Kanamycin ototoxicity and pigmentation in the guinea pig

Association of vitiligo with high-frequency sensorineural hearing loss: a systematic review and meta-analysis

The association between vitiligo and hearing loss has been noted but the specific frequencies and degrees of hearing impairment remain unclear. The objective of this systematic review was to investigate the relationship between vitiligo and hearing thresholds at various specific frequencies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE and Embase for relevant studies from inception to 10th April 2021. Case-control studies, cross-sectional, or cohort studies that compared the frequency-specific hearing thresholds between vitiligo patients and age-matched non-vitiligo controls were included. There were neither language nor geographic limitations. We used the Newcastle-Ottawa Scale to assess the risk of bias of included studies. The DerSimonian and Laird random-effects model was utilized in meta-analyses due to expected clinical heterogeneity. We included 9 case-control studies with 371 vitiligo patients and 349 controls, which were rated with low or unclear risk. We found neither relevant cross-sectional nor cohort studies. The meta-analysis showed that when compared with controls, vitiligo patients had significantly higher pure-tone hearing thresholds at 2000, 4000, and 8000 Hz. In conclusions, vitiligo patients are prone to high-frequency sensorineural hearing loss.

Absence of strial melanin coincides with age-associated marginal cell loss and endocochlear potential decline

Cochlear stria vascularis contains melanin-producing intermediate cells that play a critical role in the production of the endocochlear potential (EP) and in maintaining the high levels of K(+) that normally exist in scala media. The melanin produced by intermediate cells can be exported to the intrastrial space, where it may be taken up by strial marginal cells and basal cells. Because melanin can act as an antioxidant and metal chelator, evidence for its role in protecting the stria and organ of Corti against noise, ototoxins, and aging has long been sought. While some evidence supports a protective role of melanin against noise and ototoxins, no evidence yet presented has demonstrated a clear role for melanin in maintaining the EP during aging. We tested this by comparing basal turn EPs and a host of cochlear cellular metrics in aging C57BL/6 (B6) mice and C57BL/6-Tyr(c-2J) mice. The latter mice carry a naturally occurring inactivating mutation of the tyrosinase locus, and produce no strial melanin. Because these two strains are coisogenic, and because pigmented B6 mice show essentially no age-related EP decline, they provide an ideal test of importance of melanin in the aging stria. Pigmented and albino B6 mice showed identical rates of hearing loss and sensory cell loss. However, after two years of age, basal turn EPs significantly diverged, with 42% of albinos showing EPs below 100 mV versus only 18% of pigmented mice. The clearest anatomical correlate of this EP difference was significantly reduced strial thickness in the albinos that was highly correlated with loss of marginal cells. Combined with findings in human temporal bones, plus recent work in BALB/c mice and gerbils, the present findings point to a common etiology in strial presbycusis whereby EP reduction is principally linked to marginal cell loss or dysfunction. For any individual, genetic background, environmental influences, and stochastic events may work together to determine whether marginal cell density or function falls below some critical level, and thus whether EP decline occurs.

Cisplatininduzierte Hörstörungen bei Kindern in Abhängigkeit von der Pigmentierung der Iris

BACKGROUND

Cisplatin is commonly used as a chemotherapeutic agent in the treatment of solid tumors. Ototoxicity is an important side-effect. Melanin in the inner ear either plays an otoprotective role or has a negative influence on hearing. The concentration of cochlear melanin correlates with its concentration in the iris.

PATIENTS AND METHODS

We retrospectively examined 65 children (37 males, 28 females, average age 7.5 years) treated with cisplatin at the University Clinic of Muenster, Germany. We checked whether their eye color could be inferred from the prevalence and extent of cisplatin-induced hearing loss.

RESULTS

We found a hearing loss of >20 dB in 29 light-eyed and in 21 dark-eyed patients. Seven light-eyed and eight dark-eyed patients did not suffer from hearing impairment. Using the chi(2)-test on these four parameters, we found no significant connection between iris pigmentation and the prevalence or extent of hearing loss, although light-eyed children (80.6%) suffered more from hearing loss than dark-eyed children (72.4%). After the end of therapy with cisplatin, the prevalence of hearing loss was 83.3% in children up to 6 years and 71.4% in children older than 6 years. The average cumulative dose of cisplatin was 372 mg/m(2) of body surface in children with hearing loss, compared to 390 mg/m(2) in children without hearing loss.

CONCLUSION

We found no significant correlation between iris pigmentation (eye color) and hearing loss. Cisplatin-induced hearing loss occurs frequently and requires repeated monitoring.

