The potential role of epigenetic modulations in BPPV maneuver exercises.

Kun-Ling Tsai,Ching-Hsia Hung,Chia-To Wang,Yi-Ju Tsai,Yuan-Yang Cheng,Chia-Hua Kuo,Hsin-I Ma,Chung-Lan Kao

doi:10.18632/oncotarget.9446

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common complaints encountered in clinics and is strongly correlated with advanced age or, possibly, degeneration. Redistribution exercises are the most effective approaches to treat BPPV, and canalith repositioning procedure (CRP) cure most BPPV cases. However, the mechanisms through which the treatment modulates systemic molecules in BPPV patients remain largely unknown. In this study, we report that the miR-34a and Sirtuin 1 (SIRT1) genes correlated with the treatment effects of CRP in BPPV subjects. We found that miR-34a expression was largely inhibited and SIRT1 expression was significantly reversed after BPPV maneuver treatment. We also confirmed that the PPAR-γ, PGC-1 and FoxO gene expressions were decreased immediately after canalith repositioning procedure (CRP) for BPPV, and were largely increased after a complete cure of BPPV. Moreover, we observed that after a complete recovery of BPPV, the ROS concentrations, pro-inflammatory cytokine concentrations and p53 expression levels were attenuated. We conclude that BPPV treatment might involve some epigenetic regulations through the mediation of miR-34a, SIRT1 functions and repression of redox status.

Highlights

Benign paroxysmal positional vertigo (BPPV) is one of the most common complaints encountered in otology, neurology and rehabilitation clinics
We demonstrated miR-34a levels were significantly higher and Sirtuin 1 (SIRT1) expression levels were significantly lower in blood samples of BPPV patients immediately after BPPV treatment (BPPV attacked) compared with the samples collected after completion of treatments
FoxO, PGC-1α, PPAR-γ and p53 expression levels were altered after recovery of BPPV

Summary

Introduction

Benign paroxysmal positional vertigo (BPPV) is one of the most common complaints encountered in otology, neurology and rehabilitation clinics. The typical presentation of BPPV is intense, brief vertigo spells that are provoked by a change in head position [1]. Benign paroxysmal positional vertigo is believed to be the consequence of displaced otoconia within the semicircular canals located in the inner ear [2]. Individuals with a history of head trauma or ear infections are prone to developing BPPV [3]. BPPV occurrence is highly related to advanced age or, possibly, degeneration. One previous study suggested that age, migraines, hypertension, hyperlipidemia and stroke are independently associated with BPPV [4]. The occurrence and recurrence rates are increased among the senior population [5]

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