A subpopulation of Menière's patients produce antibodies that bind to endolymphatic sac antigens.

The endolymphatic sac (ES) has been suggested to serve an important immunological role within the inner ear. Meanwhile, immunological mechanisms have been studied in connection with Meniere's disease. The aim of this study is to look for and recognize antibodies against the ES in the sera of patients with Meniere's disease, using the technique of indirect immunofluorescence. Sera from 50 patients with Meniere's disease, from an animal model of autoimmune inner ear disease, and from healthy controls were tested against ES tissue substrates obtained from guinea pigs. Immunoglobulin deposition in the ES was found in 20 patients (40%) compared with one control (10%). The difference was statistically significant when computing the odds ratios at 95% confidence level. Fluorescein labeling was demonstrated in the ES epithelium in 16% and in the surrounding perisaccular stroma in 24%. Identical immunoreactivity against the ES tissue was depicted in the sera of the experimental animal model. These findings support the possibility of humoral immunological involvement in the Meniere's disease process. Immunological derangement of the ES function could be the first step in a cascade of reactions leading to endolymphatic hydrops and presenting as Meniere's disease.