Plasmatic osmolality in Menière's disease

Celestino, D; Ralli, Giovanni

doi:10.1017/s0022215100090708

Cited by 6 publications

(6 citation statements)

References 7 publications

(1 reference statement)

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“…This dysregulation could manifest in two ways: (i) the perilymphatic–endolymphatic osmotic gradient, which constitutes the driving force for transcellular water movements across the AQP4/AQP5–water shunt, is disturbed and/or (ii) the AQP-based transcellular water permeability of the AQP4/AQP5–water shunt is altered. In line with (i), altered serum osmolarities have been reported in Ménière’s patients in acute attacks and during remission phases [ 5 , 11 , 12 , 50 , 53 , 81 ]. Moreover, in the clinical diagnosis of Ménière’s disease, the sugar alcohol glycerol is administered orally or intravenously to increase the serum and perilymph osmolarity and thereby osmotically drain the hydropic endolymphatic fluid space and temporarily improve audiometric hearing thresholds (in the early disease state when endolymphatic hydrops remains reversible) [ 54 ].…”

Section: Discussionsupporting

confidence: 71%

Regulation of the perilymphatic–endolymphatic water shunt in the cochlea by membrane translocation of aquaporin-5

Eckhard

Santos

Liu

et al. 2015

Pflugers Arch - Eur J Physiol

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Volume homeostasis of the cochlear endolymph depends on radial and longitudinal endolymph movements (LEMs). LEMs measured in vivo have been exclusively recognized under physiologically challenging conditions, such as experimentally induced alterations of perilymph osmolarity or endolymph volume. The regulatory mechanisms that adjust LEMs to the physiological requirements of endolymph volume homeostasis remain unknown. Here, we describe the formation of an aquaporin (AQP)-based “water shunt” during the postnatal development of the mouse cochlea and its regulation by different triggers. The final complementary expression pattern of AQP5 (apical membrane) and AQP4 (basolateral membrane) in outer sulcus cells (OSCs) of the cochlear apex is acquired at the onset of hearing function (postnatal day (p)8–p12). In vitro, hyperosmolar perfusion of the perilymphatic fluid spaces or the administration of the muscarinic agonist pilocarpine in cochlear explants (p14) induced the translocation of AQP5 channel proteins into the apical membranes of OSCs. AQP5 membrane translocation was blocked by the muscarinic antagonist atropine. The muscarinic M3 acetylcholine (ACh) receptor (M3R) was identified in murine OSCs via mRNA expression, immunolabeling, and in vitro binding studies using an M3R-specific fluorescent ligand. Finally, the water shunt elements AQP4, AQP5, and M3R were also demonstrated in OSCs of the human cochlea. The regulation of the AQP4/AQP5 water shunt in OSCs of the cochlear apex provides a molecular basis for regulated endolymphatic volume homeostasis. Moreover, its dysregulation or disruption may have pathophysiologic implications for clinical conditions related to endolymphatic hydrops, such as Ménière’s disease.Electronic supplementary materialThe online version of this article (doi:10.1007/s00424-015-1720-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 71%

Regulation of the perilymphatic–endolymphatic water shunt in the cochlea by membrane translocation of aquaporin-5

Eckhard

Santos

Liu

et al. 2015

Pflugers Arch - Eur J Physiol

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“…Based on these results, p-Osm is thought to be modified in patients with Ménière's disease. The serum and p-Osm levels in these subjects have already been studied [5][6][7] . However, the results are controversial.…”

Section: Discussionmentioning

confidence: 99%

Antidiuretic Hormone and Osmolality in Patients with Ménière’s Disease

Kakigi

Takeda²

2008

ORL

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Plasma antidiuretic hormone (p-ADH) and plasma osmolality (p-Osm) levels were studied in patients with Ménière’s disease. In 147 cases, the p-ADH levels were measured during remission and in the acute phase of the disease. In 100 of 147 cases, the p-Osm levels were determined both in remission and in the acute phase. In remission, the p-ADH and p-Osm levels were higher than the normal limits. In the acute phase, the p-ADH level was higher than that in remission, consistent with previous reports. Moreover, the p-Osm level was unchanged. Although the p-ADH level is regulated by that of p-Osm, the kidney must show an escape phenomenon from antidiuresis. Besides, other factors must increase the amount of p-ADH. Further study is needed to reveal the cause of the rise in p-ADH and p-Osm levels.

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“…Thus a systemic abnormality in acid-base balance producing a metabolic alkalosis has been observed (Weille, 1967;Celestino et al, 1976). Other workers have found elevated serum osmolalities in between 22 per cent and 33 per cent of Meniere's patients (Angelborg et al, 1973;Celestino and Ralli, 1980). Morrison (1981) reported osmolality results in 300 Meniere's patients and observed that the mean level was well within normal limits.…”

Section: Discussionmentioning

confidence: 97%

Oral acetazolamide in Menière's disease

Brookes¹,

Booth²

1984

J. Laryngol. Otol.

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The therapeutic efficacy of oral acetazolamide has been evaluated in a small pilot study of 14 patients with Menière's disease (23 hydropic ears). Symptomatic improvement was found in 4 cases. In 2 of these patients the improvement was not sustained, whilst another had to stop the drug due to the development of bilateral renal calculi. A deterioration in symptoms was seen in 3 cases. Significant adverse side-effects were encountered in 6 of the 13 patients (46.2 per cent) who complied with drug dosage instructions. It is suggested that this high incidence of side-effects may be consistent with a general metabolic difference between Menière's patients and normal subjects. We conclude that oral acetazolamide has no place in the medical treatment of Menière's disease.

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Plasmatic osmolality in Menière's disease

Cited by 6 publications

References 7 publications

Regulation of the perilymphatic–endolymphatic water shunt in the cochlea by membrane translocation of aquaporin-5

Regulation of the perilymphatic–endolymphatic water shunt in the cochlea by membrane translocation of aquaporin-5

Antidiuretic Hormone and Osmolality in Patients with Ménière’s Disease

Oral acetazolamide in Menière's disease

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