In contrast, previous studies tended to use whole inner ear tissue. of human inner ear fluid using liquid column mass spectrometry, the autoimmune reaction between circulating autoantibodies in patient serum and multiple antigens using the Protoarray system, the immune reaction between patient serum and mouse inner ear tissues using western blot analysis. Nine proteins, including immunoglobulin and its variants and interferon regulatory factor 7, were found only in the inner ear fluid of patients with Meniere’s disease. Enhanced immune reactions with 18 candidate antigens were detected in patients with Meniere’s disease in Protoarray analysis; levels of 8 of these antigens were more than 10-fold higher in patients than in controls. Antigen-antibody reactions between mouse inner ear proteins with molecular weights of 23C48 kDa and 63C75 kDa and patient sera were detected in 8 patients. These findings suggest that autoimmunity could be one of the pathologic mechanisms behind Meniere’s disease. Multiple autoantibodies and antigens may be involved in the autoimmune reaction. Specific antigens that caused immune reactions with patient’s serum in Protoarray analysis can be candidates for the diagnostic biomarkers of Meniere’s disease. Toll-like receptor modulator Introduction In 1861, Prosper Meniere first described Meniere’s disease as an inner ear disorder that manifests as fluctuating vertigo, sensorineural hearing loss, tinnitus, and aural fullness. The prevalence of Meniere’s disease is 3.5C513 per 100,000, which is higher than the prevalence of Toll-like receptor modulator systemic lupus erythematosus (SLE) and multiple sclerosis [1]. The unpredictable nature of Meniere’s disease has a serious effect on patients’ daily life. During active Toll-like receptor modulator episodes, the quality of life score of patients with Meniere’s disease is thought to be lower than that of AIDS patients treated with AZT, that of patients with severe chronic obstructive pulmonary disease, and that of noninstitutionalized patients with Alzheimer’s disease [2]. The main pathologic Toll-like receptor modulator site is thought to be the inner ear, which consists of the cochlea, vestibule, and endolymphatic sac. A characteristic finding of Meniere’s disease is the dilatation of the endolymphatic compartment of the inner ear caused by an increase in endolymph (endolymphatic hydrops, Fig. 1) [3]. The proposed etiologies of endolymphatic hydrops are autoimmune, allergic, genetic, traumatic, and infectious (viral) [4]C[9]. These finally result in endolymphatic hydrops by deteriorating ion homeostasis and fluid volume regulation in the inner ear [3]. However, the exact pathologic mechanism underlying endolymphatic hydrops is still unknown. Open in a separate window Figure EFNA1 1 Schematic drawing of the inner ear and endolymphatic hydrops as a mechanism for Meniere’s disease.The inner ear consists of the cochlea, vestibule, and endolymphatic sac (ES). The utricle (U), saccule (S), and semicircular canals (SCCs) form the vestibule. A. Normal inner ear structure. B. Endolymphatic hydrops in patients with Meniere’s disease. Certain findings have provided evidence that autoimmunity may underlie the pathology of Meniere’s disease. Toll-like receptor modulator The prevalence of systemic autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis, and SLE in patients with Meniere’s disease is 3- to 8-fold higher than in the general population [10]. In addition, autoantibodies such as the anti-heat-shock protein 70, anti-68 kD inner ear protein antibody, anti-myelin peroxidase zero antibody, and anti-thyroid peroxidase antibody have been detected in the serum of patients with Meniere’s disease [11]C[14]. However, these autoantibodies were not found in all of the patients. Previous studies tended to investigate only a select few target proteins instead of conducting mass screening; in addition, many of these studies used western blot analyses to detect antigen-antibody reactions between patient serum and animal inner ear tissues, which can demonstrate the existence of an antigen-antibody reaction but provides no information on the identity of the.
