主要和次要的自身免疫性疾病和听力损失
Nathan Creber1,2, Manohar Bance1,3
1Cambridge University Hospitals, NHS Trust, Cambridge, UK.
Current opinion in otolaryngology & head and neck surgery
|August 21, 2025
概括
自免疫内耳疾病 (AIED) 的诊断是具有挑战性的,但一种新的分类,即免疫媒介内耳疾病 (IMIED),可以扩大理解. 类固醇仍然是关键, 其他疗法对治疗这种罕见的听力损失有希望.
科学领域:
- 耳鼻喉科
- 免疫学
- 听力学
背景情况:
- 自免疫内耳疾病 (AIED) 呈现为波动性,渐进性,双侧神经传感性听力损失.
- 由于缺乏确定的标准,对AIED的诊断很困难,这阻碍了对其原因的理解.
- AIED的治疗包括免疫调节药物.
研究的目的:
- 审查AIED的诊断和管理.
- 引入免疫媒介内耳疾病 (IMIED) 的新分类系统.
- 评估AIED的诊断生物标志物和治疗策略.
主要方法:
- 对AIED诊断和治疗的文献综述.
- 对拟议的IMIED分类系统进行分析.
- 对诊断生物标志物的疗效和临床效用进行评估.
- 对类固醇治疗的重新评估以及对类固醇节约剂和生物药物的讨论.
主要成果:
- 免疫媒介内耳疾病 (IMIED) 的新分类扩大了对免疫调节反应的疾病范围.
- 不同的诊断生物标志物显示出不同的临床疗效.
- 类固醇治疗仍然是AIED的第一线治疗方法.
- 在长期治疗中, 节制类固醇疗法是有效的,
结论:
- 应将AIED视为IMIED的更广泛范围,允许治疗转化.
- 诊断生物标志物需要谨慎解释;类固醇反应对诊断至关重要.
- 类固醇节约剂对于长期的AIED治疗是有效的,现代生物药物需要进一步研究.
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