High Serum Levels of Otolin-1 in Patients With Benign Paroxysmal Positional Vertigo Predict Recurrence.

Zhenyi Fan,Xiaoxiong Lu,Weiwei Han,Wang Yan,Min Zhou,Zhizhou Hu,Yunqin Wu,Xiaoxia Liu

doi:10.3389/fneur.2022.841677

Abstract

BackgroundOtolin-1 is an inner ear-specific protein that is exclusively expressed in otoconia and vestibule and cochlea cells. Recent investigations reported that otolin-1 can cross the blood-labyrinthine barrier and that the levels in serum well-reflected otolith status. Serum otolin-1 levels in patients with benign paroxysmal positional vertigo (BPPV) are significantly elevated compared with healthy controls. We aimed to explore whether otolin-1 can also serve as a biomarker for predicting BPPV recurrence.MethodPatients at our institution with new-onset of idiopathic BPPV between May, 2017 and May, 2018 were recruited and followed up for 2 years. All demographic data of the patients were collected, and serum levels of otolin-1 and other laboratory indicators were measured and compared according to the recurrence status.ResultsA total of 74 patients, who met the inclusion criteria were enrolled in this study, of which 27 (36.5%) patients had suffered one or more episodes of recurrence after undergoing canal repositioning treatments during the study. The serum levels of otolin-1 in patients with recurrent BPPV were significantly higher than those in patients without recurrent BPPV (363.9 vs. 309.8 pg/ml, p = 0.001). In multivariate analysis comparing the second to fourth quartiles (Q2–Q4) against the first quartile (Q1) of otolin-1, the level of otolin-1 in Q4 could significantly predict BPPV recurrence, and the odds ratio (OR) was elevated by approximately 812% (OR = 9.12; 95% confidence interval [CI]: 1.44–57.9; p = 0.019).ConclusionHigh serum levels of otolin-1 were associated with an increased risk of BPPV recurrence, and further investigation is required to confirm this association and clarify the exact mechanism.

Highlights

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo and affects nearly 17% of patients with dizziness or vertigo
Higher serum levels of otolin-1 were observed in patients with recurrent BPPV than in those patients without recurrence (363.9 [interquartile range (IQR): 318.2– 417.9] pg/ml vs. 309.8 [280.1–334.9] pg/ml; Z = −3.329; p = 0.001)
This study showed the following: 1) Serum levels of otolin-1 in patients with recurrent BPPV were significantly higher than those in patients with non-recurrent BPPV; 2) elevated serum levels of otolin1 were associated with a higher risk of recurrent BPPV, suggesting that otolin-1 may be a risk factor for the recurrence of BPPV

Summary

Introduction

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo and affects nearly 17% of patients with dizziness or vertigo. BPPV sometimes recurs with a reported recurrence rate ranging from 7 to 50%, depending on the clinical setting, which results in anxiety and poor quality of life in patients [4, 5]. Several studies have explored the risk factor-associated recurrence of BPPV, but the conclusions are conflicting [6, 7]. Recent investigations reported that otolin-1 can cross the blood-labyrinthine barrier and that the levels in serum well-reflected otolith status. Serum otolin-1 levels in patients with benign paroxysmal positional vertigo (BPPV) are significantly elevated compared with healthy controls. We aimed to explore whether otolin-1 can serve as a biomarker for predicting BPPV recurrence

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