{"id":"https://openalex.org/W7225083012","doi":"https://doi.org/10.3389/fimmu.2026.1950826","title":"Immune heterogeneity and the immune\u2013barrier\u2013hydrops framework in M\u00e9ni\u00e8re\u2019s disease: current evidence, uncertainties, and testable hypotheses","display_name":"Immune heterogeneity and the immune\u2013barrier\u2013hydrops framework in M\u00e9ni\u00e8re\u2019s disease: current evidence, uncertainties, and testable hypotheses","publication_year":2026,"publication_date":"2026-11-02","ids":{"openalex":"https://openalex.org/W7225083012","doi":"https://doi.org/10.3389/fimmu.2026.1950826"},"language":"en","primary_location":{"id":"doi:10.3389/fimmu.2026.1950826","doi":"https://doi.org/10.3389/fimmu.2026.1950826","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1950826","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1950826/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1950826/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5121873084","display_name":"Dongmei Guan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I53411278","display_name":"Chengdu University of Traditional Chinese Medicine","ror":"https://ror.org/00pcrz470","country_code":"CN","type":"education","lineage":["https://openalex.org/I53411278"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Dongmei Guan","raw_affiliation_strings":["Chengdu University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chengdu University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I53411278"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004418422","display_name":"Xinghong Liu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I53411278","display_name":"Chengdu University of Traditional Chinese Medicine","ror":"https://ror.org/00pcrz470","country_code":"CN","type":"education","lineage":["https://openalex.org/I53411278"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xinghong Liu","raw_affiliation_strings":["Chengdu University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chengdu University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I53411278"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5107934163","display_name":"Xiaoyi Zhang","orcid":"https://orcid.org/0000-0002-2344-0856","observed_orcids":["https://orcid.org/0000-0002-2344-0856","https://orcid.org/0009-0004-9090-2100"]},"institutions":[{"id":"https://openalex.org/I53411278","display_name":"Chengdu University of Traditional Chinese Medicine","ror":"https://ror.org/00pcrz470","country_code":"CN","type":"education","lineage":["https://openalex.org/I53411278"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaoyi Zhang","raw_affiliation_strings":["Chengdu University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chengdu University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I53411278"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135791962","display_name":"Zhang Jingqi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I53411278","display_name":"Chengdu University of Traditional Chinese Medicine","ror":"https://ror.org/00pcrz470","country_code":"CN","type":"education","lineage":["https://openalex.org/I53411278"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jingqi Zhang","raw_affiliation_strings":["Chengdu University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chengdu University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I53411278"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5147430204","display_name":"Hui Xie","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210118397","display_name":"Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital","ror":"https://ror.org/01qh26a66","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210118397"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Hui Xie","raw_affiliation_strings":["Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital","institution_ids":["https://openalex.org/I4210118397"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5147430204"],"corresponding_institution_ids":["https://openalex.org/I4210118397"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.79579188,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"17","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10542","display_name":"Vestibular