الفهرس 
ANATOMY OF THE EAROnly 14 pages are availabe for public view
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Abstract
Autoimmune inner ear disease or ”AIED” consists of a syndrome of progressive hearing loss and/or dizziness which is caused by antibodies or immune cells attacking the inner ear.
HSP70, which is present in the inner ear, is believed to protect cells by dissolving and refolding misfolded or denatured protein. It is induced by various forms of stress including heat, ischemia, toxic agents and free radicals. Antibodies against HSP70 were detected in serum from group of patients with actively progressing idiopathic sensorineural hearing loss.
This work aimed to detect the prevalence of anti-HSP70 and other immunological parameters in patients with AIED, and their role in diagnosis.
The material of this study composed of 25 patients with SNHL. Ten healthy subjects with matching age and sex were included as control group.
General immunological tests (ESR, CRP, RF and ANA) were estimated in sera of patients and controls. ESR was elevated in 64% of patients (16 out of 25), while only 10% (1 case out of 10) had elevated ESR in control group. CRP, RF and ANA were positive in 36% (9 out of 25), 8% (2 out of 25) and 4% (1 out of 25) of patients, respectively, but none of controls was positive as regards these tests. A comparative analysis was performed between patient and control groups and showed highly significant difference for ESR and CRP. Thus, ESR and CRP could be of value in suspecting immunological aspect of hearing loss i.e. good screening tests.
WB technique was used to determine the reactivity of sera from patients and controls against HSP70. It was found that 76% of patients were positive for anti-HSP70 and none of controls was positive. An extremely significant difference was shown between the two groups.
Diagnostic reliability was tested in this study for anti-HSP70 and there was excellent performance; 76% sensitivity, 100% specificity, 100% positive predictive rate, 62.5% negative predictive rate and 82.9% efficiency.
from the above mentioned results we may conclude that AIED should be taken in consideration in the differential diagnosis of sensorineural hearing loss as it may occur with any age, sex and with any degree of hearing loss.
A diagnostic test panel for AIED should include ESR and CRP as routine screening tests.
Antibodies against HSP70 can be used to prove humoral immune response against inner ear components in patients with sensorineural hearing loss and can be reliably used as a specific diagnostic test for AIED when detected early in the disease and before treatment.