Demonstration of autoantibodies to the endolymphatic sac in Meniere's disease.

Recent evidence suggests that immune mechanisms may underlie some cases of Meniere's disease. This study was conducted to determine whether an autoimmune mechanism is involved. Sera from 30 patients with Meniere's disease were reacted with human endolymphatic sacs and examined by indirect immunohistochemistry and fluorescence microscopy. Three of the samples (10%) showed positive staining, indicating immunoglobulin G (IgG) binding against the sac. No positive staining occurred when sera from healthy individuals or phosphate-buffered saline was used as a control. Clinical data showed an association between immunoreactivity and extent of disease (worse hearing over a shorter disease course and bilateral involvement). This study suggests that, in some cases of Meniere's disease, autoantibodies directed against human endolymphatic sac are present in the sera, supporting the theory that a specific autoimmune reaction takes place in a minority of patients with Meniere's disease.