Ménières & HERPES

If you haven’t heard about the connection between Meniere’s Disease and Herpes Viruses then I suggest you start by reading one of my earlier and most popular posts, “Ménière’s Disease: Is Psychoneuroimmunology (PNI) & Herpes the Cause?"

There are currently 47 studies on PubMed dating back to 1952 which discuss Meniere’s Disease and herpes viruses, with the most recent studies published in 2008. Many of these studies show a link between Meniere’s Disease and Herpes Viruses &/or suggest further research. Why then have there been no further studies?

Meniere sufferers from all over the globe comment that they have benefited from incorporating herpes antiviral strategies into their health regimens (such as L-Lysine &/or Acyclovir). This warrants serious consideration by the medical community, particularly those that represent us.

Below are extracts from some of those studies, for a complete list go to PubMed to search “meniere herpes”. Search PubMed

For information on the antiviral medications Acyclovir, Famciclovir & L-Lysine  read my post.

Some studies discussing Ménières & Herpes Simplex Virus (HSV):

2008

“Herpes virus and Ménière's disease.”

Gartner M, Bossart W, Linder T. Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Luzern, Luzern, Switzerland.

The main goal of this study was to examine the vestibular ganglia from patients with intractable classic Ménière's disease (MD) for the presence or absence of DNA from three neurotropic viruses herpes simplex virus 1 and 2 (HSV1, HSV2) and varicella zoster virus (VZV) and to investigate the hypothesis that MD is associated with virus reactivation within Scarpa's ganglion. Although HSV and VZV appear to be present in many ganglion cells throughout the human body, we were unable to find genomic DNA of these viruses in patients with definite MD and disabling vertigo, who underwent vestibular neurectomy. Based on these results, reactivation of HSV1 and VZV in the vestibular ganglion does not seem to play a role in the pathogenesis of MD.

2008

“Sequence Variants in Host Cell Factor C1 Are Associated With Ménière’s Disease”

Jeffrey T. Vrabec, Liqian Liu, Bingshan Li, and Suzanne M. Leal. Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A. Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, U.S.A

Is there a genetic basis for the development of Ménière’s (MD) disease? 

The minor allele at each SNP site was significantly more common in controls, suggesting that individuals bearing these alleles are at reduced risk of developing MD. The functional consequences of the SNPs in host cell factor C1 are unknown. A viable hypothesis for disease development is presented based on the known interaction between HCFC1 and the herpes simplex viral protein VP16.

2007

“Viral infection and serum antibodies to heat shock protein 70 in the acute phase of Ménière's disease.”

DiBerardino F, Cesarani A, Hahn A, Alpini D. Department of Audiology-Ear, Nose, and Throat, I.R.C.C.S. Fondazione Policlinico, Mangiagalli e Regina Elena, University of Milan, Italy.

Though Ménière's disease (MD) etiology is unknown, growing evidence suggests that autoimmunity may be involved in its development. The aim of this prospective study was to investigate the presence of anti-heat shock protein 70 (anti-HSP70) antibodies during the acute phase of MD and to relate its presence to the antibody pattern. We examined the sera of 13 patients by Western blot immunoassays for reactivity to bovine inner-ear antigen (anti-HSP70) antibodies. The presence of viral antibodies and autoantibodies (herpes simplex, types 1, 2; herpes zoster; cytomegalovirus; Epstein-Barr; IgM; IgG; cardiolipin; thyroglobulin and thyroperoxidase; and antinuclear, antimitochondrial, and anti-smooth-cell antibodies) were also tested. We found reactivity to HSP70 in only 1 of the 13 MD patients (7.7%), and it occurred during herpes zoster reactivation. We found no relationship between the presence of antibodies to HSP70 and immunological or viral testing.

2004

“Incidence of virus infection as a cause of Meniere's disease or endolymphatic hydrops assessed by electrocochleography.”

Selmani Z, Marttila T, Pyykkö I. Department of Otolaryngology, Central Hospital of Satakunta, Sairaalantie 3, 28130, Pori, Finland.

Meniere's disease (MD) may follow viral infection such as by neurotropic viruses known to invade the endolymphatic sac (ES) and provoke endolymphatic hydrops (EH). The objective of this study was to investigate whether neurotropic viruses may cause infection of the inner ear and provoke EH. Antiviral immunoglobulin (IgG) assay against herpessimplex 1 (HSV1), herpes simplex 2 (HSV2), adenovirus (ADV), varicella zoster virus (VZV) and cytomegalovirus (CMV) were performed in 109 patients with an advanced stage of MD and compared with those obtained from 26 patients operated on because of vestibular schwannoma (VS), who served as a control group, to evaluate whether there is an association between the IgG levels and the ECoGs summating potential/action potential ratio (SP/AP ratio) in the MD group. In MD patients, the IgG titre against VZV and ADV were significantly higher than in the control (schwannoma) group. However, no correlation was found between the IgG levels against ADV and VZV with the SP/AP ratio. Neurotropic viruses such VZV and ADV may play a role in the pathogenesis of MD, despite the absence of association between the levels of IgG titres and the SP/AP ratio.

