1983;93:410-417. 9. Hughes GB, Mosciscki R, Barna BP, San Martin JE. Laboratory diagnosis of immune inner ear disease . Am J Otol . 1994;15:198-202. 10. Mayot DM, Bene MC, Dron K, Perrin C, Faure GC. Immunological alterations in patients with sensorineural hearing disorders . Clin Immunol Immunopathol . 1993; 68:41-45.Crossref 11. Arnold W, Pfaltz R, Altermatt HJ. Evidence of serum antibodies against inner ear tissues in the blood of patients with certain sensorineural hearing disorders . Acta Otolaryngol (Stockh) . 1985;99:437-444.Crossref 12. Plester D, Soliman AM. Autoimmune hearing loss . Am J Otol . 1989;10:188-192.Crossref 13. Veldman JE, Hanada T, Meeuwsen F. Diagnostic and therapeutic dilemmas in rapidly progressive sensorineural hearing loss and sudden deafness . Acta Otolaryngol (Stockh) . 1993;113:303-306.Crossref 14. Harris JP, Sharp PA. Inner ear autoantibodies in patients with rapidly progressive sensorineural hearing loss . Laryngoscope . 1990;100:516-524.Crossref 15. Yamanobe S, Harris JP. Inner specific autoantibodies . Laryngoscope . 1993;103: 319-325.Crossref 16. Joliat T, Seyer J, Bernstein J, et al. Antibodies against a 30 kilodalton cochlear protein and type II and IX collagens in the serum of patients with inner ear diseases . Ann Otol Rhinol Laryngol . 1992;101:1000-1006. 17. Mosciscki RA, San Martín JE, Quintero CH, Rauch R, Nadol JB, Bloch KJ. Serum antibody to inner ear proteins in patients with progressive hearing loss . JAMA . 1994;272:611-616.Crossref 18. Kanzaki J, Taiji H, Ogawa K. Evaluation of hearing recovery and efficacy of steroid treatment in sudden deafness . Acta Otolaryngol Suppl (Stockh) . 1988;456: 31-36.Crossref 19. Yamamoto M, Kanzaki J, Ogawa K, Ogawa S, Tsuchihashi N. Evaluation of hearing recovery in patients with sudden deafness . Acta Otolaryngol Suppl (Stockh) . 1994;514:37-40.Crossref 20. Ikeda K, Kobayashi T, Itoh Z, Suzuki H, Kusakari J, Takasaka T. Immunological abnormality of the serological test in bilateral sensorineural hearing loss . ORL J Otorhinolaryngol Relat Spec . 1989;51:268-275.Crossref 21. Kanzaki J, Inove Y, Ouchi T. Immunological findings of serological tests in steroidresponsive sensorineural hearing loss . Acta Otolaryngol Suppl (Stockh) . 1994; 514:66-69.Crossref 22. Helfgott SM, Mosciscki RA, San Martín J, et al. Correlation between antibodies to type II collagen and treatment outcome in bilateral progressive sensorineural hearing loss . Lancet . 1991;337:387-389.Crossref 23. Fowell D, McKnight AJ, Powrie F, et al. Subset of CD4+ T cells and their roles in the induction and prevention of autoimmunity . Immunol Rev . 1991;123:37-64.Crossref 24. Morimoto C, Steinberg AD, Letvin NL, et al. A defect of immunoregulatory T cell subsets in systemic lupus erythematosus patients demonstrated with anti-2H4 antibody . J Clin Invest . 1987;79:762-768.Crossref 25. Kahan L, Hamzoui K, Ayed K. Abnormalities of T lymphocyte subsets in Behçet's disease demonstrated with anti-CD45RA and anti-CD29 monoclonal antibodies . J Rheumatol . 1992;19:742-746. 26. Tanaka S, Matsuyama T, Steinberg AD, Schossman SF, Morimoto C. Antilymphocyte antibodies against CD4+2H+ cell population in patients with systemic lupus erythematosus . Arthritis Rheum . 1989;32:398-405.Crossref 27. Kahan A, Kahan A, Picard F, Menkes CJ, Amor B. Abnormalities of T lymphocyte subsets in systemic sclerosis demonstrated with anti-CD45RA and anti-CD29 monoclonal antibodies . Ann Rheum Dis . 1991;50:354-358.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1997.01900070056009
