Potential role of angiotensin II in noise-induced increases in inner ear blood flow

Transportation Noise Pollution and Cardiovascular Health

Epidemiological studies have found that transportation noise increases the risk for cardiovascular morbidity and mortality, with solid evidence for ischemic heart disease, heart failure, and stroke. According to the World Health Organization, at least 1.6 million healthy life years are lost annually from traffic-related noise in Western Europe. Traffic noise at night causes fragmentation and shortening of sleep, elevation of stress hormone levels, and increased oxidative stress in the vasculature and the brain. These factors can promote vascular (endothelial) dysfunction, inflammation, and arterial hypertension, thus elevating cardiovascular risk. The present review focusses on the indirect, nonauditory cardiovascular health effects of noise. We provide an updated overview of epidemiological research on the effects of transportation noise on cardiovascular risk factors and disease, and mechanistic insights based on the latest clinical and experimental studies and propose new risk markers to address noise-induced cardiovascular effects in the general population. We will discuss the potential effects of noise on vascular dysfunction, oxidative stress, and inflammation in humans and animals. We will elaborately explain the underlying pathomechanisms by alterations of gene networks, epigenetic pathways, circadian rhythm, signal transduction along the neuronal-cardiovascular axis, and metabolism. We will describe current and future noise mitigation strategies. Finally, we will conduct an overall evaluation of the status of the current evidence of noise as a significant cardiovascular risk factor.

Health position paper and redox perspectives - Disease burden by transportation noise

Transportation noise is a ubiquitous urban exposure. In 2018, the World Health Organization concluded that chronic exposure to road traffic noise is a risk factor for ischemic heart disease. In contrast, they concluded that the quality of evidence for a link to other diseases was very low to moderate. Since then, several studies on the impact of noise on various diseases have been published. Also, studies investigating the mechanistic pathways underlying noise-induced health effects are emerging. We review the current evidence regarding effects of noise on health and the related disease-mechanisms. Several high-quality cohort studies consistently found road traffic noise to be associated with a higher risk of ischemic heart disease, heart failure, diabetes, and all-cause mortality. Furthermore, recent studies have indicated that road traffic and railway noise may increase the risk of diseases not commonly investigated in an environmental noise context, including breast cancer, dementia, and tinnitus. The harmful effects of noise are related to activation of a physiological stress response and nighttime sleep disturbance. Oxidative stress and inflammation downstream of stress hormone signaling and dysregulated circadian rhythms are identified as major disease-relevant pathomechanistic drivers. We discuss the role of reactive oxygen species and present results from antioxidant interventions. Lastly, we provide an overview of oxidative stress markers and adverse redox processes reported for noise-exposed animals and humans. This position paper summarizes all available epidemiological, clinical, and preclinical evidence of transportation noise as an important environmental risk factor for public health and discusses its implications on the population level.

Noise and Air Pollution as Risk Factors for Hypertension: Part II-Pathophysiologic Insight

Traffic noise and air pollution are environmental stressors found to increase risk for cardiovascular events. The burden of disease attributable to environmental stressors and cardiovascular disease globally is substantial, with a need to better understand the contribution of specific risk factors that may underlie these effects. Epidemiological observations and experimental evidence from animal models and human controlled exposure studies suggest an essential role for common mediating pathways. These include sympathovagal imbalance, endothelial dysfunction, vascular inflammation, increased circulating cytokines, activation of central stress responses, including hypothalamic and limbic pathways, and circadian disruption. Evidence also suggests that cessation of air pollution or noise through directed interventions alleviates increases in blood pressure and intermediate surrogate pathways, supporting a causal link. In the second part of this review, we discuss the current understanding of mechanisms underlying and current gaps in knowledge and opportunities for new research.

Transportation noise pollution and cardiovascular disease

Epidemiological studies have found that transportation noise increases the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischaemic heart disease. According to the WHO, ≥1.6 million healthy life-years are lost annually from traffic-related noise in Western Europe. Traffic noise at night causes fragmentation and shortening of sleep, elevation of stress hormone levels, and increased oxidative stress in the vasculature and the brain. These factors can promote vascular dysfunction, inflammation and hypertension, thereby elevating the risk of cardiovascular disease. In this Review, we focus on the indirect, non-auditory cardiovascular health effects of transportation noise. We provide an updated overview of epidemiological research on the effects of transportation noise on cardiovascular risk factors and disease, discuss the mechanistic insights from the latest clinical and experimental studies, and propose new risk markers to address noise-induced cardiovascular effects in the general population. We also explain, in detail, the potential effects of noise on alterations of gene networks, epigenetic pathways, gut microbiota, circadian rhythm, signal transduction along the neuronal-cardiovascular axis, oxidative stress, inflammation and metabolism. Lastly, we describe current and future noise-mitigation strategies and evaluate the status of the existing evidence on noise as a cardiovascular risk factor.

