A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Anti-Heat Shock Protein 70 Antibodies for the Detection of Autoimmune Hearing Loss

Ianuale, Carolina; Cadoni, Gabriella; Feo, Emma De; Liberati, Luca; Simo, Rachel Kamgaing; Paludetti, Gaetano; Ricciardi, Walter; Boccia, Stefania

doi:10.1097/mao.0b013e31827d0b8b

Cited by 20 publications

(10 citation statements)

References 26 publications

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“…Among these, the most researched is the Anti-Heat Shock Protein 70 antibody (Hsp 70), which also has not demonstrated efficiency in diagnosing such illness. 23 …”

Section: Discussionmentioning

confidence: 99%

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Rossini

Penido

Munhoz

et al. 2016

Int Arch Otorhinolaryngol

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Introduction Several authors have demonstrated the relationship between sudden sensorineural hearing loss (SNHL) and systemic autoimmune diseases (SAD). Immune-mediated SNHL can rarely present as unilateral sudden SNHL and manifests itself in the contralateral ear only after years. It presents clinical relevance for being one of the few SNHL that may be reversible given that early and appropriate treatment is applied. Objective The objective of this study is to describe the clinical presentations and audiological findings from patients with idiopathic sudden SNHL and SAD associated with a probable diagnosis of immune-mediated SNHL. Furthermore, we strive to estimate the prevalence of SAD in patients with sudden SNHL. Methods This is an observational retrospective cohort. We have selected and studied patients with SAD. Revision of available literature on scientific repositories. Results We evaluated 339 patients with sudden SNHL. Among them, 13 (3.83%) patients suffered from SAD. Three patients had bilateral involvement, a total of 16 ears. We evaluate and describe various clinical, epidemiological, and audiological aspects of this sample. Conclusion In our sample of patients with sudden SNHL, the prevalence of SAD was found relevant. The majority had tinnitus and dizziness concomitant hearing loss, unilateral involvement and had experienced profound hearing loss at the time of the installation. In spite of instituted treatment, most cases showed no improvement in audiometric thresholds. Apparently, patients with sudden SNHL and SAD have a more severe initial impairment, higher percentage of bilateral, lower response to treatment, and worse prognosis than patients with sudden SNHL of unknown etiology.

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“…Among these, the most researched is the Anti-Heat Shock Protein 70 antibody (Hsp 70), which also has not demonstrated efficiency in diagnosing such illness. 23 …”

Section: Discussionmentioning

confidence: 99%

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Rossini

Penido

Munhoz

et al. 2016

Int Arch Otorhinolaryngol

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“…Positivity for anti-68 kD protein antibody is associated with the diagnosis of autoimmune hearing loss [ 3 , 4 , 6 , 40 ], although no single antibody-related test result presently known establishes or excludes ASNHL diagnosis. In the present study, the percentages of the patients who had subnormal serum levels of IgG1 or IgG3 did not differ significantly between those with and those without anti-68 kD protein antibody.…”

Section: Discussionmentioning

confidence: 99%

“…Autoimmune sensorineural hearing loss (ASNHL), also called autoimmune inner ear disease or autoimmune hearing loss, is characterized by rapidly progressive sensorineural hearing loss not explained by other defined causes [ 1 - 3 ]. Inner ear antigens that have been proposed as targets of putative deleterious autoantibodies in ASNHL include, but are not limited to, 68 kD protein (often called heat-shock protein) [ 4 - 6 ], 30 kD protein (often called myelin Protein 0 or P0) [ 7 , 8 ], type II collagen [ 9 ], choline transporter-like protein 2 [ 10 - 12 ], cochlin [ 13 ], and inner ear supporting cell antigen [ 14 ]. Many patients with ASNHL experience rapid improvement of hearing with initial immunosuppressive therapy such as corticosteroids (systemic or intratympanic) [ 15 ], methotrexate [ 16 ], or cyclophosphamide [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Serum immunoglobulins in 28 adults with autoimmune sensorineural hearing loss: increased prevalence of subnormal immunoglobulin G1 and immunoglobulin G3