Differential effects of gentamicin on the distribution of cochlear function in albino and pigmented guinea pigs

It has been suggested that the high affinity of melanin pigment for aminoglycoside antibiotics may cause these drugs to bind preferentially to the pigmented inner ear, producing greater ototoxicity than in the amelanotic albino cochlea. However, evidence of greater ototoxicity in albinos has led to the hypothesis that melanin inhibits the toxicity of these drugs in the pigmented inner ear. On the other hand, ototoxicity in the pigmented animals may simply be delayed relative to the albinos, only to become equal or even more severe with time. The present study was conducted to determine whether a relatively low dose of gentamicin (68.5 mg/kg) would produce differential ototoxicity between albino and pigmented guinea pigs which would persist long after drug exposure had stopped. Nine pigmented and eight albino guinea pigs were given gentamicin sulfate for 14 consecutive days, and were then allowed a two-month recovery period before cochlear analysis; 11 pairs of saline-injected or untreated albino and pigmented guinea pigs served as controls. The results showed that the gentamicin-treated albinos had significantly elevated thresholds for the compound action potential from the auditory nerve (CAP), and significantly lower endocochlear potentials (EP) and cochlear microphonic (CM) input-output voltage functions when compared to their respective controls, or to either group of pigmented guinea pigs. The CAP in drug-treated pigmented animals did not differ significantly from controls, and the differences in EP and CM were marginally significant. The results indicate that the pigmented cochlea is less susceptible to gentamicin than the albino cochlea, and support the hypothesis that melanin may inhibit aminoglycoside ototoxicity in the pigmented inner ear.

Distribution and features of melanocytes during inner ear development in pigmented and albino rats

In this developmental study, the distribution and features of melanocytes in the inner ear of pigmented and albino rats was investigated with the use of an antibody, which specifically reacts with a melanocyte differentiation antigen present in the membranes of (pre)melanosomes. Melanocyte precursors could be traced from 13 days post conception onwards and the course was followed to their targets in the inner ear. Melanocytes which settle in the modiolus appeared to reach their target along another pathway than strial and vestibular melanocytes. No difference was observed in the melanocyte distribution between pigmented and albino rats. The integration of melanocytes into the stria vascularis was associated with an increased rate of melanosome production in both strains, but in the albinos far fewer melanosomes were produced. After the stria had reached maturity, melanosome production was arrested and melanosomes were subject to lysosomal digestion. In the stria of the pigmented rats, cells with aggregations of disintegrating melanosomes appeared and persisted into adulthood. In the adult, the majority of the intermediate cells contained only a few scattered melanosomes, while melanosomes could only rarely be detected in the albinos. These observations indicate that there is a close relationship between melanosome production and the process of interdigitation of melanocytes with the marginal cells. It seems unlikely that melanosomes or melanin make any important contribution to the function of the adult stria vascularis. Outside the stria, the features of melanocytes in both strains were similar to skin melanocytes.

Albino and pigmented gerbil auditory function: influence of genotype and gentamicin

Auditory function of albino and pigmented gerbils was examined before and after treatment with the ototoxic aminoglycoside antibiotic gentamicin. Auditory brainstem responses (ABRs) and cochlear nerve compound action potentials (CAPs) were measured in response to pure tones having frequencies between 2 and 32 kHz. Age-matched albinos had significantly lower CAP, but not ABR, thresholds than pigmented gerbils. Gentamicin treatment elevated CAP and ABR thresholds in both genotypes, but pigmented gerbils were less severely affected. Compared to the ABR, the CAP is a more sensitive measure of ototoxicity and pigmentation differences. CAP tuning curves (TCs) were another sensitive measure of genotypic differences in susceptibility to ototoxicity. TC tip thresholds from pigmented animals given gentamicin were not as elevated as the TC tip thresholds of albinos.

Turn-specific and pigment-dependent differences in the stria vascularis of normal and gentamicin-treated albino and pigmented guinea pigs

The aims of the present study were to determine which structures in the stria vascularis (SV) may depend upon the presence of pigmented melanocytes both for normal morphology and for the expression of gentamicin ototoxicity in the inner ear. These pigment-dependent influences were inferred through comparisons of the SV in pigmented guinea pigs and in albinos containing nonpigmented melanocytes. Results were obtained from 6 albino and 8 pigmented guinea pigs given gentamicin, and from 3 albino and 3 pigmented control animals not receiving the drug. One-month old animals received gentamicin daily (100 mg/kg) for 14 days and recovered for an additional 14 days before being prepared for electron microscopy. The SV from each of the 4 cochlear turns was analyzed using stereological point counting procedures. In control animals, differences were found in the higher cochlear turns, where volume density for the marginal cells in albinos was abnormally large (turns 3 and 4), while the volume density for intermediate cells (melanocytes) was abnormally small (turn 3). Cell volume estimates for the intermediate cells were significantly smaller in the albino than pigmented control animals in the higher cochlear turns, indicating that functional abnormalities may be found in the albino cochlea. In animals exposed to gentamicin, marginal cell volume density was reduced significantly in turn 4 of albinos, but not in any region of the pigmented inner ears. Radial area of SV and estimates of the absolute volumes for marginal cells in albinos given gentamicin also were significantly reduced in turn 1 compared to their controls; such differences were not observed in the pigmented animals. The results indicate that marginal cell size is significantly reduced in albino but not pigmented animals 14 days after gentamicin exposure, and further suggest a role of pigmented melanocytes in ameliorating gentamicin-induced cochlear damage.

