title: Corticosteroid response and supporting cell antibody in autoimmune hearing loss.
abstract: OBJECTIVE
  To determine whether antibodies to supporting cells are associated with response to corticosteroids in patients with autoimmune sensorineural hearing loss.
  
  
  METHODS
  Prospective analysis of antibody to inner-ear antigens.
  
  
  METHODS
  Collaborating otology practices in Pennsylvania, Michigan, and Indiana.
  
  
  METHODS
  Sixty-three patients with rapidly progressive unilateral or bilateral sensorineural hearing loss of unknown cause suggestive of autoimmune sensorineural hearing loss.
  
  
  METHODS
  Pretreatment audiometry, serum analysis by Western blot (WB) and immunofluorescence (IF) tests, corticosteroid therapy, and follow-up audiometry.
  
  
  METHODS
  Antibody reactivity and audiogram changes were analyzed for association with response to treatment.
  
  
  RESULTS
  More than half of the patients (37/63) had antibodies to both a 68- to 72-kDa protein and to inner-ear supporting cells, 16 patients had positive results on one assay only, and 10 had negative results on both. Twenty-eight patients improved and 35 did not. The WB findings did not correlate with response. Of the WB-positive patients, 49% (21/43) improved, as did 35% (7/20) of the WB-negative patients (P = .30). In contrast, 53% (25/47) of IF-positive patients improved, compared with only 19% (3/16) in the IF-negative group (P = .02). Of those who improved, 89% (25/28) were IF positive.
  
  
  CONCLUSIONS
  Antibody to an inner-ear supporting cell antigen was significantly associated with hearing improvement after corticosteroid therapy (relative rate, 2.8). Patients with IF-positive serum are nearly 3 times more likely to experience improved hearing with corticosteroid treatment than those who are IF negative. Antibodies to inner-ear supporting cell antigen may have value in diagnosis and treatment of patients with autoimmune sensorineural hearing loss.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor 48109-0506, USA.
authors.forename: Hisham
authors.initials: H
authors.lastname: Zeitoun
authors.forename: Jennifer Gray
authors.initials: JG
authors.lastname: Beckman
authors.forename: H Alexander
authors.initials: HA
authors.lastname: Arts
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Lansford
authors.forename: David S
authors.initials: DS
authors.lastname: Lee
authors.forename: Hussam K
authors.initials: HK
authors.lastname: El-Kashlan
authors.forename: Steven A
authors.initials: SA
authors.lastname: Telian
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Denny
authors.forename: Anna
authors.initials: A
authors.lastname: Ramakrishnan
authors.forename: Thankam S
authors.initials: TS
authors.lastname: Nair
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Disher
authors.forename: Robert T
authors.initials: RT
authors.lastname: Sataloff
authors.forename: Susan G
authors.initials: SG
authors.lastname: Fisher
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Carey
mesh_terms: D000328:Adult; D000368:Aged; D001299:Audiometry; D001323:Autoantibodies / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D001327:Autoimmune Diseases / Q000188:drug therapy*; D015153:Blotting, Western; D016009:Chi-Square Distribution; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D005938:Glucocorticoids; D008775:Methylprednisolone