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Keithley EM. Inner ear immunity. Hear Res 2022; 419:108518. [DOI: 10.1016/j.heares.2022.108518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
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Kiyokawa Y, Ariizumi Y, Ohno K, Ito T, Kawashima Y, Tsunoda A, Kishimoto S, Asakage T, Tsutsumi T. Indications for and extent of elective neck dissection for lymph node metastasis from external auditory canal carcinoma. Auris Nasus Larynx 2020; 48:745-750. [PMID: 33386189 DOI: 10.1016/j.anl.2020.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We aim to clarify the frequency of lymph node metastasis of external auditory canal (EAC) carcinoma, including susceptible locations, adequate extent of elective neck dissection, and the relationship between the tumor infiltration site and lymph node metastasis. PATIENTS AND METHODS From 2003 to 2018, 63 patients with EAC carcinoma at Tokyo Medical and Dental University Hospital were enrolled in this study. The T and N stages, locations of clinically positive lymph nodes, prognoses, and anatomic site of tumor infiltration were analyzed after treatment. RESULTS Clinically positive lymph node metastasis (cN+) was detected in 18 patients (28.6%), consisting of T1, T2, T3, and T4 disease in 1 (6%), 2 (22%), 8 (38%), and 7 (41%) patients, respectively. The metastatic locations were at level II in 10 patients, parotid gland nodes in 7, preauricular nodes in 5, level Ib in 3, level Va in 3, level III in 1, and superficial cervical nodes in 1. Neck recurrence was determined in two of 45 patients with clinically negative lymph nodes (cN0), with the metastatic locations being levels II, Ib, and III. Among 18 cN+ cases, neck recurrence was noted in 2 of 9 patients who underwent neck dissection. Neck lesions were found to be manageable in all five patients who underwent docetaxel, cisplatin, 5-fluorouracil, and radiation therapy (TPF-RT). No relationship was noted between the tumor infiltration site and lymph node metastasis among T3/4 canrcinoma patients. CONCLUSIONS Elective neck dissection could be indicated only in T3/4 patients with free flap reconstruction. Levels Ib to III are considered appropriate for elective neck dissection in cN0 cases. Levels Ib to III and Va indicated favorable sites, even in cases with metastasis in the parotid gland or preauricular area. Furthermore, TPF-RT could be a useful option even in cN+ cases.
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Affiliation(s)
- Yusuke Kiyokawa
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan; Department of Otolaryngology Head and Neck Surgery, Musashino Red Cross Hospital, Tokyo, Japan.
| | - Yousuke Ariizumi
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuchika Ohno
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taku Ito
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiyuki Kawashima
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsunobu Tsunoda
- Department of Otolaryngology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Seiji Kishimoto
- Department of Head and Neck Surgery, Kameda Medical Center, Kamogawa, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Tsutsumi
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
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Schuh JCL. Mucosa-Associated Lymphoid Tissue and Tertiary Lymphoid Structures of the Eye and Ear in Laboratory Animals. Toxicol Pathol 2020; 49:472-482. [PMID: 33252012 DOI: 10.1177/0192623320970448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mucosa-associated lymphoid tissue (MALT) of special senses is poorly described and can be confused with nonspecific mononuclear cell infiltrates and tertiary lymphoid structures (TLS). In the eye, MALT consists mostly of conjunctiva-associated lymphoid tissue (CALT) and lacrimal drainage-associated lymphoid tissue (LDALT). In humans, CALT and LDALT are important components of the normal eye-associated lymphoid tissue (EALT), but EALT is less frequently described in ocular tissues of animals. The EALT are acquired postnatally in preferential mucosal sites, expand with antigenic exposure, form well-developed lymphoid follicles, and are reported to senesce. Lymphoid follicles that are induced concurrently with chronic inflammation are more appropriately considered TLS but must be differentiated from inflammation in MALT. Less understood is the etiology for formation of lymphoid tissue aggregates in the ciliary body, limbus, or choroid of healthy eyes in animals and humans. In the healthy eustachian tube and middle ear of animals and humans, MALT may be present but is infrequently described. Concurrent with otitis media, lymphoid follicles in the eustachian tube are probably expanded MALT, but lymphoid follicles in the middle ear may be TLS. The purpose of this comparative review is to familiarize toxicologic pathologists with MALT in the special senses and to provide considerations for differentiating and reporting eye and ear MALT from immune or inflammatory cell infiltrates or inflammation in nonclinical studies, and the circumstances for reporting TLS in compartments of the eye and ear.
