This article originally appeared in the Winter 2026 issue of On The Level.
Allergy and autoinflammation drive persistent systemic inflammatory response in Meniere’s Disease: A longitudinal study.
Reviewed by Jose Antonio Lopez-Escamez, MD, PhD
Understanding the Study
This research looked at why Ménière’s disease (MD)—a condition that causes dizzy spells (vertigo), hearing loss, and ear pressure—affects people so differently. Doctors have long suspected that the immune system plays a role, but “inflammation” can mean different things. The study asked:
- Do some patients show signs of allergic inflammation?
- Are there other autoimmune diseases (when the immune system attacks the body)?
- Or autoinflammatory (when the body’s first-line defenses go into overdrive)?
- And can we tell these groups apart using blood tests?
How the Study Was Done
The researchers followed 72 people with Ménière’s disease for two years. Several times during that period, they measured cytokines—proteins that signal inflammation—in each person’s blood. They looked for patterns and tracked whether those patterns stayed the same or changed over time.
They also took some patients’ blood plasma into the lab and exposed it to immune cells to see how it affected them. This helped the scientists understand which type of immune response each patient’s blood triggered.
What They Found
Four clear groups emerged:
- Allergic type (about 25%) – These patients had high IgE, the antibody linked with allergies. Their blood made immune cells behave like those involved in allergic reactions.
- Autoimmune type (about 20%) – These patients had higher TNF-alpha levels, a chemical often elevated in autoimmune diseases.
- Autoinflammatory type (about 13%) – These patients had higher IL-1β, a sign of activation of the NLRP3 inflammasome, part of the body’s “danger alarm” system.
- Low-inflammation type (about 40%) – These people had very low levels of inflammatory markers and they could be part of the patients with genetic mutation.
Most people stayed in the same group throughout the study, suggesting that these immune patterns are relatively stable over time. Some overlap existed—for example, some patients with an allergic-type phenotype also showed autoinflammatory activity, suggesting that inflammation can be mixed.
Why It Matters
Ménière’s disease is probably not a single illness but a group of related disorders with different immune causes. That might explain why one treatment works for some people and not others.
If future studies confirm these findings, doctors could someday use blood tests to personalize treatment:
- Allergy-type patients might benefit from allergy-related medicines.
- Autoinflammatory patients might respond better to drugs that target the inflammasome or the IL-1β pathway.
- Autoimmune-type patients might need therapies that quiet specific immune attacks.
- Those with low inflammation might need completely different, non-immune approaches.
What It Means for Patients
The study doesn’t test treatments, but it offers hope. By identifying clear immune “signatures,” doctors could move toward tailored care instead of one-size-fits-all treatment. About 60% of participants showed some form of inflammation, while 40% did not, reminding us that not every case of Ménière’s disease is driven by inflammation.
Takeaway
This research shows that the immune system plays an important—but varied—role in Ménière’s disease. Recognizing whether a person’s disease is allergic, autoimmune, autoinflammatory, or non-inflammatory could someday guide more effective, individualized treatments.
Source
Lidia Frejo, Francisca E. Cara, Marisa Flook, Paula Robles-Bolivar, Alba Escalera-Balsera, Maria Alharilla Montilla-Ibañez, Emilio Dominguez-Duran, Marta Martinez-Martinez, Patricia Perez-Carpena, Jose Antonio Lopez-Escamez, Allergy and autoinflammation drive persistent systemic inflammatory response in Meniere Disease: A longitudinal study, Clinical Immunology, Volume 271, 2025, 110413, ISSN 1521-6616, https://doi.org/10.1016/j.clim.2024.110413.
