Tumor Necrosis Factor-Alpha and Interleukin-4 Levels in Patients With Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Background and Objectives The pathogenesis of idiopathic sudden sensorineural hearing loss (ISSNHL), an otologic emergency disease, remains unclear. Several studies have attempted to illustrate the association between cytokines and ISSNHL. The purpose of this study was to evaluate the prognostic significance of various cytokines in patients with ISSNHL. Subjects and Method In this case-control study, a total of 55 patients with ISSNHL underwent treatment with oral prednisolone for 2 weeks. Serum cytokine levels, including interleukins (ILs) (IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12), and tumor necrosis factors (TNF-α and TNF-β), were measured using human cytokine panels at first visit. Patient characteristics such as age, gender, the status of hypertension, diabetes mellitus, vertigo, time from onset to visit, and initial hearing levels were also evaluated. Results Serum levels of cytokines were correlated with the prognosis of ISSNHL patients. IL-4 ≥0.225 (pg/mL) and TNF-α ≥5.155 (pg/mL) were significantly associated with poor therapeutic outcomes (OR=44.317, <i>p</i>=0.015 and OR=269.465, <i>p</i>=0.006, respectively). In addition, age and initial hearing levels were also significant prognostic factors. Conclusion Patients’ age, initial hearing levels, and serum levels of IL-4 and TNF-α prior to treatment are associated with hearing recovery and can be used as prognostic factors for patients with ISSNHL.