Oxidative stress and inflammation contribute to traffic noise-induced vascular and cerebral dysfunction via uncoupling of nitric oxide synthases

Environmental pollution and non-chemical stressors such as mental stress or traffic noise exposure are increasingly accepted as health risk factors with substantial contribution to chronic noncommunicable diseases (e.g. cardiovascular, metabolic and mental). Whereas the mechanisms of air pollution-mediated adverse health effects are well characterized, the mechanisms of traffic noise exposure are not completely understood, despite convincing clinical and epidemiological evidence for a significant contribution of environmental noise to overall mortality and disability. The initial mechanism of noise-induced cardiovascular, metabolic and mental disease is well defined by the „noise reaction model“ and consists of neuronal activation involving the hypothalamic-pituitary-adrenal (HPA) axis as well as the sympathetic nervous system, followed by a classical stress response via cortisol and catecholamines. Stress pathways are initiated by noise-induced annoyance and sleep deprivation/fragmentation. This review highlights the down-stream pathophysiology of noise-induced mental stress, which is based on an induction of inflammation and oxidative stress. We highlight the sources of reactive oxygen species (ROS) involved and the known targets for noise-induced oxidative damage. Part of the review emphasizes noise-triggered uncoupling/dysregulation of endothelial and neuronal nitric oxide synthase (eNOS and nNOS) and its central role for vascular dysfunction.

•

Exposure to (traffic) noise causes non-auditory (indirect) cardiovascular and cerebral health harms via neuronal activation.

•

Noise activates the HPA axis and sympathetic nervous system increasing levels of stress hormones, vasoconstrictors and ROS.

•

Noise induces inflammation and stimulates several ROS sources leading to cerebral and cardiovascular oxidative damage.

•

Noise leads to eNOS and nNOS uncoupling contributing to cardiometabolic disease and cognitive impairment.

Physiology of Local Renin-Angiotensin Systems

Since the first identification of renin by Tigerstedt and Bergmann in 1898, the renin-angiotensin system (RAS) has been extensively studied. The current view of the system is characterized by an increased complexity, as evidenced by the discovery of new functional components and pathways of the RAS. In recent years, the pathophysiological implications of the system have been the main focus of attention, and inhibitors of the RAS such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin (ANG) II receptor blockers have become important clinical tools in the treatment of cardiovascular and renal diseases such as hypertension, heart failure, and diabetic nephropathy. Nevertheless, the tissue RAS also plays an important role in mediating diverse physiological functions. These focus not only on the classical actions of ANG on the cardiovascular system, namely, the maintenance of cardiovascular homeostasis, but also on other functions. Recently, the research efforts studying these noncardiovascular effects of the RAS have intensified, and a large body of data are now available to support the existence of numerous organ-based RAS exerting diverse physiological effects. ANG II has direct effects at the cellular level and can influence, for example, cell growth and differentiation, but also may play a role as a mediator of apoptosis. These universal paracrine and autocrine actions may be important in many organ systems and can mediate important physiological stimuli. Transgenic overexpression and knock-out strategies of RAS genes in animals have also shown a central functional role of the RAS in prenatal development. Taken together, these findings may become increasingly important in the study of organ physiology but also for a fresh look at the implications of these findings for organ pathophysiology.

