Possible role of peptides derived from otosclerotic bone in the mechanism of sensorineural hearing loss

Histologic otosclerosis is associated with the presence of measles virus in the stapes footplate

HYPOTHESIS

Persistent measles virus infection of the otic capsule is presumed to be one of the etiologic factors in otosclerosis. The viral pathogenesis of otosclerosis could be established only by correlative analysis: histologic examination of the stapes footplates and reverse-transcriptase polymerase chain reaction amplification of the viral RNA. At present, histologic analysis of the removed stapes footplates is the only appropriate method of distinguishing otosclerotic and nonotosclerotic stapes fixations.

BACKGROUND

The presence of measles virus was shown in otosclerotic patients by reverse-transcriptase polymerase chain reaction amplification of the viral RNA and detecting the viral proteins by immunohistochemistry.

METHODS

Nucleic acids (mRNA, vRNA, and DNA) were extracted from ankylotic stapes footplates of stapes fixation patients (n = 44). Measles virus genomic nucleoprotein RNA was amplified by seminested reverse-transcriptase polymerase chain reaction. Amplification results were correlated to postoperative histologic findings.

RESULTS

Measles virus RNA was detectable only in histologically otosclerotic stapes footplates (n = 32). Histology for virus-negative footplates (n = 12) excluded otosclerosis. Virus-negative stapes footplates showed annular calcification (n = 8), bone resorption with increased numbers of hemosiderophages (n = 2), and mononuclear cell infiltration with osteolysis (n = 2).

CONCLUSION

Stapes ankylosis is a heterogenous disease causing conductive hearing loss with different causes. Nonotosclerotic stapes fixations may belong to degenerative disorders with variable histopathology. Otosclerosis is an inflammatory disease resulting from persisting measles virus infection of the otic capsule.

Measles Virus Prevalence in Otosclerotic Stapes Footplate Samples

HYPOTHESIS

The cause of otosclerosis is still unknown. Persistent measles virus infection of the otic capsule is supposed to be one of the etiologic factors in otosclerosis. Chronic viral antigen expression on the surface of infected cells can induce a secondary autoimmune reaction against the otic capsule.

BACKGROUND

In the past 15 years, some reports proposed the possible etiologic role of measles virus in otosclerosis. The presence of measles virus was shown in otosclerotic patients by reverse-transcriptase polymerase chain reaction amplification of the viral RNA, detecting the viral proteins by immunohistochemistry and detecting antimeasles immunoglobulin G in the perilymph samples. Many concerns were elicited by these results.

METHODS

Nucleic acid was extracted from pulverized, frozen stapes footplate samples of otosclerotic patients. Measles virus RNA was amplified by reverse-transcriptase polymerase chain reaction: reverse transcription and the first round polymerase chain reaction amplification was performed by heat stable recombinant Thermus thermophilus polymerase, whereas in the nested round, polymerase chain reaction Taq-polymerase was used. Measles virus nucleoprotein RNA-specific oligonucleotide primers were used in these reactions. An Edmonston-type measles virus served as a positive control and cortical bone fragments or stapes superstructures served as negative controls.

RESULTS

Among 34 otosclerotic patients, 20 stapes footplate samples contained measles virus RNA. Measles virus RNA was not detected in other bone specimens of the patients.

CONCLUSION

The etiologic role of measles virus in the pathogenesis of otosclerosis should be considered. The 14 negative samples may be genetically determined otosclerotic cases.

Increased Activity of the Diastrophic Dysplasia Sulfate Transporter in Otosclerosis and Its Inhibition by Sodium Fluoride

HYPOTHESIS

This study investigates the function of the diastrophic dysplasia sulfate transporter (DTDST) in otosclerotic bone and the effect on it of sodium fluoride (NaF).

BACKGROUND

Otosclerosis is a localized bone dystrophy with increased bone turnover. DTDST is implicated in the regulation of the bone turnover.

MATERIALS AND METHODS

Primary cultures of cells were obtained from the stapes and external auditory canal (EAC) of 26 patients with otosclerosis and from nine control patients. Sulfate uptake was quantified under basal conditions and with NaF. The NaF signaling pathways were investigated using forskolin and verapamil.

RESULTS

The relative initial rates of sulfate uptake and the apparent Vmax values were: otosclerotic stapes > EAC > control stapes = control EAC. The sulfate uptake by the otosclerotic stapes was correlated with the loss of sensorineural hearing. The amounts of DTDST mRNA (RNase protection assay) in the four subgroups did not differ. NaF (10(-6)M, 1 hr) inhibited sulfate uptake by the otosclerotic stapes and EAC cells but not by control samples.

CONCLUSION

The authors believe that whether the increased DTDST activity is a cause or an effect of otosclerosis, it appears to be a specific target for NaF treatment.

Human otosclerotic bone-derived peptide decreases the gain of the electromotility in isolated outer hair cells

An otosclerotic peptide (OP) (Sziklai et al., 1985a.b) was purified from perilymph and stapes footplate of otosclerotic patients by Sephadex G-25 gel column chromatography and subsequent isotachophoretic (ITP) separation. The transfer function of the electromotility was measured by inserting the isolated outer hair cells (OHC) into a partitioning microchamber (Evans et al., 1991) and applying a series of pairs of brief square-pulse stimuli with opposite polarity and with increasing magnitude. Somatic length changes of the inserted part of the OHCs were measured by an optoelectronic system. The isotachophoretically homogeneous peptide exerted a gain and magnitude decreasing effect on the transfer function of electromotility of isolated OHCs of the guinea pig, in vitro. The operating point of the electromotility did not change due to the effect of the peptide. The peptide decreased the electromotile performance within a minute and bath exchange to normal saline did not completely restore the transfer curve to baseline. Application of caffeine to the cells already under the effect of the otosclerotic peptide produced an opposite effect: gain and magnitude increase. Simultaneous application of acetylcholine (ACh) did not antagonize the effect of OP. The underlying mechanism of the action of OP on the transfer function of electromotility of OHCs is postulated to involve the modulation of intracellular Ca2- concentration.

Inhibition of myosin light-chain kinase activity in the organ of Corti by 0.3-5 kilodalton substances of the otosclerotic perilymph

The guinea pig organ of Corti contains myosin light-chain kinase (MLCK) activity. The upper and lower most parts of the cochlea do not show significantly different activities of the enzyme, which is Ca2+ and calmodulin-dependent. Short-term noise exposure does not cause a significant change. 0.3-5 Kilodalton substances of the otosclerotic perilymph, separated by SG-25 column chromatography, inhibit the MLCK activity in in vitro organ of Corti preparations. This inhibitory action of the perilymph substances can also be observed with the purified MLCK of turkey gizzard. The activity of the enzyme can be specifically inhibited by cyclic AMP-dependent protein kinase.