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Rai V, Wood MB, Feng H, Schabla NM, Tu S, Zuo J. The immune response after noise damage in the cochlea is characterized by a heterogeneous mix of adaptive and innate immune cells. Sci Rep 2020; 10:15167. [PMID: 32938973 PMCID: PMC7495466 DOI: 10.1038/s41598-020-72181-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023] Open
Abstract
Cells of the immune system are present in the adult cochlea and respond to damage caused by noise exposure. However, the types of immune cells involved and their locations within the cochlea are unclear. We used flow cytometry and immunostaining to reveal the heterogeneity of the immune cells in the cochlea and validated the presence of immune cell gene expression by analyzing existing single-cell RNA-sequencing (scRNAseq) data. We demonstrate that cell types of both the innate and adaptive immune system are present in the cochlea. In response to noise damage, immune cells increase in number. B, T, NK, and myeloid cells (macrophages and neutrophils) are the predominant immune cells present. Interestingly, immune cells appear to respond to noise damage by infiltrating the organ of Corti. Our studies highlight the need to further understand the role of these immune cells within the cochlea after noise exposure.
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MESH Headings
- Adaptive Immunity
- Animals
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Cochlea/immunology
- Cochlea/injuries
- Cochlea/pathology
- Disease Models, Animal
- Evoked Potentials, Auditory, Brain Stem/immunology
- Female
- Hearing Loss, Noise-Induced/immunology
- Hearing Loss, Noise-Induced/pathology
- Hearing Loss, Noise-Induced/physiopathology
- Immunity, Innate
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Leukocyte Common Antigens/metabolism
- Macrophages/immunology
- Macrophages/pathology
- Male
- Mice
- Mice, 129 Strain
- Mice, Inbred C57BL
- Mice, Transgenic
- Neutrophils/immunology
- Neutrophils/pathology
- Organ of Corti/immunology
- Organ of Corti/injuries
- Organ of Corti/pathology
- RNA-Seq
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
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Affiliation(s)
- Vikrant Rai
- Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Megan B Wood
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Hao Feng
- Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Nathan M Schabla
- Department of Medical Microbiology and Immunology and Flow Cytometry Core, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Shu Tu
- Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Jian Zuo
- Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA.
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
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Frye MD, Ryan AF, Kurabi A. Inflammation associated with noise-induced hearing loss. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:4020. [PMID: 31795714 PMCID: PMC7480080 DOI: 10.1121/1.5132545] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/17/2019] [Accepted: 06/20/2019] [Indexed: 05/22/2023]
Abstract
Inflammation is a complex biological response to harmful stimuli including infection, tissue damage, and toxins. Thus, it is not surprising that cochlear damage by noise includes an inflammatory component. One mechanism by which inflammation is generated by tissue damage is the activation of damage-associated molecular patterns (DAMPs). Many of the cellular receptors for DAMPS, including Toll-like receptors, NOD-like receptors, and DNA receptors, are also receptors for pathogens, and function in the innate immune system. DAMP receptors are known to be expressed by cochlear cells, and binding of molecules released by damaged cells to these receptors result in the activation of cell stress pathways. This leads to the generation of pro-inflammatory cytokines and chemokines that recruit pro-inflammatory leukocytes. Extensive evidence indicates pro-inflammatory cytokines including TNF alpha and interleukin 1 beta, and chemokines including CCL2, are induced in the cochlea after noise exposure. The recruitment of macrophages into the cochlea has also been demonstrated. These provide substrates for noise damage to be enhanced by inflammation. Evidence is provided by the effectiveness of anti-inflammatory drugs in ameliorating noise-induced hearing loss. Involvement of inflammation provides a wide variety of additional anti-inflammatory and pro-resolution agents as potential pharmacological interventions in noise-induced hearing loss.