Loss of Peripheral Right-Ear Advantage in Age-Related Hearing Loss

In young adults with normal hearing, the right ear is more sensitive than the left to simple sounds (peripheral right-ear advantage) and to processing complex sounds such as speech (central right-ear advantage). In the present investigation, the effects of hearing loss and aging on this auditory asymmetry were examined at both peripheral and central levels. Audiograms and transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission amplitudes were used to assess cochlear function. The contralateral suppression of TEOAEs was measured to assess the medial olivocochlear efferent system. The Hearing in Noise Test (HINT; binaural speech) was conducted to assess higher central auditory function. A group of aged subjects with normal hearing (flat audiograms) were compared to a group of aged subjects with sloping audiograms (presbycusis). At the cochlear (peripheral) level, the normal hearing group showed significantly higher otoacoustic emission amplitudes for the right ear compared to the left ear, which is consistent with the right-ear dominance normally seen in young adults. However, this finding was reversed in the presbycusic group that showed higher left-ear emission amplitudes. At the brainstem level, the amplitudes of TEOAE contralateral suppression were small and no significant difference was found between the right and left ears in both groups. On the contrary, HINT results showed a continuous dominance of the right ear (left hemisphere) in both groups, which was consistent with previous reports showing that the right hemisphere is more affected by age than the left hemisphere.

Sarthran preserves cochlear microcirculation and reduces temporary threshold shifts after noise exposure

The cause of noise-induced hearing loss remains unclear despite years of both epidemiologic and experimental investigation. Among the many possible pathophysiologic mechanisms that may contribute to noise-induced temporary or permanent threshold shifts are insufficiencies in cochlear blood flow. Although the literature is inconsistent, several histologic and physiologic studies demonstrate signs of reduced circulation in the cochlea after noise exposure. Recent studies using computer-enhanced intravital microscopy complement these earlier findings. Evidence suggests that these microcirculatory events are mediated in part by several circulating factors, including the potent vasoactive peptide angiotensin. This study investigated this possibility by pretreating with the angiotensin receptor antagonist sarthran during noise exposure and examining both cochlear microcirculation and auditory sensitivity. The results of these experiments show noise-induced ischemia in the lateral wall of the cochlea and temporary threshold shifts. Treatment with sarthran prevented this noise-induced microcirculatory ischemia and preserved auditory sensitivity at the low frequencies tested. These findings support a role for the angiotensinergic system during noise exposure and suggest that preservation of cochlear blood flow is functionally related to auditory sensitivity.

Correlative evidence of hypertension and altered cochlear microhomeostasis: electrophysiological changes in the spontaneously hypertensive rat

The spontaneously hypertensive rat model has been used to show that hypertension is an important pathophysiological risk factor in age-related hearing loss. In the present study, compound action potential (CAP), electrochemical potential (ECP), and potassium concentration (CK+) measurements were taken from the cochlea of genetically predisposed, spontaneously hypertensive rats (SHR) and from normotensive Wistar-Kyoto (WKY) rats. In the SHR model, as the duration of hypertension increased with the animal's age (from 3 to 8 months), CAP thresholds increased, ECP increased in marginal cells only, and CK+ increased in both endolymph and marginal cells. Collectively, the data suggest that ionic alternations of cellular potentials are involved in hearing changes in the hypertensive state. Ultimately, such data may assist in understanding hearing loss in individuals who are diagnosed with hypertension.

Noise-induced elevations of plasma endothelin (ET-3)

The endothelins (ETs) are a novel family of peptides which participate in hemodynamic homeostasis. Elevated levels of circulating ETs are evident in several stress related conditions and are associated with a variety of vascular pathophysiologies. The purpose of the current study was to test the possibility that plasma concentrations of endothelin increase following noise exposure using radioimmunoassay (RIA). No difference in plasma endothelin was detected in rats subjected to brief noise exposure (30 min of 100 dB SPL broad-band noise) compared to control animals. Statistically significant elevations in plasma endothelin (ET-3) were measured in animals exposed to prolonged noise exposure (90 min and 72 h of 100 dB SPL broad-band noise). These results suggest that hemodynamic alterations, and potential vascular pathophysiologies accompanying prolonged exposure to noise are mediated by endothelin.

Brain angiotensin receptor subtypes in the control of physiological and behavioral responses

This review summarizes emerging evidence that supports the notion of a separate brain renin-angiotensin system (RAS) complete with the necessary precursors and enzymes for the formation and degradation of biologically active forms of angiotensins, and several binding subtypes that may mediate their diverse functions. Of these subtypes the most is known about the AT1 site which preferentially binds angiotensin II (AII) and angiotensin III (AIII). The AT1 site appears to mediate the classic angiotensin responses concerned with body water balance and the maintenance of blood pressure. Less is known about the AT2 site which also binds AII and AIII and may play a role in vascular growth. Recently, an AT3 site was discovered in cultured neoblastoma cells, and an AT4 site which preferentially binds AII(3-8), a fragment of AII now referred to as angiotensin IV (AIV). The AT4 site has been implicated in memory acquisition and retrieval, and the regulation of blood flow. In addition to the more well-studied functions of the brain RAS, we review additional less well investigated responses including regulation of cellular function, the modulation of sensory and motor systems, long term potentiation, and stress related mechanisms. Although the receptor subtypes responsible for mediating these physiologies and behaviors have not been definitively identified research efforts are ongoing. We also suggest potential contributions by the RAS to clinically relevant syndromes such as dysfunctions in the regulation of blood flow and ischemia, changes in cognitive affect and memory in clinical depressed and Alzheimer's patients, and angiotensin's contribution to alcohol consumption.