and auditory disorders","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2808","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10542","display_name":"Vestibular and auditory disorders","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2808","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10334","display_name":"Hearing, Cochlea, Tinnitus, Genetics","score":0.0052999998442828655,"subfield":{"id":"https://openalex.org/subfields/2809","display_name":"Sensory Systems"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10861","display_name":"Ear Surgery and Otitis Media","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/meniere-s-disease","display_name":"Meniere's disease","score":1.0},{"id":"https://openalex.org/keywords/endolymphatic-hydrops","display_name":"endolymphatic hydrops","score":0.9549999833106995},{"id":"https://openalex.org/keywords/immune-heterogeneity","display_name":"immune heterogeneity","score":0.8989999890327454},{"id":"https://openalex.org/keywords/blood-labyrinth-barrier","display_name":"blood-labyrinth barrier","score":0.8330000042915344},{"id":"https://openalex.org/keywords/immune-endotypes","display_name":"immune endotypes","score":0.5289999842643738},{"id":"https://openalex.org/keywords/inflammasome-signaling","display_name":"inflammasome signaling","score":0.8169999718666077},{"id":"https://openalex.org/keywords/th2-response","display_name":"Th2 immune response","score":0.8830000162124634},{"id":"https://openalex.org/keywords/mast-cells","display_name":"mast cells","score":0.9940000176429749},{"id":"https://openalex.org/keywords/complement-system","display_name":"complement system","score":0.7620000243186951},{"id":"https://openalex.org/keywords/cytotoxic-t-lymphocytes","display_name":"cytotoxic T lymphocytes","score":0.9589999914169312},{"id":"https://openalex.org/keywords/inner-ear","display_name":"inner ear","score":0.5920000076293945},{"id":"https://openalex.org/keywords/mri-image-enhancement","display_name":"MRI enhancement","score":0.6679999828338623},{"id":"https://openalex.org/keywords/pathogenesis","display_name":"pathogenesis","score":0.4740000069141388}],"concepts":[{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.6559000015258789},{"id":"https://openalex.org/C2777209026","wikidata":"https://www.wikidata.org/wiki/Q412405","display_name":"Inflammasome","level":3,"score":0.5807999968528748},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.4706999957561493},{"id":"https://openalex.org/C169760540","wikidata":"https://www.wikidata.org/wiki/Q207011","display_name":"Neuroscience","level":1,"score":0.4596000015735626},{"id":"https://openalex.org/C136449434","wikidata":"https://www.wikidata.org/wiki/Q428253","display_name":"Innate immune system","level":3,"score":0.4449000060558319},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.4447999894618988},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.423799991607666},{"id":"https://openalex.org/C51785407","wikidata":"https://www.wikidata.org/wiki/Q2627568","display_name":"Effector","level":2,"score":0.41920000314712524},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.39500001072883606},{"id":"https://openalex.org/C89611455","wikidata":"https://www.wikidata.org/wiki/Q6804646","display_name":"Mechanism (biology)","level":2,"score":0.3734999895095825},{"id":"https://openalex.org/C2779341262","wikidata":"https://www.wikidata.org/wiki/Q182581","display_name":"Immunity","level":3,"score":0.3528999984264374},{"id":"https://openalex.org/C193419808","wikidata":"https://www.wikidata.org/wiki/Q1645075","display_name":"Acquired immune system","level":3,"score":0.33709999918937683},{"id":"https://openalex.org/C127716648","wikidata":"https://www.wikidata.org/wiki/Q104053","display_name":"Phenotype","level":3,"score":0.32260000705718994},{"id":"https://openalex.org/C3018263421","wikidata":"https://www.wikidata.org/wiki/Q80083","display_name":"Human studies","level":2,"score":0.3100000023841858},{"id":"https://openalex.org/C2777016536","wikidata":"https://www.wikidata.org/wiki/Q7168713","display_name":"Peripheral tolerance","level":4,"score":0.30809998512268066},{"id":"https://openalex.org/C46762472","wikidata":"https://www.wikidata.org/wiki/Q178648","display_name":"Peripheral","level":2,"score":0.30469998717308044},{"id":"https://openalex.org/C2780607864","wikidata":"https://www.wikidata.org/wiki/Q928697","display_name":"Sensorineural