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Fibrinogen is not a prognostic factor for response to HELP-apheresis in sudden sensorineural hearing loss (SSHL)

  • Otology
  • Published:
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Abstract

Higher levels of fibrinogen or cholesterol were associated with improved hearing recovery in SSHL patients after treatment with HELP-apheresis (Heparin-induced extracorporeal LDL precipitation apheresis). The present trial was performed to demonstrate HELP-related effects on relevant metabolic and inflammatory parameters in the context of SSHL treatment. In the framework of a single arm non-controlled trial, we investigated the variation of metabolic and inflammatory parameters using HELP-apheresis for a defined group of 100 patients with SSHL. Based on cut off inclusion criteria (Serum LDL-cholesterol >1.6 g/l and/or fibrinogen >2.0 g/l, SSHL in minimum three frequencies more than 30 dB, time after event not longer than 6 days), the protocol followed a strict time line with one single shot HELP-apheresis and follow-up monitoring including laboratory parameters at six defined time points. If HELP-apheresis could not effect improvement of hearing on day 5, additional corticosteroid treatment was applied. Concentration of anti-inflammatory IL-10 increased while other proinflammatory parameters declined. Serum levels of all measured sterols and apolipoproteins decreased significantly. None of the investigated parameters were suitable to predict hearing improvement of the patients. Levels of fibrinogen and LDL-cholesterol were not prognostic for outcome after HELP-apheresis. A significant (p < 0.001) increase of anti-inflammatory IL-10 after apheresis was notable, while most of the proinflammatory parameters declined. Despite the limited validity of a single arm non-controlled trial, these alterations on immune modulating factors indicate possible secondary pleiotropic effects caused by HELP-apheresis.

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Acknowledgments

This study was supported financially by the Roland Ernst Foundation for public health care, Dresden and B Braun Avitum AG, Melsungen.

Conflict of interest

Thomas Berger and Andreas Dietz have spoken at congresses sponsored by B Braun Avitium AG and have received honoraria for lecturing.

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Authors and Affiliations

  1. Department of Head Medicine and Oral Health, ENT-Department, University Hospital Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany

    T. Berger, B. Hagemeyer & A. Dietz

  2. Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital, Leipzig, Germany

    T. Kaiser, U. Ceglarek & J. Thiery

  3. Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University Hospital Leipzig, Leipzig, Germany

    M. Scholz

  4. Ear- and Hearing Institute Tinnitus-clinic Dr. Hesse, Witten/Herdecke University, Bad Arolsen, Germany

    G. Hesse

  5. Department of Internal Medicine Neurology and Dermatology, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany

    A. Bachmann & M. Stumvoll

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  1. T. Berger
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Berger, T., Kaiser, T., Scholz, M. et al. Fibrinogen is not a prognostic factor for response to HELP-apheresis in sudden sensorineural hearing loss (SSHL). Eur Arch Otorhinolaryngol 272, 3693–3703 (2015). https://doi.org/10.1007/s00405-014-3449-9

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