Melanin in the inner ear. An experimental study with control and kanamycin-intoxicated colored guinea-pigs

Following several studies on the effects of kanamycin toxicity on the inner ears of guinea pigs, we have studied the importance of melanin in this phenomenon. Transmission electron microscopy showed that, under the influence of kanamycin, the intermediate strial cells developed a secretory aspect similar to that seen in skin melanocytes. This aspect as yet has never been described for the inner ear cells. A planimetric, morphometric method was also used to determine the strial cell melanin status in control animals. Additional findings in the study confirmed an increase in the number of melanosomes during kanamycin poisoning. Statistical data are discussed.

Differential susceptibility to gentamicin ototoxicity between albino and pigmented guinea pigs

The known chemical affinity of melanin pigment for aminoglycoside antibiotics has led to the suggestion that higher concentrations of these drugs will bind to the pigmented inner ear and produce greater ototoxicity compared to the nonpigmented albino cochlea. Although this has provided a compelling hypothesis, results from the few investigations to address this question have been equivocal. In the present study, cochlear microphonic (CM) thresholds were recorded from albino and pigmented guinea pigs both before and two weeks after exposure for 14 consecutive days to 100 mg/Kg gentamicin. Cochleae were dissected and half-turn segments prepared for surface examination of the organ of Corti. After gentamicin exposure, threshold shifts averaged a statistically reliable 33 dB in albinos and 19 dB for the pigmented animals. Anatomical studies revealed a significant 44% mean outer hair cell loss in albinos compared to a 21% loss in the pigmented inner ears. The results showed that albinos display greater ototoxicity from gentamicin than do pigmented guinea pigs. Aminoglycosides are known to exert toxicity through interaction with polyphosphoinositides found in high concentrations in the inner ear. Cochleae in both albino and pigmented animals appear to possess significant phospholipid concentrations and bind toxic levels of these drugs independent of inner ear pigment content. However, evidence showing that melanin can inhibit aminoglycoside activity in vitro suggests that, once these drugs bind to pigmented tissue, they may undergo inactivation in a manner unavailable to the nonpigmented albino cochlea. The present results are consistent with the possibility that cochlear melanin may inhibit gentamicin activity in vivo and decrease the severity of aminoglycoside ototoxicity in the pigmented inner ear.

Melanine value in the stria vascularis of pigmented guinea-pigs treated by kanamycin

In a previous report, kanamycin (400 mg/kg/d) seemed to increase the number of melanine granulations in intermediate cells of the stria vascularis, especially in the second and third turns. To precise these data, melanine was studied in those turns by ultrastructural morphometry in a control group with 12 animals. We observed a large intra-individual and inter-individual variation before intoxication. Thus, the meaning of melanine modifications by kanamycin must be carefully evaluated.

Comparative oto-vestibular effects in the pigmented guinea pig after dibekacin and netilmicin treatment

We treated groups of pigmented guinea pigs with either intramuscular netilmicin or dibekacin at 100 and 150 mg/kg per day for 3 weeks. Saline was used as the control solution. All animals were tested weekly for both vestibular and auditory functions. The vestibular function was evaluated by the duration of post-rotatory nystagmus (PRN) elicited by interrupting the rotation of the animal around the vertical axis; auditory function was evaluated by the threshold response for the Preyer's pinna reflex (PPR). All animals were then sacrificed and either their labyrinths or Corti organs were processed for further investigations using the scanning electron microscope (SEM). The duration of PRN decreased over the treatment period in all of the groups as a result of adaptation. However, 150 mg/kg dibekacin produced a significant decrease of the PRN responses as compared to the control and other groups. This effect also continued during the recovery period. Likewise, the PPR threshold of the animals receiving 150 mg/kg dibekacin showed a significant increase at the end of the treatments and during the recovery period, while the other dibekacin group had no significant auditory impairment. Netilmicin at both doses did not significantly affect responses following either vestibular or auditory stimulations. SEM observations demonstrated that the sensory epithelia of the labyrinths and Corti organs affected by 150 mg/kg dibekacin had great losses of stereocilia, while comparable doses of netilmicin (150 mg/kg) had only very moderate losses of stereocilia in the labyrinths but not in the Corti organs.

