The role of anti-endothelian cell autoantibodies (AECAs) in sensorineural sudden hearing loss

Immunologic causes of sudden hearing loss (SHL) are not yet well defined although serological autoantibodies against organ specific and not organ-specific antigens of the inner ear are reported. AECAs represent a heterogeneous group of antibodies directed against a variety of antigen determinants on endothelial cells that are detected in various inflammatory disorders. They may interfere with several endothelial cells functions and therefore may be of pathophysiological relevance. The Authors investigated the presence of AECAs in patients affected by SHL to verify if immune-mediated vasculitis may play a role in human SHL. Forty-five consecutive patients (mean age 35 ys) affected by SHL and 20 normal subjects were included. AECA were positive in 21/45 (47%) thus significantly differing from normal population on which only 2 of 20 tested cases were positive (p=0.03). Human sera of AECA positive patients were incubated against guinea pig cochlear sections and a positive immunoreactivity to inner ear antigens was obtained by indirect immunofluorescence assay. In conclusion, this study suggests that AECAs could be considered as markers of immune-mediated SHL.