title: Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  We investigated whether inflammatory biomarkers and stress are involved in the pathophysiology of idiopathic sensorineural hearing loss (ISHL).
  
  
  METHODS
  Individual cohort study.
  
  
  METHODS
  Two tertiary centers.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology, School of Medicine, Keio University, Tokyo, Japan. masoeur13@mac.com
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Masuda
authors.forename: Sho
authors.initials: S
authors.lastname: Kanzaki
authors.forename: Shujiro
authors.initials: S
authors.lastname: Minami
authors.forename: Jun
authors.initials: J
authors.lastname: Kikuchi
authors.forename: Jin
authors.initials: J
authors.lastname: Kanzaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sato
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000175:diagnosis*; D003639:Hearing Loss, Sudden / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007694:Killer Cells, Natural; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha