内耳免疫現象によるめまい発症について

抄録

The hypothesis that certain types of vertigo develop through immunopathological mechanisms has been advocated for over 80 years. These days, many reports have been published that link immunity and vertigo with a variety of proposed immune-related etiologies, from autoimmunity to non-autoimmunity. Due to the inaccessibility of the labyrinth, it is difficult to take out obtain specimens of the inner ear tissue. In this paper, we present an animal model of Meniere's disease. Immune reaction following secondary antigen challenge in the endolymphatic sac of guinea pigs led to the development of endolymphatic hydrops, fluctuating hearing loss, precipitation of vertigo and suppression of the caloric response, similar to the symptomatology of Meniere's disease. These results strongly suggest that immune reaction in the endolymphatic sac is the likely cause of vertigo in Meniere's disesae. It is difficult to clinically distinguish between autoimmune inner ear disease and Meniere's disease, because of their clinical similarity. Western blotting examination of the serum for inner ear autoantibodies may aid in the differential diagnosis. Immunosuppressive drug treatment may be effective in patients with severe vertigo who show resistance to therapies used for Meniere's disease.