What Causes Autoimmune Inner Ear Disease ?
The cause of AIED is generally assumed to be related to either antibodies or immune cells that cause damage to the inner ear. There are several theories as to how these might arise, analogously to other putatative autoimmune disorders: Bystander damage: In this theory damage to the inner ear causes cytokines to be released which provoke, after a delay, additional immune reactions. This theory might explain the attack/remission cycle of disorders such as Meniere’s disease. There is evidence for cytokines in the cochlea including interleukin-1A, TNF-alpha, NFkB P65 and P50, and IkBa (Adams, 2002). Drugs that block TNF such as etanercept (see treatment section) seem to be potentially effective in AIED (Rahmen et al, 2001). The endolymphatic sac lumen expresses TNF-alpha (Satoh et al, 2003), which may be another way wherebye Meniere’s disease is linked to AIED. Other autoimmune disorders such as Crohn’s disease also seem to be linked to TNF, and other ear diseases such as otosclerosis also