Substance P increases cochlear blood flow without changing cochlear electrophysiology in rats

Carotid artery infusions of substance P yielded reductions in systemic blood pressure and elevations in cochlear blood flow (CoBF), measured via laser Doppler flowmeter, with no alterations in cochlear action potentials or cochlear microphonics in Wistar-Kyoto rats. Additionally, direct micro-infusions of substance P into the anterior inferior cerebellar artery, which contributes to the local vascular perfusion of the cochlea, yielded elevations in CoBF with no changes in systemic blood pressure. Pretreatment with a specific substance P receptor antagonist, ([D-Pro2,D-Trp7,9]SP) via the carotid artery or the anterior inferior cerebellar artery, diminished subsequent substance P-induced vascular responses. These results suggest that endogenous substance P, like other vasoactive peptides, may interact with a substance P-specific receptor population in the cochlea and may therefore participate in the ongoing regulation of CoBF. These findings also support the premise that vasodilatory hormones, along with vasoconstrictive agents, may be involved in the autoregulation of CoBF.

Regulatory role of brain angiotensins in the control of physiological and behavioral responses

Considerable evidence now indicates that a separate and distinct renin-angiotensin system (RAS) is present within the brain. The necessary precursors and enzymes required for the formation and degradation of the biologically active forms of angiotensins have been identified in brain tissues as have angiotensin binding sites. Although this brain RAS appears to be regulated independently from the peripheral RAS, circulating angiotensins do exert a portion of their actions via stimulation of brain angiotensin receptors located in circumventricular organs. These circumventricular organs are located in the proximity of brain ventricles, are richly vascularized and possess a reduced blood-brain barrier thus permitting accessibility by peptides. In this way the brain RAS interacts with other neurotransmitter and neuromodulator systems and contributes to the regulation of blood pressure, body fluid homeostasis, cyclicity of reproductive hormones and sexual behavior, and perhaps plays a role in other functions such as memory acquisition and recall, sensory acuity including pain perception and exploratory behavior. An overactive brain RAS has been identified as one of the factors contributing to the pathogenesis and maintenance of hypertension in the spontaneously hypertensive rat (SHR) model of human essential hypertension. Oral treatment with angiotensin-converting enzyme inhibitors, which interfere with the formation of angiotensin II, prevents the development of hypertension in young SHR by acting, at least in part, upon the brain RAS. Delivery of converting enzyme inhibitors or specific angiotensin receptor antagonists into the brain significantly reduces blood pressure in adult SHR. Thus, if the SHR is an appropriate model of human essential hypertension (there is controversy concerning its usefulness), the potential contribution of the brain RAS to this dysfunction must be considered during the development of future antihypertensive compounds.

Effects of various noise exposures on endocochlear potentials correlated with cochlear gross responses

Changes in endocochlear potentials (EP), cochlear microphonics (CM), and compound action potentials (CAP) with noise exposure were investigated in guinea pigs. The animals were anesthetized and immobilized and exposed to white noise at intensities ranging from 105 to 125 dB. The negative EP (N-EP) was induced by anoxia and was investigated during and after noise exposure. It was found that the general EP (G-EP, the sum of both positive EP (P-EP) and N-EP) increased remarkably during exposure to 115 dB noise but decreased during exposure to 125 dB noise. A smaller absolute value of N-EP was encountered only during exposure to 125 dB noise. The results shed light on the relationship between EP and CM, CAP changes, and the potential mechanism of EP change and its significance in noise-induced hearing loss.

