Immunology and inner ear diseases have finally crossed paths. There are several ear diseases associated with hearing loss, vertigo, and tinnitus, including Meniere's disease, otosclerosis, and autoimmune sensorineural hearing loss. These diseases all have immunologic manifestations.Witebsky defined the following criteria to determine the relationship of immunologic phenomena to disease etiology following Koch's postulates:The autoimmune response must be regularly associated with the disease.A replica of the disease must be inducible in laboratory animals.Immunopathologic changes in the natural and experimental diseases should parallel each other.Transfer of the autoimmune illness should be possible by transfer of the serum or lymphoid cells from diseased individuals to normal recipients.Table 1 lists some ear diseases that have immunologic features.We wish to review some of the immunologic tests that would be useful in making diagnoses or in following patients with these diseases. Routine tests, available in most clinical laboratories, measure B cell functions, T cell functions, complement systems, and neutrophil functions in addition to a variety of autoantibody tests. There is no known specific immunologic test for ear disease at the present time. The few available methods in research laboratories are not yet well enough standardized for general use. This is mainly because of the nonavailability of tissue antigens and the lack of their immunochemical characterization.
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