Immune alterations in vestibular neuritis: a retrospective database pilot study on T and B lymphocyte profiles and cytokine levels

TL;DR

This study found immune system changes in people with vestibular neuritis, suggesting immune markers could help predict outcomes and guide treatment.

Contribution

The study is the first to comprehensively analyze T and B lymphocyte subsets and cytokine levels in vestibular neuritis patients.

Findings

VN patients had higher B lymphocytes, CD3+CD4+ T cells, and CD4+/CD8+ T cell ratio compared to controls.

Elevated IL-6 and reduced IL-17A levels were observed in VN patients.

Immune markers correlated with disease severity and functional outcomes.

Abstract

Vestibular neuritis (VN) etiology remains elusive, with hypotheses suggesting viral infection, non-infectious inflammation, or immune responses. Evaluating T and B Lymphocyte Subsets and cytokines gives a comprehensive snapshot of the body’s immune function and inflammatory state. But comprehensive studies focusing on the T and B lymphocyte subsets and cytokine levels in VN are limited. This study aims to assess the T and B lymphocyte subsets and cytokine expressions in the blood of VN patients. This study shed light on its pathogenesis and provided valuable hematological markers for clinical prognosis.

A retrospective analysis was conducted on subjects diagnosed with VN. Patients included exhibited acute, first-episode, persistent vertigo with accompanying symptoms of nausea, vomiting, postural instability, specific nystagmus, and positive head impulse test results. Exclusion criteria included hearing impairments, prior vestibular disorders, recent steroid therapy, and autoimmune conditions. Patients underwent blood tests (T and B lymphocyte subsets, cytokines) and DHI evaluations within days of onset, with a secondary assessment at discharge. Healthy individuals served as controls.

The study included 25 individuals with VN (aged 34–73 years, 13males) and 25 healthy controls (aged 33–74 years, 7males). VN patients exhibited elevated levels of total B lymphocytes, helper/inducer (CD3+CD4+) T cells, and the helper/suppressor (CD4+/CD8+) T cell ratio all of which were statistically significant compared to the control group. In contrast, reduced levels of total T lymphocytes, suppressor/cytotoxic T cells, and natural killer cells were observed. Elevated Interleukin-6 levels and decreased Interleukin-17A levels were seen in the VN group. There are differences in the levels of CD3+CD4+ T cells and CD4+/CD8+ T cell ratio among patients in the three groups of mild, moderate, and severe, with the severe group significantly higher than the mild group. Admission levels of CD3+CD4+ T cells showed positive correlations with the DHI-Functional score within 1–3 days. Admission levels of CD3+CD4+ T cells and CD4+/CD8+ T cell ratio are positively correlated with all DHI scores at discharge.

Immunological perturbations are implicated in pathogenesis of VN. Evaluation of these immune markers could offer insights into prognostic outcomes for VN patients, leading to development of therapeutic strategies.

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