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Although there are a number of reports concerned with the role of immunity in the sudden onset of progressive sensorineural hearing loss, there are few references dealing with the involvement of immunemediated mechanisms in sudden deafness. Objective: To study the phenotype of peripheral blood lymphocytes in a group of patients with sudden deafness by use of 3-color flow cytometry. Design: The study was carried out prior to the start of steroid therapy. Fourteen patients underwent a follow-up study once steroid therapy had been completed. Prospective analysis, case-control. Setting: Tertiary case referral center, ambulatory and hospitalized care. Patients: Twenty-two patients (13 men and 9 women; mean age, 45.3 years) were compared with 14 healthy control subjects (9 men and 5 women; mean age, 36 years). Patients were divided in 2 groups according to their response to steroid therapy. Results: Decreased numbers of both CD4+ helper cells (38.4% vs 45.5%; P=.04) and CD8+ cytotoxic cells (17.5% vs 22.3%; P=.02) were observed in patients and compared with those in the control subjects, as well as reduced numbers of CD4+CD45RA+ cells (14.4% vs 29.3%; P=.01) and CD8+CD45RA+ naive cells (18.2% vs 25.4%; P=.04). In the group of patients with a good response to steroid therapy (group 1), a tendency toward normalization of the CD4+ (pretreatment, 38.6%; posttreatment, 44.6%), CD4+CD45RA+ (pretreatment, 15.2%; posttreatment, 21.7%), and CD4+CD45RO+ (pretreatment, 21.1%; posttreatment, 18.2%) cell counts was observed, with a slight decrease in the CD8+ population (pretreatment, 18%; posttreatment, 15.7%). However, in patients with a poorer response (group 2), while there were increases in the CD4+ (pretreatment, 38%; posttreatment, 50%) and CD4+CD45RA+ (pretreatment, 12.8%; posttreatment, 16.7%) cell counts after steroid therapy, there was a significant increment in the CD4+CD45RO+ memory cell count (pretreatment, 14,1%; posttreatment, 28.5%) and low CD8+CD45RA+ counts (pretreatment, 14.6%; posttreatment, 15.5%). No differences were observed in the numbers of B or natural killer cells or in the presence of activation antigens CD25 and HLA-DR when pretreatment and posttreatment levels were compared. Conclusion: These results demonstrate significant abnormalities in the subpopulations of lymphocytes in patients with sudden hearing loss, suggesting the existence of immune-mediated responses in the inner ear as possible etiopathogenic factors in this entity.Arch Otolaryngol Head Neck Surg. 1997;123:712-717 References 1. Wilson RB, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss . Arch Otolaryngol Head Neck Surg . 1980;106:772-776.Crossref 2. McCabe BF. Autoimmune sensorineural hearing loss . Ann Otol Rhinol Laryngol . 1979;88:585-589. 3. Yoon TH, Paparella MM. Systemic vasculitis: a temporal bone histopathologic study . Laryngoscope . 1989;99:600-609.Crossref 4. Rowe-Jones JM, Macallan DC, Sorooshian M. Polyarteritis nodosa presenting as bilateral sudden onset cochleo-vestibular failure in a young woman . J Laryngol Otol . 1990;104:562-564.Crossref 5. Schuknecht HF, Nadol JB. Temporal bone pathology in a case of Cogan's syndrome . Laryngoscope . 1994;104:1135-1142.Crossref 6. Hughes GB, Barna BP, Tomsak RL, Calabrese LH. Autoimmune reactivity in Cogan's syndrome: a preliminary report . Arch Otolaryngol Head Neck Surg . 1983; 91:24-32. 7. Cole RR, Jahrsdoerfer RA. Sudden hearing loss: an update . Am J Otol . 1988;9: 211-215. 8. Hughes GB, Kinney SE, Barna BP, Calabrese LH. Autoimmune reactivity in Meniere's disease: a preliminary report . Laryngoscope . 