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Affiliation(s)
- Mitchell D Frye
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75080, USA
| | - Allen F Ryan
- Department of Surgery/Otolaryngology, University of California San Diego, School of Medicine, and Veterans Administration Medical Center, La Jolla, California 92093, USA
| | - Arwa Kurabi
- Department of Surgery/Otolaryngology, University of California San Diego, School of Medicine, and Veterans Administration Medical Center, La Jolla, California 92093, USA
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Salt AN, Hirose K. Communication pathways to and from the inner ear and their contributions to drug delivery. Hear Res 2018; 362:25-37. [PMID: 29277248 PMCID: PMC5911243 DOI: 10.1016/j.heares.2017.12.010] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 01/04/2023]
Abstract
The environment of the inner ear is highly regulated in a manner that some solutes are permitted to enter while others are excluded or transported out. Drug therapies targeting the sensory and supporting cells of the auditory and vestibular systems require the agent to gain entry to the fluid spaces of the inner ear, perilymph or endolymph, which surround the sensory organs. Access to the inner ear fluids from the vasculature is limited by the blood-labyrinth barriers, which include the blood-perilymph and blood-strial barriers. Intratympanic applications provide an alternative approach in which drugs are applied locally. Drug from the applied solution enters perilymph through the round window membrane, through the stapes, and under some circumstances, through thin bone in the otic capsule. The amount of drug applied to the middle ear is always substantially more than the amount entering perilymph. As a result, significant amounts of the applied drug can pass to the digestive system, to the vasculature, and to the brain. Drugs in perilymph pass to the vasculature and to cerebrospinal fluid via the cochlear aqueduct. Conversely, drugs applied to cerebrospinal fluid, including those given intrathecally, can enter perilymph through the cochlear aqueduct. Other possible routes in or out of the ear include passage by neuronal pathways, passage via endolymph and the endolymphatic sac, and possibly via lymphatic pathways. A better understanding of the pathways for drug movements in and out of the ear will enable better intervention strategies.
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Affiliation(s)
- Alec N Salt
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, USA.
| | - Keiko Hirose
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, USA
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Lohrberg M, Wilting J. The lymphatic vascular system of the mouse head. Cell Tissue Res 2016; 366:667-677. [PMID: 27599481 PMCID: PMC5121175 DOI: 10.1007/s00441-016-2493-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/15/2016] [Indexed: 12/25/2022]
Abstract
Histological studies of the lymphatic vascular system in adult mice are hampered because bones cannot be sectioned properly. Here, we decalcified the heads of 14-day-old mice, embedded them in paraffin and stained resultant serial sections with the lymphendothelial-specific antibodies Lyve-1 and Podoplanin. We show that the tissues with the highest lymphatic vascular density are the dermis and the oral mucous membranes. In contrast, the nasal mucous membrane is devoid of lymphatics, except for its most basal parts below the vomeronasal organ. The inferior nasal turbinate contains numerous lymphatics and is connected to the nasolacrimal duct (NLD), which is ensheathed by a dense network of lymphatics. The lymphatics of the eye lids and conjunctiva are connected to those of the inferior nasal turbinate. We suggest that cerebro-spinal fluid (CSF) can drain via the optic nerve and NLD lymphatics, whereas CSF drained via the Fila olfactoria into the nasal mucous membrane is used for moisturization of the respiratory air. Tongue, palatine and buccal mucous membranes possess numerous lymphatics, whereas the dental pulp has none. Lymphatics are present in the maxillary gland and close to the temporomandibular joint, suggesting the augmentation of lymph flow by chewing and yawning. Lymphatics can also be found in the dura mater and in the dural septae entering into deeper parts of the brain. Our findings are discussed with regard to CSF drainage and potential routes for ocular tumor dissemination.
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Affiliation(s)
- Melanie Lohrberg
- Department of Anatomy and Cell Biology, University Medical School Göttingen, Göttingen, Germany.
