内耳免疫及炎症介导的耳聋研究进展

Research Progress on Hearing Loss Mediated by Inner Ear Immunity and Inflammation

免疫和炎症介导的内耳疾病被认为是导致感音性耳聋的机制之一,内耳炎症是血管通过扩张并招募免疫细胞进入耳蜗来免受病原体或组织损伤的重要过程,但免疫细胞分泌炎症因子过多也会导致正常细胞损伤而导致病理结果。随着医疗条件的改善和居民生活环境的变化,感染性聋和药物性聋患病人数显著减少,噪声性聋、老年性聋、遗传性聋所占的比例明显提高。这其中相当部分噪声性和老年性耳聋患者的致病因素里也有易感基因的影响,并且近年来多项研究显示:遗传因素诱发内耳免疫环境改变、发生炎症介导的耳聋也是重要病因之一,所以遗传性耳聋的比例增加最为明显。本文将总结内耳的免疫细胞、免疫分子的种类,重点阐述巨噬细胞通过趋化因子及其受体募集和免疫细胞介导噪声性耳聋、药物性耳聋和遗传性耳聋的途径。

Immunity and inflammation-mediated inner ear diseases are considered to be one of the mechanisms leading to sensorial hearing loss.Inner ear inflammation is an important process in which blood vessels dilate and immune cells enter the cochlea to protect against pathogens or tissue damage.However,excessive production of inflammatory factors by immune cells can lead to damage of normal cells and pathological changes.As healthcare and living conditions improve,hearing loss related to ear infections and ototoxic drugs has decreased significantly,while hearing loss related to noise exposure,age and genetic factors has become increasingly prominent.A considerable pathogenic factor in noise-induced and age-related hearing loss patients is genetic susceptibility.In recent years,a number of studies have shown that genetic factors can cause changes in the immune environment of the inner ear,with inflammation being an important cause for hearing damage,leading to an increase of hereditary hearing loss.In this review,we will summarize the type of immune cells and immune molecules in the inner ear,focusing on the recruitment of macrophages through chemokines and their receptors,as well as noise-and drug-induced hearing loss and hereditary hearing loss mediated by immune cells through Toll-like receptors and NOD receptors.