Serum Fibrinogen Level and Cytokine Production as Prognostic Biomarkers for Idiopathic Sudden Sensorineural Hearing Loss

Abstract

ObjectivesNo clinically useful prognostic factors have been identified for idiopathic sudden sensorineural hearing loss (ISSNHL). The current study therefore sought to identify useful prognostic factors for idiopathic sudden sensorineural hearing loss from blood biomarkers while attempting to classify the pathogenic mechanism and formulate treatment strategies based on these results.Study DesignProspective cohort study.SettingTertiary referral center.MethodsA total of 47 patients with acute phase ISSNHL were treated with steroid at an initial dose of 1 mg/kg/day and hyperbaric oxygen therapy and followed up for 6 months. Serum fibrinogen levels, peripheral blood mononu- clear cells (PBMCs), and interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α production levels from PBMCs were measured, after which patient’s pre- and post- treatment hearing was compared.ResultsIn the overall cohort, the mean improvement level, mean recovery rate, and mean fibrinogen level was 20.3 dB, 46.2%, 292.0 mg/mL, respectively. The mean levels of IL-1β, IL-6, and TNF-α produced by peripheral blood mononu- clear cells cultured under lipopolysaccharide stimulation were 318.4, 498.1, and 857.6 pg/mL, respectively. High fibrinogen levels were associated with poor hearing progno- sis. Lipopolysaccharide-stimulated cytokine production by PBMCs did not correlate with hearing changes; however, the prognosis was significantly better in patients with low fibrinogen levels and high IL-1β levels produced by PBMCs than in other patients.ConclusionsOur results suggest that patients with simple inflammatory-type ISSNHL responded well to standard therapy. Therefore, serum fibrinogen levels and PBMCs cytokine production may help determine the management of ISSNHL based on its pathogenic mechanism.

The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss

“…Only at visit 3 did it show a correlation with uric acid ( r = 0.404), a result that was probably not related to SSNHL. In contrast to IL-1F7, the TH2 cytokines IL-4 and IL-6 have already been described as being involved in processes associated with SSNHL ( 26 , 62 ). It is noteworthy that although our results showed no significant changes over the course of the visits, both cytokines showed a positive correlation at visit 2 ( r = 0.547).…”

“…An example of this is the decrease in IFN-γ and IL-12 levels and the increase in TNF-α levels and monocyte counts in patients with SSNHL compared to controls ( 25 ). Another interesting fact is that SSNHL patients with better prognosis had mononuclear cells that produced higher levels of IL-1β after activation with LPS ( 26 ).…”

Environmental Risk Factors, Protective Factors, and Biomarkers for Hearing Loss: An Umbrella Review

“…The complexity of HL pathophysiology is reflected in multimodal studies that have investigated the association of many genetic and environmental factors with HL, and biomarkers that may reflect the influence of these factors 10 . Although some progress has been made in exploring biomarkers and the risk of HL, the results of these studies have been inconsistent, and the degree of association with HL is still controversial 11‐13 . In the field of HL, there have been many systematic reviews and meta‐analyses focused on assessing environmental risk factors, environmental protection factors, and biomarkers.…”