Deficiency of naive T cells in patients with sudden deafness

• Published in: Archives of otolaryngology--head & neck surgery Vol. 123; no. 7; p. 712
• Main Authors: García-Berrocal, J R, Vargas, J A, Ramírez-Camacho, R A, González, F M, Gea-Banacloche, J C, Vergara, J, Durántez, A
• Format: Journal Article
• Language: English
• Published: United States 01.07.1997
• Subjects: Adolescent; Adult; Autoimmune Diseases - drug therapy; Autoimmune Diseases - immunology; Case-Control Studies; CD4-Positive T-Lymphocytes - drug effects; CD4-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - drug effects; CD8-Positive T-Lymphocytes - immunology; Female; Flow Cytometry - methods; Glucocorticoids - therapeutic use; Hearing Loss, Sudden - drug therapy; Hearing Loss, Sudden - immunology; Humans; Immunologic Deficiency Syndromes - drug therapy; Immunologic Deficiency Syndromes - immunology; Immunophenotyping; Leukocyte Common Antigens - drug effects; Leukocyte Common Antigens - immunology; Male; Methylprednisolone - therapeutic use; Middle Aged; Prospective Studies
• ISSN: 0886-4470
• DOI: 10.1001/archotol.1997.01900070056009

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 immune-mediated mechanisms in sudden deafness. To study the phenotype of peripheral blood lymphocytes in a group of patients with sudden deafness by use of 3-color flow cytometry. 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. Tertiary case referral center, ambulatory and hospitalized care. 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. 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. 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.