メニエール病におけるストレス・ホルモンと内リンパ嚢・水代謝

Abstract

Some sicknesses are well known to be provoked by inadequate adaptation to physical and/or psychogenic stress in daily life. Attacks of Meniere's disease characterized by vertigo, fluctuating hearing loss and tinnitus due to inner ear pathology represent a common example. Furthermore, this disease has been proposed to especially occur in civilized people living a stressed lifestyle, i.e. “Menierization is civilization”. However, it is very difficult to prove a significant relationship between stress and inner ear pathology, since the definition of stress is too obscure for scientific analysis of these aspects. Since the oto-pathology in Meniere's disease was first revealed to be inner ear endolymphatic hydrops through temporal bone studies in 1938, it has gradually become understood that inner ear endo-organ tissues, including the endolymphatic sac, prepare the fluid homeostatic system via water metabolism-related molecules such as vasopressin and aquaporin. Subsequently, it was proposed that the pathogenesis in Meniere's disease could be inner ear endolymphatic hydrops due to a disorder of water metabolism-related molecules. In the present paper, we would like to discuss the neuroscientific relationship between stress and inner ear pathology by reviewing plasma vasopressin (an anti-diuretic stress hormone) and its receptor, V2 receptor, in the endolymphatic sac (an inner ear endo-organ for endolymph absorption) in patients with Meniere's disease.