1983;93:410-417. 9. Hughes GB, Mosciscki R, Barna BP, San Martin JE. Laboratory diagnosis of immune inner ear disease . Am J Otol . 1994;15:198-202. 10. Mayot DM, Bene MC, Dron K, Perrin C, Faure GC. Immunological alterations in patients with sensorineural hearing disorders . Clin Immunol Immunopathol . 1993; 68:41-45.Crossref 11. Arnold W, Pfaltz R, Altermatt HJ. Evidence of serum antibodies against inner ear tissues in the blood of patients with certain sensorineural hearing disorders . Acta Otolaryngol (Stockh) . 1985;99:437-444.Crossref 12. Plester D, Soliman AM. Autoimmune hearing loss . Am J Otol . 1989;10:188-192.Crossref 13. Veldman JE, Hanada T, Meeuwsen F. Diagnostic and therapeutic dilemmas in rapidly progressive sensorineural hearing loss and sudden deafness . Acta Otolaryngol (Stockh) . 1993;113:303-306.Crossref 14. Harris JP, Sharp PA. Inner ear autoantibodies in patients with rapidly progressive sensorineural hearing loss . Laryngoscope . 1990;100:516-524.Crossref 15. Yamanobe S, Harris JP. Inner specific autoantibodies . Laryngoscope . 1993;103: 319-325.Crossref 16. Joliat T, Seyer J, Bernstein J, et al. Antibodies against a 30 kilodalton cochlear protein and type II and IX collagens in the serum of patients with inner ear diseases . Ann Otol Rhinol Laryngol . 1992;101:1000-1006. 17. Mosciscki RA, San Martín JE, Quintero CH, Rauch R, Nadol JB, Bloch KJ. Serum antibody to inner ear proteins in patients with progressive hearing loss . JAMA . 1994;272:611-616.Crossref 18. Kanzaki J, Taiji H, Ogawa K. Evaluation of hearing recovery and efficacy of steroid treatment in sudden deafness . Acta Otolaryngol Suppl (Stockh) . 1988;456: 31-36.Crossref 19. Yamamoto M, Kanzaki J, Ogawa K, Ogawa S, Tsuchihashi N. Evaluation of hearing recovery in patients with sudden deafness . Acta Otolaryngol Suppl (Stockh) . 1994;514:37-40.Crossref 20. Ikeda K, Kobayashi T, Itoh Z, Suzuki H, Kusakari J, Takasaka T. Immunological abnormality of the serological test in bilateral sensorineural hearing loss . ORL J Otorhinolaryngol Relat Spec . 1989;51:268-275.Crossref 21. Kanzaki J, Inove Y, Ouchi T. Immunological findings of serological tests in steroidresponsive sensorineural hearing loss . Acta Otolaryngol Suppl (Stockh) . 1994; 514:66-69.Crossref 22. Helfgott SM, Mosciscki RA, San Martín J, et al. Correlation between antibodies to type II collagen and treatment outcome in bilateral progressive sensorineural hearing loss . Lancet . 1991;337:387-389.Crossref 23. Fowell D, McKnight AJ, Powrie F, et al. Subset of CD4+ T cells and their roles in the induction and prevention of autoimmunity . Immunol Rev . 1991;123:37-64.Crossref 24. Morimoto C, Steinberg AD, Letvin NL, et al. A defect of immunoregulatory T cell subsets in systemic lupus erythematosus patients demonstrated with anti-2H4 antibody . J Clin Invest . 1987;79:762-768.Crossref 25. Kahan L, Hamzoui K, Ayed K. Abnormalities of T lymphocyte subsets in Behçet's disease demonstrated with anti-CD45RA and anti-CD29 monoclonal antibodies . J Rheumatol . 1992;19:742-746. 26. Tanaka S, Matsuyama T, Steinberg AD, Schossman SF, Morimoto C. Antilymphocyte antibodies against CD4+2H+ cell population in patients with systemic lupus erythematosus . Arthritis Rheum . 1989;32:398-405.Crossref 27. Kahan A, Kahan A, Picard F, Menkes CJ, Amor B. Abnormalities of T lymphocyte subsets in systemic sclerosis demonstrated with anti-CD45RA and anti-CD29 monoclonal antibodies . Ann Rheum Dis . 1991;50:354-358.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Jul 1, 1997

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