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-specific oligonucleotide probes method in 41 patients with sudden sensorineural hearing loss and in 206 healthy control subjects. Initial hearing levels at the onset of hearing loss and final hearing levels after treatment were evaluated 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) were compared with 206 controls. Patients were divided into 2 groups according 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 frequency of HLA alleles was evaluated, the frequencies of HLA-DRBI*14 (relative risk [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 corticosteroid 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 combination analysis showed that the frequencies of DQA1*03 and *05 had a high RR 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 marker in forecasting a prognosis in Korean patients with sudden sensorineural hearing.