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Different Distribution of HLA Class II Alleles According to Response to Corticosteroid Therapy in Sudden Sensorineural Hearing Loss
Sang W. Yeo, MD, PhD;
Shi-Nae Park, MD;
Yong-Soo Park, MD;
Byung-Do Suh, MD, PhD;
Hoon Han, MD, PhD;
Hee-Baeg Choi, PhD;
Tai-Gyu Kim, MD, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:945-949.
Objective To investigate the association of HLA class II alleles with the susceptibility
to sudden sensorineural hearing loss and with the results of corticosteroid
treatment in the Korean population.
Design HLA-DRB1, -DQA1, -DQB1, and -DPB1 genotyping by the sequence-specific
oligonucleotide probes method in 41 patients with sudden sensorineural hearing
loss and in 206 healthy control subjects. Initial hearing levels at the onset
of hearing loss and final hearing levels after treatment were evaluated for
the association with HLA class II alleles.
Setting Tertiary care referral center, ambulatory and hospitalized care.
Subjects Forty-one patients (24 men and 17 women; mean age, 49.2 years) were
compared with 206 controls. Patients were divided into 2 groups according
to their response to corticosteroid therapy (good response vs nonresponse).
Results The frequencies of HLA-DRB1, -DQA1, -DQB1, and -DPB1 alleles were not
significantly different between patients and controls (P>.05). When an association between the results of corticosteroid treatment
and the frequency of HLA alleles was evaluated, the frequencies of HLA-DRB1*14
(relative risk [RR] = 3.5, P<.02), -DQA1*03 (RR
= 4.2, P<.02), and -DQA1*05 (RR = 3.1, P<.03) were significantly increased, but HLA-DQA1*01 (RR = 0.2, P<.004) and -DQB1*06 (RR = 0.2, P<.009) were decreased in the group nonresponsive to corticosteroid
therapy, compared with the controls. The distribution of HLA-DQA1*01 (P<.04), -DQB1*06 (P<.02),
and -DQA1*03 (P<.003) was significantly different
between the responsive and the nonresponsive groups. HLA-DQA1 allelic combination
analysis showed that the frequencies of DQA1*03 and *05 had a high RR value
in patients with sudden sensorineural hearing loss (RR = 4.1, P<.003) and in patients in the nonresponsive group (RR = 8.9, P<.001), compared with the controls.
Conclusion The presence of HLA class II alleles may be a useful genetic marker
in forecasting a prognosis in Korean patients with sudden sensorineural hearing
loss.
From the Departments of Otolaryngology (Drs Yeo, S-N. Park, Y-S. Park,
and Suh) and Microbiology and Immunology (Drs Han, Choi, and Kim), College
of Medicine, The Catholic University of Korea, Seoul.
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