感音神经性聋相关内耳免疫及炎症机制的研究进展  

Mechanisms of Inner Ear Immune and Inflammation Related to Sensorineural Hearing Loss

作　　者：塞娜[1] 韩维举[1] SAI Na;HAN Weijiu(Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing,100853,China)

机构地区：[1]解放军总医院耳鼻咽喉头颈外科,北京100853

出　　处：《中华耳科学杂志》2018年第2期221-226,共6页Chinese Journal of Otology

基　　金：国家自然科学基金面上项目(No:81770992;81470683)~~

摘　　要：感音神经性聋(sensorineural hearing loss,SNHL)是由于内耳与听觉皮层之间的听觉通路一个或多个部分的功能障碍而导致的常见临床疾病。其发病机制包括局部缺氧缺血、病毒感染以及微创伤等,但具体的病理机制仍不清楚。免疫和炎症介导的内耳疾病被认为是导致SNHL的机制之一,并且抗炎和免疫治疗对部分SNHL的听力恢复有效。此外,糖皮质激素治疗SNHL在临床上广泛应用,其可能机制包括抗炎作用,但具体机制尚不清楚。本文综述内耳免疫/炎症反应在SNHL,主要是噪声性耳聋、突发性耳聋、感染性聋、老年性聋和自身免疫性内耳病的病理生理学中的作用,以及免疫/炎症介导的SNHL的治疗。将免疫/炎症因子和免疫细胞(特别是巨噬细胞)作为治疗靶点,综述调节内耳免疫系统以修复组织并改善SNHL患者听力可能的干预措施。Sensorineural hearing loss(SNHL)is a common clinical condition resulting from dysfunction in the inner ear.Although several mechanisms have been postulated including ischemia,viral infection/reactivation and microtrauma,little is known about its etiopathology.Immune-mediated inner ear diseases have been described and accepted as part of SNHL pathophysiology,which responds to immunosuppressive therapy.Glucocorticoids are widely used in clinical practice,the possible mechanisms of which include anti-inflammatory effects,although the precise mechanism has not been determined.The roles of inner ear immune/inflammatory responses in the pathophysiology of SNHL,and immune and inflammation-targeted treatment of SNHL are discussed in this article.In addition,possible interventions modulating immune/inflammatory factors and immune cells(especially macrophages),as therapeutic targets,to repair the tissue and improve hearing in patients with SNHLwill be discussed.

关 键 词：感音神经性聋 免疫反应 炎症反应 巨噬细胞 糖皮质激 

分 类 号：R764[医药卫生—耳鼻咽喉科]