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. 2024 Jul 2:15:1382096.
doi: 10.3389/fneur.2024.1382096. eCollection 2024.

The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss

Jônatas Bussador do Amaral  1 , Kelly Abdo Peron  1 , Tracy Lima Tavares Soeiro  1 , Marina Cançado Passarelli Scott  1 , Flávia Tatiana Pedrolo Hortense  1 , Michelly Damasceno da Silva  2 , Carolina Nunes França  2 , Luiz Henrique da Silva Nali  2 , André Luis Lacerda Bachi  2 , Norma de Oliveira Penido  1
Affiliations

The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss

Jônatas Bussador do Amaral et al. Front Neurol. .

Abstract

Introduction: Sudden sensorineural hearing loss (SSNHL) is a common emergency symptom in otolaryngology that requires immediate diagnosis and treatment. SSNHL has a multifactorial etiology, and its pathophysiologic mechanisms may be associated with inflammatory and metabolic changes that may affect the cochlear microenvironment or its nervous component, thus triggering the process or hindering hearing recovery. Therefore, the aim of this study was to assess metabolic and inflammatory changes to identify systemic parameters that could serve as prognostic factors for hearing recovery in patients with SSNHL.

Materials and methods: Thirty patients with a sudden hearing loss of at least 30 dB in three contiguous frequencies were enrolled in this study. Patients were followed up for 4 months and peripheral blood samples were collected at 7 days (V1), 30 days (V2) and 120 days (V3). Interleukins (IL)-1F7, IL-2, IL-4, IL-5, IL-6, IL-10, interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and adiponectin were quantified in serum. In addition, lipid and glycemic profiles as well as concentration of creatinine, uric acid, fructosamine, peroxide, total proteins and albumin were analyzed. Patients underwent weekly ear-specific hearing tests with standard pure tone thresholds for frequencies of 250-8,000 Hz, speech recognition threshold and word recognition score.

Results: Patients with SSNHL were divided into a group of patients who did not achieve hearing recovery (n = 14) and another group who achieved complete and significant recovery (n = 16). Most serologic parameters showed no significant changes or values indicating clinical changes. However, IFN-γ levels decreased by 36.3% between V1 and V2. The cytokine TNF-α showed a statistically significant decrease from V1 to V3 (from 22.91 to 10.34 pg./mL). Adiponectin showed a decrease from 553.7 ng/mL in V1 to 454.4 ng/mL in V3.

Discussion: Our results show that serologic cytokine levels change in the acute phase of manifestation of SSNHL and establish a parallel between systemic changes and improvements in hearing, especially TNF-α, which showed differences in hearing recovery. The use of IFN-γ, TNF-α and adiponectin may elucidate the clinical improvement in these patients.

Keywords: IFNγ; TNF-α; adiponectin; cytokines; inflammation; metabolism; sudden sensorineural hearing loss.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Audiometric evaluations of 30 patients followed up for 120 days. (A) Four-frequency pure tone average (4fPTA) in decibels (dB). (B) Word recognition score (WRS) in percentages (%). For statistical analysis, Wilcoxon test was used and p-values <0.05 were considered significant.
Figure 2
Figure 2
Metabolic assessments of 30 patients followed up for 120 days. Protein profile: albumin (A) and total proteins (B). Glycemic profile: glucose (C) and fructosamine (D). Uric acid (E), peroxide (F), creatinine (G), and adiponectin (H) Wilcoxon test was used for statistical analysis in (C), (E–G), Anova one way (A,B,H), and paired t test in (D). Values of p < 0.05 were considered significant.
Figure 3
Figure 3
Lipid profile of 30 patients followed up for 120 days. Total cholesterol (A), triglycerides (B), LDL (C), and HDL (D). For statistical analysis, Wilcoxon test was used in (A,B), and paired t-test was used in (C,D). Values of p < 0.05 were considered significant.
Figure 4
Figure 4
Inflammatory cytokines of 30 patients followed up for 120 days. Interleukin 1F7 (A), interleukin 2 (B), interleukin 4 (C), interleukin 5 (D), interleukin 6 (E), interleukin 10 (F), interferon γ (G), and TNF-α (H). The Wilcoxon test was used for statistical analysis, and p values <0.05 were considered significant.
Figure 5
Figure 5
Heat map of metabolic and inflammatory parameters in patients with sudden sensorineural hearing loss. The values for each patient are shown in the small squares, with the color intensity representing the highest values in blue, the average values in white and the lowest values in red for each analyte tested after 7 days (V1), 30 days (V2) and 120 days (V3). The graph is divided according to hearing recovery, with 14 patients having partial and no recovery and 16 having complete and significant hearing recovery. V1 = 7 days, V2 = 30 days and V3 = 120 days. 4fPTA, four-frequency pure tone average; WRS, word recognition score; Perox, peroxide; Frut, frutosamine; Gluc, glucose; Colest, cholesterol; Trigly, triglycerides; U. acid, uric acid; Creat, creatinine; Alb, albumin; Adipo, adiponectin.
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Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp process number 2021/07346-6). Norma de Oliveira Penido received funding from National Council for Scientific and Technological Development (CNPq process number 302910/2020-4).

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