| | - Jörg Wilting
- Department of Anatomy and Cell Biology, University Medical School Göttingen, Göttingen, Germany
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Perilymph Kinetics of FITC-Dextran Reveals Homeostasis Dominated by the Cochlear Aqueduct and Cerebrospinal Fluid. J Assoc Res Otolaryngol 2015; 16:357-71. [PMID: 25801074 DOI: 10.1007/s10162-015-0512-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/13/2015] [Indexed: 02/07/2023] Open
Abstract
Understanding how drugs are distributed in perilymph following local applications is important as local drug therapies are increasingly used to treat disorders of the inner ear. The potential contribution of cerebrospinal fluid (CSF) entry to perilymph homeostasis has been controversial for over half a century, largely due to artifactual contamination of collected perilymph samples with CSF. Measures of perilymph flow and of drug distribution following round window niche applications have both suggested a slow, apically directed flow occurs along scala tympani (ST) in the normal, sealed cochlea. In the present study, we have used fluorescein isothiocyanate-dextran as a marker to study perilymph kinetics in guinea pigs. Dextran is lost from perilymph more slowly than other substances so far quantified. Dextran solutions were injected from pipettes sealed into the lateral semicircular canal (SCC), the cochlear apex, or the basal turn of ST. After varying delays, sequential perilymph samples were taken from the cochlear apex or lateral SCC, allowing dextran distribution along the perilymphatic spaces to be quantified. Variability was low and findings were consistent with the injection procedure driving volume flow towards the cochlear aqueduct, and with volume flow during perilymph sampling driven by CSF entry at the aqueduct. The decline of dextran with time in the period between injection and sampling was consistent with both a slow volume influx of CSF (~30 nL/min) entering the basal turn of ST at the cochlear aqueduct and a CSF-perilymph exchange driven by pressure-driven fluid oscillation across the cochlear aqueduct. Sample data also allowed contributions of other processes, such as communications with adjacent compartments, to be quantified. The study demonstrates that drug kinetics in the basal turn of ST is complex and is influenced by a considerable number of interacting processes.
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Møller MN, Kirkeby S, Vikeså J, Nielsen FC, Cayé-Thomasen P. Gene expression demonstrates an immunological capacity of the human endolymphatic sac. Laryngoscope 2015; 125:E269-75. [DOI: 10.1002/lary.25242] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Martin Nue Møller
- Department of Otorhinolaryngology; Head and Neck Surgery, Rigshospitalet (m.n.m., p.c-t.)
| | - Svend Kirkeby
- Department of Oral Medicine; Dental School; Panum Institute (s.k.); University of Copenhagen
| | - Jonas Vikeså
- Center for Genomic Medicine (j,v., f.c.n.); University of Copenhagen, Rigshospitalet
| | - Finn Cilius Nielsen
- Center for Genomic Medicine (j,v., f.c.n.); University of Copenhagen, Rigshospitalet
| | - Per Cayé-Thomasen
- Department of Otorhinolaryngology; Head and Neck Surgery, Rigshospitalet (m.n.m., p.c-t.)
- The Faculty of Health and Medical Sciences (p.c-t.); University of Copenhagen; Copenhagen Denmark
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Møller MN, Brandt C, Østergaard C, Caye-Thomasen P. Endolymphatic sac involvement in bacterial meningitis. Eur Arch Otorhinolaryngol 2014; 272:843-851. [DOI: 10.1007/s00405-014-2884-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022]
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Tan WJT, Thorne PR, Vlajkovic SM. Noise-induced cochlear inflammation. World J Otorhinolaryngol 2013; 3:89-99. [DOI: 10.5319/wjo.v3.i3.89] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/08/2013] [Accepted: 08/20/2013] [Indexed: 02/06/2023] Open
Abstract
Hearing loss is the most common sensory disability with considerable social and economic implications. According to recent World Health Organization estimates, 360 million people worldwide suffer from moderate to profound hearing loss. Exposure to excessive noise is one of the major causes of sensorineural hearing loss, secondary only to age-related hearing loss (presbyacusis). Since cochlear tissues have limited abilities of repair and regeneration, this damage can be irreversible, leading to cochlear dysfunction and permanent hearing loss. Recent studies have shown that cochlear inflammation can be induced by noise exposure and contribute to the overall pathogenesis of cochlear injury and hearing loss. The cochlea is separated from the systemic circulation by the blood-labyrinth barrier, which is physiologically similar to the blood-brain barrier of the central nervous system. Because of this feature, the cochlea was originally considered an immunologically privileged organ. However, this postulate has been challenged by the evidence of an inflammatory response in the cochlea in the presence of bacterial or viral pathogens or antigens that can cause labyrinthitis. Although the main purpose of the inflammatory reaction is to protect against invading pathogens, the inflammatory response can also cause significant bystander injury to the delicate structures of the cochlea. The cochlear inflammatory response is characterised by the generation of proinflammatory mediators (cytokines, chemokines and adhesion molecules), and the recruitment of inflammatory cells (leukocytes). Here, we present an overview of the current research on cochlear inflammation, with particular emphasis on noise-induced cochlear inflammation. We also discuss treatment strategies aimed at the suppression of inflammation, which may potentially lead to mitigation of hearing loss.