2004

“Randomized double-blinded, placebo-controlled clinical trial of famciclovir for reduction of Ménière's disease symptoms.”

Derebery MJ, Fisher LM, Iqbal Z. House Ear Institute, Los Angeles, California 90057, USA.  

Conducted a clinical trial of famciclovir for symptom control in Meniere's disease.

Famciclovir may suppress the fluctuation of hearing in Meniere's disease, but had a minimal effect on vertigo or dizziness symptoms in this study. The probable multifactorial etiology in Meniere's disease requires that further studies be conducted to determine the effects of antiviral medications.

2003

 “Herpes simplex virus and Meniere's disease”.

Vrabec JT. Bobby R Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas, USA.

This study was designed to investigate the hypothesis that Meniere's disease is associated with herpes simplex virus (HSV) reactivation in the vestibular ganglion. The study provides supportive evidence for a viral etiology in Meniere's disease.

1997

“Herpes simplex virus antibodies in the perilymph of patients with Menière disease.”

Arnold W, Niedermeyer HP. Department of Otolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, Technical University, Munich, Germany.

Evaluate the presence of IgG antibodies directed to herpes simplex virus (HSV) in the perilymph of patients with Menière disease.

Our results show the presence of HSV IgG in the perilymph of patients with Menière disease and support the hypothesis that HSV may play an important role in the etiopathogenesis of Menière disease.

1996

“Detection of viral antigen in the endolymphatic sac.”

Kumagami H. Department of Otolaryngology, School of Medicine, Nagasaki University, Japan.

A study was devised to determine whether or not any immune defense mechanism is present when a virus invades the human endolymphatic sac (ES). The ES was removed from 14 fresh autopsy cases having no known pre-mortem diseases in the middle and inner ears. Specimens were then examined for viral antigens including herpes simplex (HSV) type 1 and 2, mumps and cytomegalovirus using immunohistochemical methods. DNA examination by in situ hybridization was also performed for HSV. HSV antigen and DNA were observed in 9 of the 14 cases studied. These findings suggest that the virus invades the ES but is impeded by an immune defense mechanism under normal conditions. Since disease may alter host defenses, further studies are warranted to study the relationship between HSV and patients with Meniere's disease.

1995

“Patients with Meniére's disease possess IgE reacting with herpes family viruses.”

Calenoff E, Zhao JC, Derlacki EL, Harrison WH, Selmeczi K, Dutra JC, Olson IR, Hanson DG. Department of Otolaryngology and Head and Neck Surgery, Northwestern University Medical School, Chicago, Ill, USA.

Determine if patients with Meniere's disease possess serum IgE specific for herpes simplex virus (HSV) type 1, HSV type 2, Epstein-Barr virus, and/or cytomegalovirus.

(1) Most patients with Meniere's disease possess virus-specific IgE in their serum samples; (2) four viruses of the herpes family are capable of inducing such IgE-mediated sensitization; and (3) latent virus-specific, IgE-mediated inflammation may be an important factor in the initiation and/or sustenance of Meniere's disease.

1992

“Ménière's disease and antibody reactivity to herpes simplex virus type 1 polypeptides.”

Bergström T, Edström S, Tjellström A, Vahlne A. Department of Clinical Virology, University of Göteborg, Sahlgrens Hospital, Sweden.

It has been reported that the inner ear is capable of responding to antigen challenge. In this study, we have investigated the antibody reactivity to herpes simplex virus 1 (HSV-1) proteins in sera from patients with Ménière's disease. The HSV-1 antibody response found in patients with Ménière's disease may indicate viral reactivation and denotes the importance of further studies on the role of infectious agents in this disease.

A study discussing Herpes Zoster Oticus (HZO) & Meniere’s Syndrome Complex:

2006

“Herpes Zoster Oticus with Ménière's Syndrome Complex”

R. Meher, S. Varshney, P. Gupta, R.K. Srivastava: Herpes Zoster Oticus With Ménière's Syndrome Complex. The Internet Journal of Otorhinolaryngology. 2006 Volume 4 Number 2

We discuss a case of herpes zoster oticus with Ménière's syndrome complex in a 27 year old male. The patient presented with herpes zoster oticus with varicelliform rash, facial nerve palsy and Ménière's syndrome complex type symptoms i.e. deafness, tinnitus, vertigo, nystagmus, nausea, and vomiting. Patient was managed medically and recovered with some residual facial palsy and sensorineural hearing loss.

Severe form of Herpes zotser can involve whole of the of the vestibulocochlear nerve along with facial nerve in its entire course producing picture like Ménière's syndrome. Diagnosis in such cases can be made clinically supplemented by audiometry and MRI. Acyclovir therapy in cases of herpes zoster oticus is effective in control of disease and prevents the incidence of permanent facial palsy and treatment should be started early. Steroids reduce the incidence of post herpetic neuralgia and enhances facial nerve recovery.