High Serum Levels of Otolin-1 in Patients With Benign Paroxysmal Positional Vertigo Predict Recurrence

Zhenyi Fan; Zhizhou Hu; Weiwei Han; Xiaoxiong Lu; Xiaoxia Liu; Min Zhou; Wang Yan; Yunqin Wu

doi:10.3389/fneur.2022.841677

High Serum Levels of Otolin-1 in Patients With Benign Paroxysmal Positional Vertigo Predict Recurrence

Front Neurol. 2022 Mar 14:13:841677. doi: 10.3389/fneur.2022.841677. eCollection 2022.

Authors

Zhenyi Fan^{1

2}, Zhizhou Hu³, Weiwei Han^{2

4}, Xiaoxiong Lu^{1

2}, Xiaoxia Liu^{1

2}, Min Zhou^{1

2}, Wang Yan^{1

2}, Yunqin Wu^{1

2}

Affiliations

¹ Department of Neurology, Hwa Mei Hospital, University of Chinese Academy of Science, Ningbo, China.
² Ningbo Institute of Life and Health Industry, University of Chinese Academy of Science, Ningbo, China.
³ Department of Neurology, Longyan First Affiliated Hospital, Fujian Medical University, Longyan, China.
⁴ Department of Rehabilitation, Hwa Mei Hospital, University of Chinese Academy of Science, Ningbo, China.

Abstract

Background: Otolin-1 is an inner ear-specific protein that is exclusively expressed in otoconia and vestibule and cochlea cells. Recent investigations reported that otolin-1 can cross the blood-labyrinthine barrier and that the levels in serum well-reflected otolith status. Serum otolin-1 levels in patients with benign paroxysmal positional vertigo (BPPV) are significantly elevated compared with healthy controls. We aimed to explore whether otolin-1 can also serve as a biomarker for predicting BPPV recurrence.

Method: Patients at our institution with new-onset of idiopathic BPPV between May, 2017 and May, 2018 were recruited and followed up for 2 years. All demographic data of the patients were collected, and serum levels of otolin-1 and other laboratory indicators were measured and compared according to the recurrence status.

Results: A total of 74 patients, who met the inclusion criteria were enrolled in this study, of which 27 (36.5%) patients had suffered one or more episodes of recurrence after undergoing canal repositioning treatments during the study. The serum levels of otolin-1 in patients with recurrent BPPV were significantly higher than those in patients without recurrent BPPV (363.9 vs. 309.8 pg/ml, p = 0.001). In multivariate analysis comparing the second to fourth quartiles (Q2-Q4) against the first quartile (Q1) of otolin-1, the level of otolin-1 in Q4 could significantly predict BPPV recurrence, and the odds ratio (OR) was elevated by approximately 812% (OR = 9.12; 95% confidence interval [CI]: 1.44-57.9; p = 0.019).

Conclusion: High serum levels of otolin-1 were associated with an increased risk of BPPV recurrence, and further investigation is required to confirm this association and clarify the exact mechanism.

Keywords: benign paroxysmal positional vertigo; biomarker; canalith repositioning procedure; otolin-1; recurrence.