Platelet glycoproteins and fibrinogen in recovery from idiopathic sudden hearing loss.

Abstract

BACKGROUND:

The pathomechanism and location of idiopathic sudden sensorineural hearing loss (ISSHL) is unclear. In a previous case-control study, we found elevated fibrinogen concentrations and a higher prevalence of T allele carriers of the glycoprotein (Gp) Ia C807T polymorphism in ISSHL patients.

METHODOLOGY:

127 patients with ISSHL (mean age 53.3 years, 48.8% females), who underwent a standard therapy with high dose steroids, pentoxifyllin and sterofundine over 8 days were included. We examined the influence of GpIa genotype and fibrinogen (BclI-, A312-, HaeIII-) genotype and fibrinogen plasma levels on hearing recovery after 8 weeks (change from baseline: 0 dB  =  no recovery, >0 to 10 dB = moderate recovery, >10 dB = good recovery). In a subsample of 59 patients with ISSHL, we further studied the association of platelet glycoprotein GpIa, Ib and IIIa densities on hearing recovery as well as the possible effect-modification of platelet glycoproteins on hearing recovery by plasma fibrinogen.

RESULTS:

In univariate analysis, neither the GpIa genotype nor fibrinogen genotype (all p>0.1) but lower fibrinogen levels (p = 0.029), less vertigo (p = 0.002) and lower GpIIIa receptor density (p = 0.037, n = 59) were associated with hearing recovery. In multivariate analysis, fibrinogen significantly modified the effect of GPIa receptor density on good hearing recovery (effect-modification on multiplicative scale OR = 0.45 (95% confidence interval (0.21-0.94)), p = 0.03). GPIb receptor density below the mean was associated with a 2-fold increase in good hearing recovery both in patients with fibrinogen levels above (p = 0.04) as well as in patients with fibrinogen levels below the mean (p = 0.06). There was no indication for an effect-modification (p = 0.97).

CONCLUSIONS:

The findings suggest a vascular/rheological origin of ISSHL with unique features of thrombosis in the inner ear artery that may include complex interrelationships among platelet glycoproteins and plasma fibrinogen.

• Authors: Daniel Weiss, Bruno Neuner, Kerstin Gorzelniak, Alexis Bremer, Claudia Rudack, Michael Walter
• Journal: PloS one (PLoS One) Vol. 9 Issue 1 Pg. e86898 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24466284 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Biomarkers
• Integrin alpha2
• Fibrinogen

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Biomarkers (blood)
• Case-Control Studies
• Female
• Fibrinogen (genetics, metabolism)
• Flow Cytometry
• Genotype
• Hearing Loss, Sudden (blood, drug therapy, genetics)
• Humans
• Integrin alpha2 (genetics, metabolism)
• Male
• Middle Aged
• Polymerase Chain Reaction
• Polymorphism, Genetic (genetics)