The transcriptome characteristics of vestibular organs from delayed endolymphatic hydrops patients (Meniere's disease)

Objectives To identify genes that are related to delayed endolymphatic hydrops (DEH) in patients by RNA-Seq analysis. Design Observational study. Setting Eye & ENT Hospital, Fudan University (Shanghai, China). Participants We collected the entire vestibular system from four patients with DEH who underwent labyrinthectomy. Three control samples were collected from patients with acoustic neuroma or facial neuroma treated via the translabyrinthine approach. High-throughput RNA-Seq analysis was performed to investigate gene expression in the pathological vestibular system. Main outcome measures Our bioinformatics analysis identified 17 genes that were upregulated and eight genes that were downregulated in patients with DEH compared to the controls. Results The altered gene expression profile suggested that DEH is closely related to neuropathy and autoimmune disease. In addition, many of the differentially regulated genes were involved in cell adhesion, suggesting a role of cell adhesion in DEH. Immunofluorescence analysis confirmed the expression of PMP2 and CLDN19 in the cytoplasm of hair cells and scattered expression of MPZ at cell junctions. The protein expression levels were higher in specimens from patients with Meniere's disease and DEH compared to controls. Conclusions The protein expression profile of vestibular organs in patients with endolymphatic hydrops exhibited a degree of similarity to that of Meniere's disease. Endolymphatic hydrops is characterized by autoimmune abnormalities. DEH and Meniere's disease are likely to be different manifestations of the same disease, with disparate clinical symptoms. RNA-Seq is a useful analytical tool to characterise the vestibular pathology based on its transcriptome.