A Nationwide, Population-based Cohort Study on Potential Autoimmune Association of Ménière Disease to Atopy and Vitiligo

Abstract

Ménière disease (MD), an idiopathic disorder of sensorineural hearing loss and vertigo, shares many similarities with two common skin conditions, atopic dermatitis (AD) and vitiligo. Recent studies have suggested that MD may be related to or triggered by autoimmune conditions, notably Hashimoto thyroiditis and alopecia areata. These evidences led to the authors contemplating the possibility of immunological bridge between MD and the two skin conditions. The authors have tested this hypothesis with population-based cohort from the National Health Insurance Service Database of Korea. A cohort of 1.1 million patients was extracted from the database. Using χ2 tests, prevalence of the two skin disorders in relation to MD status was analysed. In MD patients, the odds ratios for having concurrent AD and vitiligo were 0.717 (95% CI, 0.535–0.962, p = 0.026) and 2.149 (95% CI, 1.396–3.308, p = 0.001), respectively. Females and older patients were more than twice likely to be affected by the two skin conditions. The relationship between vitiligo and MD was significant in younger subgroup only. Socio-economic subgroup analysis revealed the observed patterns are primarily a middle-upper class phenomenon. Uncertainty regarding temporal sequence of onset, and lack of detail on disease severity and subtype kept the study from more refined conclusion. In concluding, AD and vitiligo might be linked to MD through Treg-driven action of cellular immunity, but further big data-based investigations must follow.

Association of Behçet disease with psoriasis and psoriatic arthritis

“…Furthermore, to shield the study results from as many confounding variables as possible, the outcomes values were not only adjusted for sex and age, but by gross income level (brackets) and disability status as well. Indeed, it has been suggested by a multitude of authors that chronic and multisystemic disorders, especially immune-mediated ones, may be influenced by socioeconomic factors and functional impairment 40 .…”

Meniere’s Disease: The Current State of the Problem

“…Развитие БМ зависит от целого ряда факторов, которые способны приводить к развитию эндолимфатической водянки. Среди них: возраст (старше 60 лет), пол (женский) [6,23], генетическая предрасположенность [20,24], раса (белые люди) [25], низкий рост и длина ног, нарушение метаболизма [26], аутоиммунные процессы [27,28], анатомические особенности внутреннего уха [30], аллергии [31], мигрень, погодные условия с высокой влажностью и низким атмосферным давлением, употребление жирной пищи и стрессы. Однако большинство исследований ограничены отсутствием популяционных когорт и низким числом случаев; следовательно, лежащие в основе заболевания патологические механизмы остаются неясными.…”

Single cell profiling reveals a reduction of CD56dim NK-cells and other immune cells in patients with Meniere disease and high levels of cytokines

“…In this context, there is enough evidence to support that genetic factors and autoimmunity/in ammation could be involved in the etiology of MD (9). MD has been associated with various autoimmune or autoin ammatory diseases, namely rheumatoid arthritis, autoimmune thyroid disease, systemic lupus erythematosus, psoriasis, and vitiligo (10)(11)(12)(13). Also, allelic variants in immune-related genes, such as MICA, TLR10, NFKB1 have been associated with SNHL progression in MD (14)(15)(16).…”