内淋巴囊局部免疫致自身免疫性梅尼埃病及其治疗的实验研究

Experimental Research of Autoimmune Meniere's Disease Induced by Local Immune of Endolymphatic Sac and its Treatment

目的：制成自身免疫性梅尼埃病动物模型，并探讨免疫抑制剂环磷酰胺和强的松对其防治效果。方法：采用同种粗制内耳抗原（ｃｒｕｄｅｉｎｎｅｒｅａｒａｎｔｉｇｅｎ，ＣＩＥＡｇ）在已致敏的豚鼠内淋巴囊（ｅｎｄｏｌｙｍｐｈａｔｉｃｓａｃ，ＥＳ）局部免疫，并在免疫同时或免疫后使用环磷酰胺或强的松作试验性预防和治疗，观察其疗效。结果：ＥＳ局部免疫后的动物出现了针对ＣＩＥＡｇ的特异性免疫反应，并造成了与梅尼埃病极其相似的膜迷路水肿等内耳病理改变，以及明显的听觉和前庭功能障碍；而使用免疫抑制剂的各试验组动物的特异性免疫反应受到不同程度的抑制，内耳组织损伤与功能障碍明显减轻。结论：ＥＳ局部免疫是一种有效的造成梅尼埃病的方法，部分梅尼埃病患者的发病机制可能与自身免疫因素有关，免疫抑制剂环磷酰胺和强的松对其有良好的防治效果。

An animal model of autoimmune Meniere's disease (AIMD) Was established for studying the preventive and treatment effect of cytoxan (CTX) and prednisonum (PDS) on AIMD. METHODS: Isologous crude inner ear antigen (CIEAg ) was injected into the endolymphatic sac (ES) of sensitized guinea pigs so as to make a local sensitization, and the experimental preventive and treatment effect of CTX and PDS during and after immunization were observed. RESULTS:A specific immune response against CIEAg occurred and pathologic changes in inner ear (e. g. endolymphatic hydrops etc. )similar to those in Meniere's disease were found. A significant vestibular and hearing dysfunction was observed. In contrast,in animals that recieved CTX or PDS, the immune response decreased and pathologic changes were not so obvious.CONCLUSIONS: The pathogenic mechanism in some patients with Meniere's disease may be related to local autoimmune disorders in ES. CTX and PDS have a good effect in preventing and treating Mentiere'S disease.