Effect of angiotensin II on the endolymphatic sac direct current potential

The effect of angiotensin II (ANG II), known as a potent pressor hormone, on the endolymphatic sac direct current potential (ESP) was examined. Intravenous administration of ANG II produced a reversible decrease in the ESP at doses exceeding 0.1 microgram/kg. The effect of ANG II on the ESP was dose-dependent at doses of less than 3 micrograms/kg with a saturated effect at doses of more than 3 micrograms/kg. The maximum reduction of the ESP produced by ANG II was 33.8 +/- 2.9% (m +/- SE, n = 6) of the original amplitude. The action of ANG II on the ESP was blocked by propranolol (beta-adrenergic antagonist). The mechanism underlying the action of ANG II on the ESP is discussed.

The influence of intra-arterial infusion of arginine vasopressin on cochlear blood flow in the rat

Intra-arterially infused arginine vasopressin (AVP) elevated systemic blood pressure (BP) in the Sprague-Dawley rat according to a dose-response pattern while cochlear blood flow (CoBF), as measured by laser Doppler flowmetry, was elevated only at the highest dose. Skin blood flow (SBF) decreased significantly with AVP infusion. The local infusion of AVP into the anterior inferior cerebellar artery (AICA), which supplies the common cochlear artery, produced significant dose-dependent reductions in CoBF with no changes in systemic blood pressure. Pretreatment of the local cochlear supplying vessels with an AVP-specific V1 receptor antagonist attenuated subsequent AVP-induced decreases in CoBF, thereby demonstrating specificity of the response. These results suggest that CoBF is reasonably stable in response to systemic AVP infusion until blood pressure exceeds an elevation from base level of approximately +60 mm Hg. One of the mechanisms responsible for this autoregulatory response may be vasoconstriction mediated by the interaction of vasoactive peptides such as AVP and its receptors located in the vasculature of the inner ear or in the more peripheral vessels directly supplying the cochlea.

Relationship between cochlear blood flow and perilymphatic oxygen tension

To clarify the characteristics of the blood circulation in the cochlea, we correlated cochlear blood flow and perilymphatic oxygen tension at various blood pressures. Cochlear blood flow was measured in guinea pigs by laser Doppler flowmetry, and perilymphatic oxygen tension by polarography. Blood pressure changes were induced by angiotensin II injection, trimetaphan camsylate injection and blood withdrawal. Cochlear blood flow generally paralleled systemic blood pressure, indicating a close correlation. In contrast, perilymphatic oxygen tension was slower to increase and decrease. However, when systemic blood pressure was lowered more gradually, perilymphatic oxygen tension did not show the same lag. These findings indicate that perilymphatic oxygen tension parallels systemic blood pressure when changes induced are slower and in a physiological range.

Androgenic effects on angiotensin II-induced blood pressure and cochlear blood flow changes in rats

Ovariectomized, castrated, and sham-castrated rats pretreated with oil or testosterone were intra-arterially infused with saline and three doses of angiotensin II while blood pressure and cochlear blood flow were measured. The results indicated a positive dose-response relationship for blood pressure and cochlear blood flow. Sham-castrated males had higher mean blood pressure responses than castrated males, followed by ovariectomized females. Cochlear blood flow responses were higher in the sham-castrated males than the ovariectomized females, followed by the castrated males. In comparison to the male groups, the ovariectomized females evidenced the lowest, middle, and highest cochlear blood flow responses to the three increasing doses of angiotensin II. Testosterone pretreatment facilitated angiotensin-induced cochlear blood flow elevations in all three angiotensin doses. These results suggest that endogenous and exogenous androgens may alter blood pressure and/or cochlear blood flow responses to angiotensin II via different mechanisms.

Changes in endocochlear potential during anoxia after intense noise exposure

Endocochlear potentials (EPs) were investigated in healthy guinea pigs and in those exposed to white noise of 125 dB SPL for 20-80 min. EPs were measured during and after temporary anoxia (3.5 min, denoted as reversible anoxia) and then during continuous anoxia to evaluate noise-induced changes in EP properties. Succino-dehydrogenase (SDH) activity and morphologic changes in hair cells were also evaluated in surface preparations of the hair cells. It was found that changes in EPs correlated with the duration of noise exposure. The longer the noise exposure, the greater the decrease in EPs. EPs could recover in one week post-exposure, in roughly the same time needed for recovery of SDH activity in hair cells. Noise exposure also resulted in some changes in EP dynamic behaviour during and after reversible anoxia, but did not cause any significant change in maximal negative EP. The mechanisms underlying these results are discussed.

