Corticosteroid response and supporting cell antibody in autoimmune hearing loss.
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.
Zeitoun
Hisham
H
Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor 48109-0506, USA.
Beckman
Jennifer Gray
JG
Arts
H Alexander
HA
Lansford
Christopher D
CD
Lee
David S
DS
El-Kashlan
Hussam K
HK
Telian
Steven A
SA
Denny
Dawn E
DE
Ramakrishnan
Anna
A
Nair
Thankam S
TS
Disher
Michael J
MJ
Sataloff
Robert T
RT
Fisher
Susan G
SG
Carey
Thomas E
TE
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
D001323:Autoantibodies; D001324:Autoantigens; D005938:Glucocorticoids; D008775:Methylprednisolone