High resolution two-dimensional electrophoresis: technique and potential applicability to the study of inner ear disease.

Technologic progress in two-dimensional polyacrylamide gel electrophoresis (2-D Page), in combination with immunoblotting, amino acid sequencing, and computer-assisted image analysis, allowed establishment of human body fluid and tissue "reference maps," which in turn enabled meaningful comparison of data from various clinical and research centers. Altered protein profiles have been observed in plasma/serum, cerebrospinal fluid, urine, and other body fluids in numerous systemic or localized pathologic entities. Human perilymph, obtained during ear surgery or post mortem, exhibits a protein profile differing from plasma in several ways. Most interesting are the extremely high levels of high density lipoprotein-associated proteins, a group of proteins thought to play a role in atherosclerosis, nerve damage/regeneration, chronic inflammation, and Alzheimer's disease, among others. A technique is described for collection and analysis of human perilymph, using a state-of-the-art standardized 2-D Page technique. It is expected that, as in other body fluids, disease-specific protein patterns will be identified. With the possible exception of presumed perilymphatic fistula, it is not envisioned that analysis of perilymph will be used for diagnostic purposes but rather as an aid for the elucidation of the mechanisms underlying inner ear disease, whether localized or as part of systemic alterations.