Talk:Autoimmune inner ear disease

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Immcarle27.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 15:03, 16 January 2022 (UTC)

note

Immcarle27 (talk) 20:02, 6 February 2016 (UTC)

I'm not sure about all the references to drug use causing AIED. The primary locus for this connection is Rush Limbaugh; the official explanation for his deafness is AIED, the rumor is drug use, primarily OxyContin. Now, there are ototoxic drugs, to be sure; nobody questions that OxyContin in sufficient quantity can cause deafness. But does it cause AIED? It's auto-immune, which means the body is attacking itself. If the death of the ear structures is due to ototoxic drugs, that isn't the body attacking itself really. So is there a place for mentioning drug use in connection with AIED, or does it belong in its own section about ototoxic drugs? -Etoile (talk) 07:31, 7 December 2009 (UTC)

I'm planning on adding a few summary paragraphs to the article that I'll expand upon the article body. Here's what I have for the summary paragraphs so far:

Autoimmune inner ear disease (AIED) results in progressive sensorineural hearing loss (SNHL) that acts bilaterally and asymmetrically, and sometimes affects an individual's vestibular system. Research has come to the consensus that AIED is the result of antibodies or other immune cells that cause damage to structure of the inner ear such as the cochlea and vestibular system. Of note, AIED is the only known SNHL that responds to medical treatment, but withholding treatment for longer than three months may result permanent hearing loss and the need for cochlear implant installation.

Although AIED has been studied extensively over the past 25 years, no clear mechanism of pathogenesis has emerged, indicating a need for further investigation on the development of AIED. A recent paper (Goodall and Siddiq 2015) performed a literature review of all relevant articles dating back to 1980, and proposed a mechanism of pathogenesis which includes an inflammatory response and immune cell attack on inner ear structures. This response leads to an over-activation of other immune cells such as T helper cells, resulting in vascular changes and cochlear harm. The authors conclude that AIED appears to be a consequence of damaged sensorineural hearing due to electrochemical disturbances, microthrombosis, and immune cell deposition. Additionally, self-reactive antibodies and T-cells contribute to the aforementioned damage. Research has suggested a valuable next step in uncovering of AIED pathogenesis is inquiry into the role of interleukin-1β (IL-1β) (Rauch 2014)

Several medical therapies have proven beneficial in the treatment of AIED, with corticosteroid therapy being the most effective. However, corticosteroid therapy has shown to only be effective in 70% of patients, suggesting that more research into novel treatment methods is required. The goal of most AIED treatments is to administer corticosteroids over a certain period of time, re-evaluate hearing at each appointment, and eventually taper off corticosteroid administration. Ideally, patients can be tapered off with hearing fully recovered, though this is the least likely outcome. Often, tumor necrosis factor-α (TNF-α) inhibitors must be administered alongside corticosteroids to achieve a favorable outcome and eventually end to corticosteroid treatment. Recent papers have indicated that the TNF-α inhibitor, infliximab, has the potential to allow for sustained patient improvement and alleviation of symptoms (Heywood et al. 2013, Gazeu et al. 2014).

I have more sources that I haven't included yet in here. Let me know if anyone has a problem with this summary. — Preceding unsigned comment added by Immcarle27 (talk • contribs) 20:01, 6 February 2016 (UTC)

Inserted new lead section and changed symptoms, causes, and treatment sections

I added a new lead section and made adjustments to all other sections to be more current with relevant literature. — Preceding unsigned comment added by Immcarle27 (talk • contribs) 03:10, 11 February 2016 (UTC)