Laser light transmission and laser Doppler blood flow measurements on the human, rat and guinea pig cochlea

In order to test the applicability of laser-Doppler flowmetry in monitoring cochlear blood flow clinically, the thickness and the helium-neon laser light transmission of specimens of human, rat and guinea pig promontory bone and human skin were determined. Furthermore, comparative laser-Doppler measurements were taken from the promontory in patients, rats and guinea pigs. Due to the different thicknesses of the promontory bone in different species, the light transmission was found to be considerably higher for the animal cochlea (rat, 15%; guinea pig, 6.6%) than the human cochlea (1.7%). However, a clearly higher laser-Doppler signal was recorded from both the human and the rat cochleas as compared with the guinea pig. The relative laser light attenuation by the human skin specimens corresponded to that of the human promontory bone. The findings are discussed with regard to the suitability of the laser-Doppler method for blood flow measurements in the human cochlea.

A comparison of laser Doppler and intravital microscopic measures of cochlear blood flow

Many inner ear disorders may be caused by alterations in cochlear blood flow (CBF). However, each measurement technique used to monitor CBF has limitations in examining the relationship between otopathologic states and blood flow. This study investigates laser Doppler flowmetry (LDF) and its fundamental drawback: the unknown relationship of LDF output to actual CBF. LDF readings are directly compared with concurrent intravital microscopy (IVM) measures of erythrocyte velocity in the lateral wall of the guinea pig cochlea. Positive end expiratory pressure, spontaneous respiration of 5% and 10% carbon dioxide, phenylephrine, and direct electrical stimulation of the cochlea were used to manipulate CBF. High, positive correlations were found between simultaneous LDF and IVM measurements of CBF. In addition, the study demonstrated that current microdissection techniques used to perform IVM do not cause changes in CBF. IVM measurements of CBF are a more sensitive indicator of CBF changes than are LDF measures. Despite the high correlation between measurement techniques within a single manipulation, simultaneous LDF and IVM measurements differed between manipulations. This may reflect regional changes in CBF affected by these manipulations and differences in the sampled vascular beds contributing to these two measures. It is unlikely that a single calibration factor can be defined that would allow the conversion of LDF output to actual units of blood flow across different manipulations used to alter CBF.

The effects of intracerebroventricularly administered angiotensin II on blood pressure and cochlear blood flow in rats and guinea pigs

Guinea pigs and Sprague-Dawley rats were intracerebroventricularly (icv) infused with various doses of angiotensin II (AII) in order to investigate central control of and species differences in cochlear blood flow (CBF) and blood pressure (BP). The results indicated a positive dose-response relationship between icv infusions of AII for BP and CBF in members of both species. This relationship was more predictable in the guinea pig than in the rat. In addition, responses to similar AII doses between species indicated that: a) BP elevations were significantly greater in the rat than in the guinea pig, b) CBF elevations were not significantly different between the rats and guinea pigs, and c) CBF was more highly correlated with BP in the guinea pig than in the rat. These results suggest that different relationships may exist between BP and CBF in rats and guinea pigs.

Cochlear blood flow autoregulation in Wistar-Kyoto rats

Wistar-Kyoto rats (WKY) were intra-arterially infused with angiotensin II (AII) or phenylephrine for 10 min. Both vasoactive compounds produced an initial increase in cochlear blood flow (CoBF) as measured by laser Doppler flowmetry, followed by a slow steady return to baseline, despite sustained elevations in systemic blood pressure. These results suggest autoregulation of CoBF in the WKY rat. In a second experiment. All was infused directly into the anterior inferior cerebellar artery (AICA) which feeds the cochlear artery. Significant reductions in CoBF were noted without changes in systemic blood pressure. Pretreatment with the specific angiotensin-receptor antagonist, sarthran (Sar1, Thr8-AII), diminished subsequent AII-induced reductions in CoBF. These results indicate that AII binding to vascular receptors may induce vasoconstriction in the supplying vessels of the cochlea, and thus, the interaction of blood-borne AII and vascular angiotensin receptors may participate in the autoregulation of CoBF.

Blood pressure and cochlear blood flow in the guinea pig

The relationship between blood pressure and cochlear blood flow was investigated in 68 guinea pigs, using the vasoactive drugs angiotensin II, norepinephrine, phentolamine, isoproterenol, dobutamine, salbutamol, propranolol, bradykinin, papaverine, vinpocetine dilazep, and brovincamine. Cochlear blood flow increases markedly and proportionately to increases in blood pressure. By contrast, cochlear blood flow shows various responses toward a fall in blood pressure. In general, cochlear blood flow appears relatively resistant to blood pressure decrease.

