BackgroundThe mechanisms of Meniere's disease (MD) remain largely unknown. The purpose of this study was to identify possible genetic variants associated with immune regulation in MD.MethodsThe whole immune genome of 16 Chinese patients diagnosed with sporadic MD was sequenced using next-generation sequencing.ResultsDefinite pathological variants ofMEFV(c.1223G>A, c.1105C>T),COL7A1(c.5287C>T), andADA(c.445C>T) contributing to the clinical phenotype were found in three patients. Limited and likely pathological variants ofTLR3(c.2228G>A) andRAB27A(c.560G>A) were detected in one patient each. The following definite pathological variants impairing the structure and function of translated proteins were detected in 10 patients, and multigene variants occurred in five patients:PRF1(c.710C>A),UNC13D(c.1228A>C),COLEC11(c.169C>T),RAG2(c.200G>C),BLM(c.1937G>T),RNF31(c.2533G>A),FAT4(c.11498A>G),PEPD(c.788A>G),TNFSF12(c.470G>A),VPS13B(c.11972A>T),TNFRSF13B(c.226G>A),ERCC6L2(c.4613A>G),TLR3(c.2228G>A),ADA(c.445C>T),PEPD(c.151G>A), andMOGS(c.2470G>A). The following limited pathological variants impairing the structure and function of translated proteins were detected in five patients, with double gene variants identified in one patient:EXTL3(c.1396G>A),MTHFD1(c.2057G>A),FANCA(c.2039T>C),LPIN2(c.1814C>T),NBAS(c.4049T>C), andFCN3(c.734G>A).ConclusionPatients with sporadic MD carry multiple genetic variants involved in multiple steps of immune regulation, which might render patients susceptible to developing inflammation via both autoimmune and autoinflammation mechanisms upon internal stress.