CASP9 genotype confers gentamicin susceptibility in intratympanic treatment of intractable vertigo caused by Ménière's disease

Acta Otolaryngol. 2019 Apr;139(4):336-339. doi: 10.1080/00016489.2019.1575525. Epub 2019 Mar 25.

Abstract

Background: Ménière's disease (MD) is a disorder of the inner ear, causing episodes of vertigo. Although surgery is reserved for intractable MD, intratympanic gentamicin (ITG) injection has become an alternative for controlling vertigo.

Aims/objectives: To investigate the genetic basis of ITG efficacy.

Material and methods: We hypothesized that single nucleotide polymorphisms (SNPs) affect outcomes in patients with MD who receive ITG injections. Whole-exome sequencing was used to determine variations in coding regions.

Results: Multivariate analysis revealed two SNPs, rs1052571 in caspase 9 (CASP9; p = .017) and rs3745274 in cytochrome P450 2B6 (p = .053), which were associated with susceptibility to ITG injections. Only the C-allele in the rs1052571 SNP was significantly associated with susceptibility (p = .027; odds ratio: 5.95; 95% confidence interval: 1.26-28.57, by Fisher's exact test).

Conclusions and significance: Our results elucidated the role of the rs1052571 SNP and provide a genetic perspective on gentamicin efficacy (susceptibility) in treating intractable MD.

Keywords: Ménière’s disease; caspase 9; cytochrome P450 2B6; intratympanic gentamicin treatment; single nucleotide polymorphism.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Caspase 9 / genetics*
  • Female
  • Follow-Up Studies
  • Gentamicins / therapeutic use*
  • Humans
  • Injection, Intratympanic
  • Male
  • Meniere Disease / complications*
  • Middle Aged
  • Pharmacogenomic Variants
  • Polymorphism, Single Nucleotide
  • Protein Synthesis Inhibitors / therapeutic use*
  • Vertigo / drug therapy*
  • Vertigo / etiology

Substances

  • Gentamicins
  • Protein Synthesis Inhibitors
  • CASP9 protein, human
  • Caspase 9