Persistent Measles Virus Infection as a Possible Cause of Otosclerosis: State of the Art

• Published in: Ear, nose, & throat journal nose, & throat journal, 2000-08, Vol.79 (8), p.552-561
• Main Authors: Niedermeyer, Hans P., Arnold, Wolfgang, Neubert, Wolfgang J., Sedlmeier, Reinhard
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antibodies, Viral - analysis; Biological and medical sciences; Blotting, Southern; Case-Control Studies; Causes of; Chronic Disease; Complications and side effects; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Genetic Predisposition to Disease; Germany - epidemiology; Humans; Incidence; Male; Measles; Measles - complications; Measles - epidemiology; Measles - immunology; Measles - virology; Measles virus - genetics; Measles virus - immunology; Measles virus - isolation & purification; Medical sciences; Middle Aged; Non tumoral diseases; Osteitis Deformans - virology; Otorhinolaryngology. Stomatology; Otosclerosis; Otosclerosis - epidemiology; Otosclerosis - etiology; Otosclerosis - immunology; Otosclerosis - virology; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral - analysis; Sex Factors
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/014556130007900807

The etiopathogenesis of otosclerosis is still largely unexplained and remains controversial. Morphologic examinations have shown the presence of a chronic inflammation in otosclerotic tissue. Among the proposed explanations for this inflammation are an immunologic reaction against collagen, mutations of collagen gene 1A1, and a viral infection. In this paper, we focus on the role of measles virus in otosclerosis, and we review the current literature, devoting particular attention to a suspected paramyxoviral etiopathogenesis in Paget's disease. Our examination of footplate fragments by reverse transcription polymerase chain reaction testing in 95 patients with otosclerosis revealed the presence of measles virus RNA in 83% of cases. Quantification of measles virus immunoglobulin G (IgG) in otosclerosis patients indicated that the ratio of antimeasles virus IgG in total IgG was higher in perilymph than in serum. Furthermore, an almost identical incidence of otosclerosis and measles virus-caused mortality in women suggests that women are more susceptible to measles virus infection. Finally, since the introduction of the measles virus vaccination program in Europe, there has been a decline in the incidence of otosclerosis. Moreover, the average age of patients at diagnosis and surgery at our hospital has increased to 54 years. Our findings, when they are considered along with findings regarding the presence of paramyxoviral RNA in Paget's disease, support the hypothesis that measles virus is involved in the etiopathogenesis of otosclerosis.