メニエール病 : ストレスと水代謝との関連で Meniere's Disease and Stress : An Involvement of the Vasopressin-aquaporin2 System in the Inner Ear
Recently, there has been considerable evidence suggesting the hormonal control of the inner ear. The vasopressin-aquaporin2 (VP-AQP2) system may play an important role in the regulation of water in the inner ear. Endolymphatic hydrops, over-accumulation of endolymph, is thought to result from the malregulation of the VP-AQP2 system in inner ear fluid. We reported that plasma VP (p-VP) levels were elevated in Ménière's disease and that elevation was noted in cases of Ménière's disease with emotional or physical stress. Since stress is well-known to lead to excessive secretion of VP, it is likely that a stress-associated rise in p-VP causes a disturbance of the VP-AQP2 system in the inner ear, resulting in vertiginous attacks and/or aggravation of hearing in Ménière's disease. This paper reviews the clinical and experimental evidence supporting the novel view that endolymphatic hydrops, the morphological characteristics of Ménière's disease, reflects the mal-regulation of the VP-AQP2 system in inner ear fluid, and that a stress-associated rise in p-VP is one of the causative factors of vertigo and deafness in Ménière's disease.
耳鼻咽喉科臨床 101(9), 645-651, 2008-09-01
The Society of Practical Otolaryngology