Different distribution of HLA class II alleles according to response to corticosteroid therapy in sudden sensorineural hearing loss

Objective: To investigate the association of HLA class II alleles with the susceptibility to sudden sensorineural hearing loss and with the results of corticosteroid treatment in the Korean population. Design: HLA-DRB1, -DQA1, -DQBI, and -DPB1 genotyping by the sequence-specif ic oligonucleotide probes method in 41 patients with sudden sensorineural h earing loss and in 206 healthy control subjects. Initial hearing levels at the onset of hearing loss and final hearing levels after treatment were eva luated for the association with HLA class 11 alleles. Setting: Tertiary care referral center, ambulatory and hospitalized care. Subjects: Forty-one patients (24 men and 17 women; mean age, 49.2 years) we re compared with 206 controls. Patients were divided into 2 groups accordin g to their response to corticosteroid therapy (good response vs nonresponse ). Results: The frequencies of HLA-DRB1, -DQA1, -DQB1, and -DPB1 alleles were not significantly different between patients and controls (P>.05). When an association between the results of corticosteroid treatment and the frequen cy of HLA alleles was evaluated, the frequencies of HLA-DRBI*14 (relative r isk [RR]=3.5, P<.02), -DQA1*03 (RR=4.2, P<.02), and -DQA1*05 (RR=3.1, P<.03 ) were significantly increased, but HLA-DQA1*01 (RR=0.2, P<.004) and -DQB1* 06 (RR=0.2, P<.009) were decreased in the group nonresponsive to corticoste roid therapy, compared with the controls. The distribution of HLA-DQA1*01 ( P<.04), -DQB1*06 (P<.02), and -DQA1*03 (P<003) was significantly different between the responsive and the nonresponsive groups. HLA-DQA1 allelic combi nation analysis showed that the frequencies of DQA1*03 and *05 had a high R R value in patients with sudden sensorineural hearing loss (RR=4.1, P<.003) and in patients in the nonresponsive group (RR=8.9, P<001), compared with the controls. Conclusion: The presence of HLA class II alleles may be a useful genetic ma rker in forecasting a prognosis in Korean patients with sudden sensorineura l hearing.