The Autoimmune Hypothesis in Meniere’s Disease: Evidence, Mechanisms, and Future Perspectives

Meniere's disease (MD) is a chronic inner ear disorder characterized by episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness, significantly impacting patients' quality of life.The etiology of MD is complex and multifactorial, involving genetic, environmental, vascular, and immunological factors.Among the various hypotheses proposed to explain MD's pathogenesis, the autoimmune hypothesis suggests that an aberrant immune response targets inner ear antigens, leading to the characteristic symptoms of MD.This review article aims to comprehensively analyze the autoimmune hypothesis in MD, focusing on evidence, mechanisms, and future perspectives.The evidence supporting the autoimmune hypothesis includes clinical observations of higher prevalence rates of autoimmune conditions among MD patients, epidemiological links to autoimmune disorders, and laboratory findings of specific autoantibodies and elevated inflammatory cytokines.Proposed immunological mechanisms involve autoantibodies targeting inner ear antigens, molecular mimicry, and immune complex deposition, leading to inflammation and tissue damage in the inner ear.Experimental models and in vitro studies have replicated these autoimmune responses, further validating the hypothesis.Despite compelling evidence, some studies present conflicting results, highlighting the need for further research.Future directions include refining experimental models, exploring specific immunological pathways, and conducting comprehensive clinical studies.Understanding the autoimmune mechanisms in MD could lead to novel therapeutic strategies focusing on immunomodulation, potentially improving outcomes for patients with this debilitating condition.