The ototoxic effects of different doses of gentamicin on the cochlea of pigmented guinea pigs

The aims of this study were twofold: to obtain baseline data on gentamicin ototoxicity in the pigmented guinea pig, and to compare this data with an earlier study in the albino guinea pig. Animals were given ten consecutive daily doses, subcutaneously, of gentamicin at either 50, 75 or 100 mg/kg. Control animals received equivalent volumes of saline. After 3 weeks the animals were killed and their cochleae examined by light microscopy for hair cell damage. Hair cell damage was mapped onto cochleograms and subsequently quantified. Three sets of comparisons of hair cell damage were made: gentamicin group versus control group for each dose; comparisons between doses; pigmented animals versus albino animals. It was found that cochlear hair cell damage increased with increasing dose of gentamicin: 50 mg/kg was minimally ototoxic, 75 mg/kg was more ototoxic and 100 mg/kg was highly ototoxic, affecting a large extent of the spiral organ. There was a large (statistically significant) difference between the lower doses and the damage caused by 100 mg/kg. The pigmented-albino animal comparison showed albino guinea pigs to be more susceptible to gentamicin.

Outer hair cell loss and supporting cell expansion following chronic gentamicin treatment

A sequence of changes in the organ of Corti associated with the destruction of outer hair cells (OHCs) and their replacement by supporting cells following chronic gentamicin treatment has been examined using thin-sections and SEM. The progression of change of OHCs was matched by concomitant expansion of adjacent supporting cells. Hair cells ruptured in the lateral membrane. The apical fragment was retained in the reticular lamina and became surrounded basally by the expanded supporting cells. No large breaches at the surface of the organ of Corti were formed. Rather, it appeared that the tight junctions around the hair cell were maintained until junctions were established between newly adjacent supporting cells in the space once occupied by the hair cell body. Only then was the OHC apex disrupted and the debris released into the sub-tectorial space. Some features of the OHC degeneration process were reminiscent of the controlled, cellular self-destruction phenomenon of apoptosis. The results suggest the possibility that the processes of hair cell loss and replacement may be controlled enabling maintenance of permeability barriers during structural reorganisation.

A morphometric technique for analysis of cochlear vessels

A computer based system was developed for morphometric analysis of the cochlear lateral wall vasculature. Variables measured were vascular density, RBC density, vessel width, aggregation density, lumen compression count, WBC count and pigment density. Vessels were divided into three systems based on the lateral wall structures that they supplied. The results indicated that these three vessel systems were morphologically distinct in terms of their vascular density, RBC density, and vessel width. How these differences relate to functional needs of the lateral wall is discussed.

Use of albino animals for auditory research

Since Hearing Research commenced publication, 51% of reports involving the use of guinea pigs provide no information on whether the animals used were albino or pigmented. Recent evidence creates a strong suspicion that the albino mutation can influence both peripheral and central auditory function. It is concluded that information on pigmentation should always be provided in reports of auditory experiments on guinea pigs, and that the only justification for using albino animals in auditory research is to study effects of the albino mutation on hearing.

Structure side-effect sorting of drugs. VI. Ototoxicities

From a literature survey, over 130 (about 7.8%) drugs and chemicals have been associated with ototoxicities. The major classes are basic aminoglycoside and other antibiotics, anti-inflammatory drugs, antimalarials, beta-blockers, antineoplastic agents, heavy metals, diuretics, some topical agents and various miscellaneous drugs. Possible mechanisms of action are presented and discussed. These include inhibition of protein synthesis, the glycolytic cycle, the TCA cycle, energy utilization, energy generation and the respiratory system within the mitochondria membrane of the hair cell, and also alteration of the permeability of the endolymphatic membrane or alteration of the excretion system for the basic aminoglycosides in the lateral wall of the membranous cochlea. The relative rank order of ototoxicity and reactivity toward mucopolysaccharides of five aminoglycosides is found to be related to the number of basic groups in each molecule.

Some otological differences between pigmented and albino-type guinea pigs

Cochlear action potential thresholds across frequency (AP audiograms) and AP tuning curves were compared in albino (Dunkin-Hartley) guinea pigs and normal pigmented animals. AP audiograms were very similar; on average the albinos had AP thresholds 2-3 dB lower at 2 kHz and below compared with the pigmented guinea pig. AP tuning curves at 16 kHz were, on average, significantly less sharply tuned in the albino, but similar at 8, 4, and 2 kHz. Although we find only small differences in these measures of normal cochlear function, other evidence in the literature suggests that in auditory research the use of "albino" guinea pigs is best avoided.