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Miyao M, Firestein GS, Keithley EM. Acoustic trauma augments the cochlear immune response to antigen. Laryngoscope 2008; 118:1801-8. [PMID: 18806477 DOI: 10.1097/mlg.0b013e31817e2c27] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES/HYPOTHESIS To test whether noise-exposure, which activates a cochlear immune response with cytokine expression and infiltration of circulating leukocytes could augment the response to antigen (Ag). STUDY DESIGN Randomized, prospective, mice. METHODS We sensitized mice to an Ag, injected it intrathecally, and subsequently exposed the mice to noise (8-16 kHz, 90, 100, or 118 dB for 2 hours). Control mice received either noise exposure alone (100 or 118 dB), Ag challenge alone, intrathecal surgery and phosphate-buffered saline injection or no treatment. Four hours or 7 days later the mice were killed and cochlear sections were evaluated immunohistochemically for CD45, ICAM-1, and phospho-nuclear transcription factor-kappaB expression. RESULTS Intrathecal Ag injection caused no hearing loss, but did result in a small immune response. Loud noise (118 dB) caused severe hearing loss and slight inflammation. The number of CD45-positive cells was significantly greater in the Ag plus-118 dB noise group relative to the Ag-alone group or 118 dB noise-exposure group. ICAM expression was seen in the lower part of the spiral ligament and small vessels within the normal cochlea. The amount of expression increased after Ag injection and acoustic trauma. Activated nuclear transcription factor-kappaB occurred in the nuclei of hair cells, supporting cells, spiral ligament fibrocytes, and neurons 4 hours after noise exposure. CONCLUSIONS It seems that noise exposure can activate a cochlear immune response, which in the presence of Ag, allows for greater recruitment of inflammatory cells than occurred in response to Ag alone.
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Affiliation(s)
- Masumichi Miyao
- Division of Otolaryngology-Head and Neck Surgery, University of California, La Jolla, California 92093-0666, USA
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Tornabene SV, Sato K, Pham L, Billings P, Keithley EM. Immune cell recruitment following acoustic trauma. Hear Res 2006; 222:115-24. [PMID: 17081714 DOI: 10.1016/j.heares.2006.09.004] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Revised: 08/31/2006] [Accepted: 09/24/2006] [Indexed: 01/11/2023]
Abstract
Acoustic trauma induces cochlear inflammation. We hypothesized that chemokines are involved in the recruitment of leukocytes as part of a wound healing response. The cochleas of NIH-Swiss mice, exposed to octave-band noise (8-16 kHz, at 118 dB) for 2h, were examined after the termination of exposure. Leukocytes were identified immunohistochemically with antibodies to CD45 and F4/80. Gene array analysis followed by RT-PCR was performed on cochlear tissue to identify up-regulation of chemokine and adhesion molecule mRNA. The expression of the adhesion molecule ICAM-1 was also investigated immunohistochemically. Few CD45- or F4/80-positive leukocytes were observed in the non-exposed cochlea. Following acoustic trauma however, the number of CD45-positive cells was dramatically increased especially after 2 and 4 days, after which time the numbers decreased. F4/80-positive cells also increased in number over the course of a week. Gene array analysis indicated increased expression of monocyte chemoattractant protein 5 (MCP-5), monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein-1beta (MIP-1beta) and ICAM-1. RT-PCR, performed using primers for the individual mRNA sequences, confirmed the increased expression of MCP-1, MCP-5, MIP-1beta, and ICAM-1 relative to non-exposed mice. In the normal cochlea, ICAM-1 immunohistochemical expression was observed in venules, spiral ligament fibrocytes and in endosteal cells of the scala tympani. Expression increased to include more of the spiral ligament and endosteal cells after acoustic trauma. A cochlear inflammatory response is initiated in response to acoustic trauma and involves the recruitment of circulating leukocytes to the inner ear.
