ArticleFrontiers in neuroscience2026
Serum ENA-78, CXCL1, and caspase-3 are associated with disease severity and early hearing recovery in idiopathic sudden sensorineural hearing loss.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an otologic emergency with highly variable recovery despite prompt treatment. Because inflammatory chemotaxis and apoptosis are implicated in cochlear injury, serum biomarkers reflecting these pathways may improve early risk stratification. Methods: In this single-center observational study, 209 consecutive adults with unilateral ISSNHL and 209 matched healthy controls were enrolled between July 2024 and February 2026. Patients were stratified by initial pure-tone average into mild, moderate, severe, or profound hearing loss. Fasting serum ENA-78, CXCL1, and caspase-3 were quantified at admission by enzyme-linked immunosorbent assay. After standardized 10-day treatment, complete, marked, or partial hearing improvement was classified as favorable early recovery and ineffective treatment as unfavorable. Analyses included multivariable logistic regression, receiver operating characteristic (ROC) analysis, 1,000-sample bootstrap internal validation, comparison with a clinical base model using net reclassification improvement (NRI) and integrated discrimination improvement (IDI), calibration, decision-curve analysis, a nomogram, and prespecified subgroup analyses. Results: All three biomarkers were higher in patients than in controls and increased progressively with severity (all Conclusion: Admission serum ENA-78, CXCL1, and caspase-3 were associated with disease severity and early hearing recovery in ISSNHL. Their combined assessment outperformed any single marker and added value beyond routine clinical variables, although multicenter external validation and longer follow-up remain necessary before clinical implementation.
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