RESEARCH - Sensorineural hearing loss in patients with MCTD: immunological markers and cytokine levels

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J Rheumatol. 2009 Aug 14.

Sensorineural Hearing Loss in Patients with Mixed Connective Tissue

Disease: Immunological Markers and Cytokine Levels.

Hajas A, Szodoray P, Barath S, Sipka S, Rezes S, Zeher M, Sziklai I,

Szegedi G, Bodolay E.

From the Division of Clinical Immunology, 3rd Department of Medicine,

Medical and Health Science Center; and Division of Oto- Rhyno-

Laryngology, Medical and Health Science Center, University of

Debrecen, Debrecen, Hungary.

OBJECTIVE: To investigate the frequency of sensorineural hearing loss

(SNHL) in patients with mixed connective tissue disease (MCTD).

METHODS: The study population consisted of 71 patients with MCTD (69

female; 2 male), with a mean age of 57.1 +/- 7.9 years and a mean

disease duration of 14.5 +/- 8.0 years. All patients underwent

audiological evaluation that included pure tone and speech audiometry.

In addition, the systemic manifestations of the disease and drug

therapy were recorded. All patients were tested for presence of

autoantibodies. Fifty-one age-matched healthy subjects served as

controls.

RESULTS: SNHL was found in 33 (46.4%) of the 71 patients with MCTD.

There was no correlation between SNHL and age and disease duration. An

association was found between Raynaud's phenomenon (p < 0.03),

secondary antiphospholipid syndrome (APS) (p < 0.05), and SNHL. MCTD

patients with SNHL had higher serum levels of anti-U1RNP (p < 0.05),

antiendothelial cell antibodies (p < 0.001), and IgG type

anticardiolipin antibodies (p < 0.0001) than patients without SNHL.

Serum levels of interferon-gamma and tumor necrosis factor-alpha were

increased in MCTD patients with SNHL compared to patients without

SNHL. The absolute number of natural (CD4+CD25highFoxP+) regulatory T

cells (Treg) was lower compared to patients without SNHL.

CONCLUSION: In MCTD, SNHL is a specific organ manifestation and

appears frequently. We have found that pathogenic autoantibodies,

decreased levels of regulatory T cells, and overexpression of

proinflammatory cytokines may play a role in the pathogenesis of

immune mediated inner ear disorders in MCTD.

PMID: 19684145

http://www.ncbi.nlm.nih.gov/pubmed/19684145

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