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Affiliation(s)
- Stephen V Tornabene
- Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0666, USA
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Satoh H, Firestein GS, Billings PB, Harris JP, Keithley EM. Proinflammatory cytokine expression in the endolymphatic sac during inner ear inflammation. J Assoc Res Otolaryngol 2003; 4:139-47. [PMID: 12943369 PMCID: PMC3202716 DOI: 10.1007/s10162-002-3025-7] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The inner ear is capable of rapidly mounting an immune response that can ultimately lead to cochlear degeneration and permanent hearing loss. The role of the endolymphatic sac in this immune process is not clear. In order to investigate the cytokine expression of cells within the endolymphatic sac, a secondary inner ear immune response to keyhole limpet hemocyanin (KLH) was created in mice. The animals were sacrificed 3-48 h and 7 days following initiation of the immune response. The cochleas and endolymphatic sacs were assayed by immunocytochemistry for IL-1beta, TNFalpha, and IL-6. Three hours after KLH challenge of the scala tympani, the perisaccular tissue of the endolymphatic sac contained more inflammatory cells than the scala tympani or endolymphatic sac lumen. Only a few of these cells, however, expressed the proinflammatory cytokines IL-1beta and TNFalpha between 3 and 12 h after KLH injection. On the other hand, TNFalpha, which plays an important role in the cochlear secondary immune response, was expressed in cells in the endolymphatic sac lumen. The maximum percentage of cells expressing TNFalpha was seen later than in the scala tympani. Animals treated with systemic injection of the TNF blocker, etanercept, showed a reduction in the number of cells in the endolymphatic sac lumen. It is concluded that the cells in the endolymphatic sac lumen contribute to the amplification of the adaptive immune response by expressing TNFalpha, while the infiltration of cells into the perisaccular connective tissue is part of the nonspecific, innate, cochlear immune response.
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Affiliation(s)
- Hitoshi Satoh
- Division of Otolaryngology–Head and Neck Surgery, University of California, San Diego, CA 92093, USA
| | - Gary S. Firestein
- Division of Rheumatology, Allergy and Immunology, University of California, San Diego, CA 92093, USA
| | - Peter B. Billings
- Division of Otolaryngology–Head and Neck Surgery, University of California, San Diego, CA 92093, USA
| | - Jeffrey P. Harris
- Division of Otolaryngology–Head and Neck Surgery, University of California, San Diego, CA 92093, USA
- Research Service, Department of Veterans Affairs, San Diego, CA, 92161, USA
| | - Elizabeth M. Keithley
- Division of Otolaryngology–Head and Neck Surgery, University of California, San Diego, CA 92093, USA
- Research Service, Department of Veterans Affairs, San Diego, CA, 92161, USA
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Satoh H, Firestein GS, Billings PB, Harris JP, Keithley EM. Tumor necrosis factor-alpha, an initiator, and etanercept, an inhibitor of cochlear inflammation. Laryngoscope 2002; 112:1627-34. [PMID: 12352677 DOI: 10.1097/00005537-200209000-00019] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES/HYPOTHESIS The inner ear rapidly mounts an immune response that can lead to cochlear degeneration and permanent hearing loss. Identification of proinflammatory cytokine expression during the initiation of the response should lead to rational therapeutic strategies that block the response, reducing damaging sequelae. STUDY DESIGN A cochlear immune response to keyhole limpet hemocyanin (KLH) injected into the inner ear or subarachnoid space of sensitized animals was created. Etanercept was administered to a group of animals to blunt the immune response. METHODS Cochleae were immunoassayed for expression of interleukin-1beta, tumor necrosis factor-alpha, and interleukin-6 and evaluated for the amount of cochlear-infiltrated cells. RESULTS Tumor necrosis factor-alpha and interleukin-1beta were expressed by infiltrated cells shortly after KLH injection. Tumor necrosis factor-alpha was expressed whether the antigen was introduced with or without surgical trauma. Interleukin-1beta was also expressed by the cochlear fibrocytes during the immune response and in surgical control animals, but not after intrathecal injection of antigen. Interleukin-6 expression was minimal during the response. Based on this observation, animals were treated with systemic injection of Etanercept, which reduced cochlear infiltrating cell number and cochlear fibrosis. CONCLUSION Interleukin-1beta expression is a general cochlear response to trauma, whereas tumor necrosis factor-alpha expression in the infiltrated immunocompetent cells is the cytokine that induces amplification of the response that leads to cochlear disease.
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Affiliation(s)
- Hitoshi Satoh
- Division of Otolaryngology--Head and Neck Surgery, University of California, San Diego, La Jolla 92093-0666, USA
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