hearing loss","level":3,"score":0.2978000044822693},{"id":"https://openalex.org/C2776914184","wikidata":"https://www.wikidata.org/wiki/Q101991","display_name":"Inflammation","level":2,"score":0.2709999978542328},{"id":"https://openalex.org/C154317977","wikidata":"https://www.wikidata.org/wiki/Q376266","display_name":"Cytotoxic T cell","level":3,"score":0.2660999894142151},{"id":"https://openalex.org/C60644358","wikidata":"https://www.wikidata.org/wiki/Q128570","display_name":"Bioinformatics","level":1,"score":0.2612000107765198},{"id":"https://openalex.org/C2780130043","wikidata":"https://www.wikidata.org/wiki/Q192360","display_name":"Autoimmunity","level":3,"score":0.2547999918460846},{"id":"https://openalex.org/C189014844","wikidata":"https://www.wikidata.org/wiki/Q189118","display_name":"Cell type","level":3,"score":0.25459998846054077},{"id":"https://openalex.org/C2778690821","wikidata":"https://www.wikidata.org/wiki/Q212354","display_name":"Cytokine","level":2,"score":0.25099998712539673}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.3389/fimmu.2026.1950826","doi":"https://doi.org/10.3389/fimmu.2026.1950826","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1950826","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1950826/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:fce029f0a4304eafb91855789eaef059","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/fce029f0a4304eafb91855789eaef059","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Immunology, Vol 17 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fimmu.2026.1950826","doi":"https://doi.org/10.3389/fimmu.2026.1950826","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1950826","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1950826/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9763000011444092}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225083012.pdf","grobid_xml":"https://content.openalex.org/works/W7225083012.grobid-xml"},"referenced_works_count":48,"referenced_works":["https://openalex.org/W1993468405","https://openalex.org/W2024560469","https://openalex.org/W2053783072","https://openalex.org/W2096903431","https://openalex.org/W2158272793","https://openalex.org/W2775697776","https://openalex.org/W2906883698","https://openalex.org/W2948846365","https://openalex.org/W3164458332","https://openalex.org/W3171565847","https://openalex.org/W3186053696","https://openalex.org/W4205698702","https://openalex.org/W4210358368","https://openalex.org/W4211235433","https://openalex.org/W4213282828","https://openalex.org/W4311793061","https://openalex.org/W4313340418","https://openalex.org/W4318484047","https://openalex.org/W4323294685","https://openalex.org/W4376126763","https://openalex.org/W4381548118","https://openalex.org/W4385752084","https://openalex.org/W4385932990","https://openalex.org/W4386225752","https://openalex.org/W4386325494","https://openalex.org/W4386915754","https://openalex.org/W4386988769","https://openalex.org/W4386995847","https://openalex.org/W4389372815","https://openalex.org/W4392122468","https://openalex.org/W4393403561","https://openalex.org/W4400123071","https://openalex.org/W4404876346","https://openalex.org/W4405011517","https://openalex.org/W4405020557","https://openalex.org/W4408276929","https://openalex.org/W4410510947","https://openalex.org/W4413962578","https://openalex.org/W4414002821","https://openalex.org/W4414398191","https://openalex.org/W4415621453","https://openalex.org/W4416389325","https://openalex.org/W7126051305","https://openalex.org/W7130344946","https://openalex.org/W7134047479","https://openalex.org/W7154105531","https://openalex.org/W7161305208","https://openalex.org/W7164924391"],"related_works":["https://openalex.org/W2045817706","https://openalex.org/W2049047264","https://openalex.org/W1993845422","https://openalex.org/W2424710920","https://openalex.org/W2807793030","https://openalex.org/W4251884307","https://openalex.org/W1513560041","https://openalex.org/W4416389325","https://openalex.org/W2329115040","https://openalex.org/W2334012366"],"abstract_inverted_index":{"M\u00e9ni\u00e8re\u2019s":[0],"disease":[1,83],"presents":[2],"with":[3,26,305],"episodic":[4],"vertigo,":[5],"fluctuating":[6],"sensorineural":[7],"hearing":[8],"loss,":[9],"tinnitus,":[10],"and":[11,14,35,56,59,87,100,106,119,135,140,159,180,215,258,282,308,319],"aural":[12],"fullness,":[13],"commonly":[15],"features":[16],"endolymphatic":[17],"hydrops.":[18,48,181],"Yet":[19],"similar":[20],"hydropic":[21,161,265],"phenotypes":[22],"arise":[23],"in":[24,69,210,267],"patients":[25],"markedly":[27],"different":[28],"clinical":[29,303],"courses,":[30],"patterns":[31],"of":[32,82,109,197],"bilateral":[33],"involvement,":[34],"treatment":[36,239],"responses,":[37],"suggesting":[38],"that":[39,219,251,259,301],"more":[40],"than":[41],"one":[42],"upstream":[43],"process":[44],"may":[45,185],"lead":[46],"to":[47,65,172,249],"Human":[49],"tissue":[50,78],"studies,":[51],"peripheral":[52,134],"immune":[53,67,178,236,260,278,307],"profiling,":[54],"allergy-":[55],"autoimmunity-associated":[57],"findings,":[58],"blood\u2013labyrinth":[60,167],"barrier":[61,168],"imaging":[62,136,310],"all":[63],"point":[64],"possible":[66],"contributions":[68],"some":[70],"patients.":[71],"Their":[72],"interpretation":[73],"remains":[74,212],"constrained":[75],"by":[76,315],"selected":[77],"sources,":[79],"inconsistent":[80],"definitions":[81],"stage,":[84],"heterogeneous":[85],"assays,":[86],"limited":[88],"independent":[89],"replication.":[90],"We":[91,124,143],"examined":[92],"four":[93,150],"candidate":[94],"effector":[95],"mechanisms:":[96],"innate":[97],"inflammatory":[98],"amplification":[99],"inflammasome":[101],"signaling;":[102],"type":[103],"2":[104],"immunity":[105],"mast-cell-mediated":[107],"modulation":[108],"vascular":[110],"or":[111,116,156,195,233],"fluid":[112],"homeostasis;":[113],"antibody-,":[114],"immune-complex-,":[115],"complement-mediated":[117],"injury;":[118],"antigen-specific":[120],"cytotoxic":[121],"T-cell":[122],"injury.":[123],"distinguished":[125],"direct":[126],"observations":[127,288],"from":[128,133],"the":[129,166,203,230],"human":[130,317],"inner":[131],"ear":[132],"associations,":[137],"experimental":[138],"perturbations,":[139],"mechanistic":[141,280],"inference.":[142],"then":[144],"evaluated":[145],"these":[146,226],"evidence":[147,222],"streams":[148],"against":[149],"competing":[151,292],"causal":[152,204,283],"structures:":[153],"immune-first,":[154],"hydrops-":[155],"tissue-stress-first,":[157],"common-upstream-factor,":[158],"nonimmune":[160,198],"models.":[162,293],"In":[163],"this":[164],"framework,":[165],"is":[169,262,272],"not":[170,224],"assumed":[171],"be":[173],"an":[174,213],"obligatory":[175],"step":[176],"between":[177],"activation":[179],"Its":[182],"biological":[183],"state":[184],"instead":[186],"act":[187],"as":[188],"a":[189,254],"mediator,":[190],"effect":[191],"modifier,":[192],"common":[193],"consequence,":[194],"component":[196],"microvascular":[199],"disease,":[200],"depending":[201],"on":[202],"structure":[205],"under":[206],"consideration.":[207],"MRI":[208],"enhancement,":[209],"turn,":[211],"imperfect":[214],"protocol-dependent":[216],"proxy":[217],"for":[218,238,264,276],"state.":[220],"Current":[221],"does":[223],"distinguish":[225],"models":[227,296],"reliably":[228],"at":[229],"individual-patient":[231],"level":[232],"support":[234],"stable":[235],"endotypes":[237],"selection.":[240],"It":[241],"does,":[242],"however,":[243],"make":[244],"two":[245],"stronger":[246],"claims":[247],"difficult":[248],"sustain:":[250],"MD":[252],"follows":[253],"universal":[255],"immune-first":[256],"sequence":[257],"activity":[261],"required":[263],"progression":[266],"every":[268],"patient.":[269],"The":[270],"framework":[271],"therefore":[273],"most":[274],"useful":[275],"separating":[277],"detection,":[279],"contribution,":[281],"initiation,":[284],"while":[285],"specifying":[286],"which":[287],"would":[289],"discriminate":[290],"among":[291],"Resolving":[294],"those":[295],"will":[297],"require":[298],"longitudinal":[299],"cohorts":[300],"align":[302],"events":[304],"repeated":[306],"standardized":[309],"measurements,":[311],"complemented":[312],"where":[313],"feasible":[314],"local":[316],"samples":[318],"pathway-specific":[320],"perturbation.":[321]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-11-03T00:00:00"}