Autoregulation of cochlear blood flow in normotensive and spontaneously hypertensive rats following intracerebroventricularly mediated adjustment of blood pressure

Previous studies in our laboratory (Quirk et al., 1988) noted significantly impaired elevations in cochlear blood flow (CoBF) during systemic infusion of the potent vasoconstrictive agent angiotensin II (AII) in the spontaneously hypertensive rat (SHR) as compared with the normotensive Wistar-Kyoto (WKY) rat, despite similar increases in systemic blood pressure. We interpreted these results to suggest that SHRs have an exaggerated autoregulatory mechanism that controls blood supply to the cochlear vessels. However, an alternative explanation for these findings concerns the potential influence of the elevated baseline blood pressure of the SHR on CoBF. Specifically, if there is an absolute threshold blood pressure that triggers an autoregulatory response in the cochlea, then the SHRs would reach that threshold sooner than normotensive animals because they begin at a baseline blood pressure that is well above that of the WKY rat. The present study addressed this possibility by pharmacologically reducing SHR blood pressure to WKY baseline blood pressure and raising WKY to SHR baselines, followed by the infusion of previously utilized doses of AII. The results are consistent with previous findings and support our interpretation of an exaggerated autoregulation of cochlear blood supplying the SHR.

Cochlear blood flow: measurement techniques

The measurement of inner ear blood flow and other microvascular variables is subject to unique technical problems which are compounded by methodological limitations. As a result, the interpretation of experimental results is often difficult. This report discusses the most important methods currently available for cochlear blood circulation measurements and the technical problems associated with their use. The use of a combination of measurements to resolve problems of interpretation is stressed. An extensive review of the pertinent literature is provided in relation to each method.

The effects of pentoxifylline on cochlear blood flow in normotensive and spontaneously hypertensive rats

Normotensive and spontaneously hypertensive rats (SHRs) were given arterial infusions of saline and pentoxifylline in doses of 1.5, 2.0, and 3.0 mg/kg/min. Blood pressure decreased in a dose related fashion with increasing doses of pentoxifylline. Cochlear blood flow, measured via laser Doppler flowmeter, increased with infusion of pentoxifylline in members of both rat strains, but to a greater extent in SHRs than in normotensive animals. The mechanism of action appears to be decreased red blood cell rigidity which allows increased penetration of red blood cells into microvessels of the cochlea.

Blood pressure in resting, anesthetized and noise-exposed guinea pigs

This study investigated blood pressure in guinea pigs while they were 1) alert and free moving, 2) anesthetized with different anesthetics, and 3) exposed to continuous, 115 dB SPL white noise under anesthesia. The animals were prepared with a carotid artery catheter and permitted to recover for 48 h before blood pressure levels were measured. Mean arterial blood pressure in the resting, unrestrained guinea pig was 64 mmHg (+/- 1.38 S.E.). Ketamine Hydrochloride (Ketamine) significantly decreased, and Fentanyl-Citrate significantly increased, blood pressure. Fentanyl-Droperidol produced no substantial blood pressure change. Guinea pigs anesthetized with Fentanyl-Citrate and Fentanyl-Droperidol demonstrated significant blood pressure increases when exposed to noise, with the Fentanyl-Citrate group showing a greater response. Animals anesthetized with Ketamine Hydrochloride exhibited no significant blood pressure changes when exposed to the noise.

Angiotensin II and progesterone effects on laser Doppler measures of cochlear blood flow

Anesthetized, ovariectomized rats were given bolus injections of angiotensin II (AII) or saline vehicle while Cochlear Blood Flow (CBF) changes were measured using a laser Doppler flowmeter. Experimental animals were pretreated with replacement progesterone and control animals were given oil vehicle injections in place of progesterone. AII increased blood pressure and CBF. Progesterone pretreatment augmented AII-induced pressor responses, while slightly depressing the cochlear blood flow response. These results suggest that AII may be involved in the local, autoregulatory control of CBF, and in possible steroid-related alterations of susceptibility to ototraumas.

