“…As EH has been proposed to result from a disturbance in endolymphatic volume regulation that is associated with changes in the microenvironment of luminal fluid of the ES (12), understanding the molecular pathomechanism(s) underpinning the regulation of the immune reaction in the luminal fluids of ES is important both for furthering our knowledge of the physiopathology of EH and for identifying biomarkers for diagnosis or prognosis of pathologies of the MD. Recently, there has been a growing interest in developing a "liquid biopsy" of the inner ear as a surrogate for tissue biopsy to identify molecular biomarkers (13)(14)(15)(16). Proteomics analysis in samples of perilymph (13) and ES luminal fluid (ELF) (14,15) from patients with MD and controls suggested that increased inflammatory reactions Abbreviations: MD, Meniere's disease; EH, endolymphatic hydrops; ES, endolymphatic sac; ELF, ES luminal fluid; AN, acoustic neuroma; EDB, endolymphatic duct blockage; TNF-α, tumor necrosis factor α; IFN-γ, interferon-γ; IL, interleukin; Simoa, single-molecular array; RGP, resorufin β-D-galactopyranoside; PBST, triton-phosphate buffered saline; DAPI, 4 ′ ,6diamidino-2-phenylindole; ANOVA, analysis of variance; IF, immunofluorescence; SNHL, sensorineural hearing loss.…”