Bertoli¹,

Pappas²,

Barton³

et al. 2014

BMC Immunol

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BackgroundOur informal observations suggested that some patients with acute sensorineural hearing loss (ASNHL) have subnormal serum immunoglobulin (Ig) levels. We evaluated 28 consecutive adults (18 men, 10 women) at ASNHL diagnosis using: antibodies to 68 kD protein, 30 kD protein, and type II collagen; and serum total IgG, IgG subclasses, total IgA, and IgM. Reference ranges for Ig levels were mean ± 2 SD. We compared prevalences of subnormal IgG subclasses to those in 275 healthy European adults in previous reports. We also reviewed charts of consecutive adult index patients with primary Ig deficiency (35 common variable immunodeficiency, 406 IgG subclass deficiency) to identify other patients with probable ASHNL.ResultsMean age was 53 ± 10 (SD) y. Six patients (21.4%) had other autoimmunity manifestations. Antibodies to 68 kD protein, 30 kD protein, and type II collagen were detected in 21.4% (6/28), 21.1% (4/19) and 18.8% (3/16), respectively. Three patients (10.7%) had subnormal IgG1, six (21.4%) had subnormal IgG3, and four (14.3%) had subnormal IgG1 and IgG3. Some had subnormal IgG2, IgG4, IgA, and IgM (n = 1, 2, 3, and 1, respectively). Prevalences of subnormal IgG1 or IgG3 were greater in ASNHL patients (25.0% and 35.7%) than 275 controls (2.1% and 3.3%), respectively (p < 0.0001, each comparison). Relative risks of subnormal IgG1 and IgG3 in ASNHL were 11.5 [95% CI: 4.1, 31.7] and 10.9 [4.8, 25.6], respectively. Hearing improved after initial therapy in 17 patients (60.7%). Multiple regressions on Ig levels revealed no significant associations with other available variables. Logistic regressions on initial therapy response revealed a positive association with men (p = 0.0392) and a negative association with IgA (p = 0.0274). Our estimated prevalence of probable ASNHL in 35 patients with common variable immunodeficiency during a follow-up interval of 8 ± 4 y was 0% [95% CI: 0, 12.3]). Prevalence of probable ASNHL in 406 patients with IgG subclass deficiency during the same interval was 0.74% [0.19, 2.33].ConclusionsSerum levels of IgG1 or IgG3 were subnormal in 46.4% of 28 patients with ASNHL. Among adults who present with primary Ig deficiency, some may have or later develop ASNHL.

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“…Existing laboratory tests are controversial and there is no definite and widely accepted marker for the diagnosis of AIED, although several have been described 3‐7 . The most frequently described marker in AIED is the antibody to Heat Shock Protein‐70, although its utility has been debated 8‐11 . The lack of widely accepted diagnostic criteria has prevented the foundation of large trials and created differences in the inclusion criteria for published studies.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] The most frequently described marker in AIED is the antibody to Heat Shock Protein-70, although its utility has been debated. [8][9][10][11] The lack of widely accepted diagnostic criteria has prevented the foundation of large trials and created differences in the inclusion criteria for published studies. Most studies adhere to the diagnostic criteria defined by the following: (a) progressive, bilateral SNHL of at least 30 dB at one or more frequencies;…”

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confidence: 99%

Autoimmune inner ear disease: A systematic review of management

Breslin

Varadarajan

Sobel

et al. 2020

Laryngoscope Investig Oto

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Objectives: The study systematically reviewed the existing literature on the management of autoimmune inner ear disease (AIED). Study Design: Systematic review. Methods: We performed a literature search of Embase, NCBI, Cochrane, and Web of Science databases from April 1990 to April 2020. Inclusion criteria included studies that were retrospective or prospective in nature evaluating the treatment of AIED with audiometric data measuring hearing outcomes during treatment. Hearing improvement was the primary study outcome and improvement in vestibular symptoms was the secondary study outcome. Results: Sixteen of 412 candidate articles were included in our study. Systemic steroid treatment is most commonly described. Alternative treatment modalities included intratympanic steroid treatment, methotrexate, cyclophosphamide, azathioprine, infliximab, etanercept, adalimumab, golimumab, methylprednisolone, rituximab, and anakinra. Conclusion: Systemic corticosteroids are the first line treatment of AIED. Intratympanic steroids are a potential adjuvant or alternative treatment for patients who cannot tolerate or become refractory to steroid treatment. Steroid nonresponders may benefit from biologic therapy. Alternative treatment modalities including nonsteroidal immunosuppressants and biologics have been studied in small cohorts of patients with varying results. Prospective studies investigating the efficacy of biologic and nonsteroidal therapy are warranted.

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A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Anti-Heat Shock Protein 70 Antibodies for the Detection of Autoimmune Hearing Loss

Cited by 20 publications

References 26 publications

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Serum immunoglobulins in 28 adults with autoimmune sensorineural hearing loss: increased prevalence of subnormal immunoglobulin G1 and immunoglobulin G3

Autoimmune inner ear disease: A systematic review of management

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