Angiotensin II-induced changes in cochlear blood flow and blood pressure in normotensive and spontaneously hypertensive rats

Previous investigations in our laboratory have measured significant increases in the circulating levels of the potent vasoconstrictive hormone, angiotensin II (AII; 26 and 64 pg/100 microliters plasma, normal and noise exposed, respectively), during and following noise exposure in the alert rat (Wright et al., 1981). In the present study, these levels were approximated through intra-arterial infusion in the anesthetized spontaneously hypertensive rat (SHR) and normotensive Wistar-Kyoto (WKY) rat. Laser Doppler flowmeter measurements of cochlear blood flow (CBF) indicated that despite equivalent AII-induced elevations in systemic blood pressure, CBF in the SHR did not increase to the levels measured in the WKY. Pretreatment with the specific angiotensin receptor antagonist sarile, (Sar1,Ile8-AII), reduced AII-induced elevations in systemic blood pressure in members of both strains, but did not change the overall pattern of CBF. These results indicate that SHRs may have a compromised cochlear circulation that is refractory to increases in systemic blood pressure.

Ionic changes in cochlear endolymph of the guinea pig induced by acoustic injury

The effects of acoustic overstimulation on the endocochlear potential (EP) and on concentrations of ions (K+, Na+, Cl-, H+, HCO3-, and Ca2+) in endolymph were investigated using ion-selective microelectrodes. A slight but significant elevation of the EP and alkalinization of the endolymph were induced by acoustic overstimulation, whereas there was little change in the K+, Na+, Cl-, and HCO3- concentrations. The changes in H+ and HCO3- concentrations implied a depression of PCO2, suggesting an increase in blood flow to the cochlea. On the other hand, the Ca2+ concentration increased abruptly to 48 times the pre-exposure value. In contrast, no significant change in the Ca2+ concentration was observed in cochleae with damaged hair cells. We discuss the mechanism of the tone-induced Ca2+ elevation in endolymph and its effect on hearing acuity.

Recent advances in cochlear blood flow measurements

Changes in blood flow to the inner ear have been thought to influence or underlie a number of cochlear diseases, including some forms of noise-induced hearing loss, sudden hearing loss, and Meniere's disease. Recently, important advances have been made in two technologies for the study of cochlear blood flow. The first is in the area of vital microscopic studies of cochlear microcirculation, and the second is based on the introduction of laser technology in the form of laser Doppler flowmetry. In this report, measurements are given of changes in cochlear circulation caused by carbon dioxide breathing, intravenous phenylephrine injection, systemic hemodilution, positive end expiratory pressure, and direct electrical stimulation of the cochlea. From these changes, we observe that cochlear blood circulation responds to systemic blood pressure alterations and is subject to local flow control mechanisms. Linearity and speed of response of the laser Doppler instrumentation also are shown. These advances show promise for contributing to our knowledge of control mechanisms of inner ear blood flow and for revealing the influence of various pharmacologic agents of potential clinical value.

Ovarian steroid and vasoconstrictor effects on cochlear blood flow

Ovariectomized rats received intra-arterial infusions of phenylephrine and nicotine. Estrogen treatment for five days prior to these challenges diminished laser Doppler measures of cochlear blood flow (CBF) responses to phenylephrine and blood pressure responses to nicotine. Progesterone enhanced CBF responses to both phenylephrine and nicotine; combined progesterone and estrogen treatment enhanced blood pressure responses to phenylephrine. These results suggest that ovarian steroid-mediated cardiovascular effects may influence cochlear blood flow and potentially hearing functions.

Histological measures of cochlear blood flow. A validation study

Cochlear blood flow in guinea pigs was assessed using histological assessment of various red blood cell and vessel lumen parameters. Cochlear blood flow was either enhanced by administration of carbogen or inhibited by induced positive airway pressure. The resulting enhancement or reduction of blood flow in the cochlea was verified by laser Doppler velocimetry. The results generally indicate that the two measures of cochlear blood flow agree. This agreement was especially apparent when histological parameters of the vessel lumen were considered and when external wall vessels were evaluated.

The effects of nicotine on laser Doppler measures of cochlear blood flow

Anesthetized guinea pigs were given arterial bolus injections of saline or varying nicotine concentrations. Blood flow through the cochlea and skin were measured via laser Doppler and arterial blood pressure via an arterial cannula. Cochlear blood flow increased with low doses of nicotine but decreased with the highest dose, while blood pressure increased and skin flow decreased with all doses of nicotine. Control injections of saline vehicle had only minor and transient effects.