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Apaydın E, Dağlı E, Bayrak S, Kankılıç ES, Şahin H, Acar A. Protective effect of creatine on amikacin-induced ototoxicity. Braz J Otorhinolaryngol 2020; 88:651-656. [PMID: 33121925 PMCID: PMC9483946 DOI: 10.1016/j.bjorl.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction Aminoglycosides are widely known for their ototoxic side effects. Nevertheless, they are potent antibiotics used in the treatment of life-threatening conditions because of the current concern for antibiotic resistance. We hypothesized that creatine supplements which are believed to improve mitochondrial antioxidant defense system and maintain optimal energy homeostasis may improve the ototoxic side effects. Objective This study aimed to investigate the protective effects of creatine monohydrate against ototoxicity induced by amikacin in rats in an experimental animal model, using distortion product otoacoustic emissions and auditory brainstem response. Methods Twenty healthy rats were assigned to four groups (5 rats in each): the control group, the creatine monohydrate group, the amikacin group and the amikacin + creatine monohydrate group. The creatine monohydrate group received creatine at a dose of 2 g/kg once daily via gastric gavage for 21 days. The amikacin group received amikacin at a dose of 600 mg/kg by intramuscular injections once daily for 21 days. The amikacin + creatine monohydrate group received intramuscular injections of amikacin (600 mg/kg) once daily for 21 days and creatine monohydrate (2 g/kg) once daily via gastric gavage for 21 days. The control group received nothing. The distortion product otoacoustic emissions and auditory brainstem response measurements were performed on all rats on days 0, 7, 21. Results Regarding auditory brainstem response values, a significant increase in the auditory threshold was observed in the amikacin group on day 21 (p < 0.001). The amikacin+creatine monohydrate group showed significantly lower levels of auditory brainstem response auditory thresholds on day 21 in comparison to the amikacin group (p < 0.001). Additionally, the control group and the amikacin+creatine monohydrate group did not differ significantly with respect to auditory brainstem response thresholds on treatment day 21 (p > 0.05). When we compare distortion product otoacoustic emissions values, there was no significant difference between the amikacin and amikacin+creatine monohydrate groups on day 7 (p > 0.05), However significantly greater distortion product otoacoustic emissions values were observed in the amikacin+creatine monohydrate group on day 21 compared to the amikacin group (p < 0.001). Conclusion Our findings demonstrate that creatine treatment protects against amikacin ototoxicity when given at a sufficient dose and for an adequate time period.
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Affiliation(s)
- Emre Apaydın
- Kecioren Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey.
| | - Elif Dağlı
- Kecioren Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey; Guven Private Hospital, Department of Audiology, Ankara, Turkey
| | - Sevinç Bayrak
- Kecioren Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey
| | - Ekrem Said Kankılıç
- Kecioren Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey
| | - Hasan Şahin
- Guven Private Hospital, Department of Audiology, Ankara, Turkey
| | - Aydın Acar
- Kecioren Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey
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Fujimoto C, Yamasoba T. Mitochondria-Targeted Antioxidants for Treatment of Hearing Loss: A Systematic Review. Antioxidants (Basel) 2019; 8:E109. [PMID: 31022870 PMCID: PMC6523236 DOI: 10.3390/antiox8040109] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/22/2023] Open
Abstract
Mitochondrial dysfunction is associated with the etiologies of sensorineural hearing loss, such as age-related hearing loss, noise- and ototoxic drug-induced hearing loss, as well as hearing loss due to mitochondrial gene mutation. Mitochondria are the main sources of reactive oxygen species (ROS) and ROS-induced oxidative stress is involved in cochlear damage. Moreover, the release of ROS causes further damage to mitochondrial components. Antioxidants are thought to counteract the deleterious effects of ROS and thus, may be effective for the treatment of oxidative stress-related diseases. The administration of mitochondria-targeted antioxidants is one of the drug delivery systems targeted to mitochondria. Mitochondria-targeted antioxidants are expected to help in the prevention and/or treatment of diseases associated with mitochondrial dysfunction. Of the various mitochondria-targeted antioxidants, the protective effects of MitoQ and SkQR1 against ototoxicity have been previously evaluated in animal models and/or mouse auditory cell lines. MitoQ protects against both gentamicin- and cisplatin-induced ototoxicity. SkQR1 also provides auditory protective effects against gentamicin-induced ototoxicity. On the other hand, decreasing effect of MitoQ on gentamicin-induced cell apoptosis in auditory cell lines has been controversial. No clinical studies have been reported for otoprotection using mitochondrial-targeted antioxidants. High-quality clinical trials are required to reveal the therapeutic effect of mitochondria-targeted antioxidants in terms of otoprotection in patients.
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Affiliation(s)
- Chisato Fujimoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
- Department of Otolaryngology, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan.
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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El-Anwar MW, Abdelmonem S, Nada E, Galhoom D, Abdelsameea AA. Protective effect of pentoxifylline on amikacin-induced ototoxicity. EAR, NOSE & THROAT JOURNAL 2018; 97:E8-E12. [PMID: 30138519 DOI: 10.1177/014556131809700802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We conducted an animal experiment to assess the effect of adding pentoxifylline to amikacin to prevent amikacin-induced ototoxicity. This research was conducted on 24 rats arranged in four groups of 6. One group was injected with 200 mg/kg of intramuscular amikacin once daily for 14 days (AMK-only group). Another received 25 mg/kg of oral pentoxifylline and 200 mg/kg of intramuscular amikacin once daily for 14 days (PTX-AMK 14/14 group). A third group received 25 mg/kg of oral pentoxifylline for 28 days and 200 mg/kg of intramuscular amikacin once daily for 14 days on days 15 through 28 of the pentoxifylline regimen (PTX-AMK 28/14 group). Finally, a control group was administered 1 ml/day of 0.5% carboxymethyl cellulose for 28 days. Transient otoacoustic emissions (TOAEs) were statistically analyzed and serum urea and creatinine levels were measured before and after treatment. We found no significant differences in TOAEs among the groups at the study's onset, but after the experiment, TOAEs disappeared in all frequency bands in the AMK-only and PTX-AMK 14/14 groups. However, TOAEs were preserved in the PTX-AMK 28/14 group. In addition, the serum urea and creatinine levels in the PTX/AMK 28/14 group were significantly lower than the levels in the other two treatment groups (p < 0.05 for all), but not significantly different from those of the control group. We conclude, therefore, that 28 days of pentoxifylline treatment exerted a protective effect against amikacin-induced ototoxicity in rats.
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Affiliation(s)
- Mohammad Waheed El-Anwar
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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Therapeutic and protective effects of autologous serum in amikacin-induced ototoxicity. The Journal of Laryngology & Otology 2017; 132:33-40. [PMID: 29151378 DOI: 10.1017/s0022215117002304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Possible therapeutic and protective benefits of intratympanic autologous serum application in amikacin-induced ototoxicity were investigated. METHODS Twenty-four guinea pigs were separated equally into two groups: therapeutic (group A) and protective (group B). Transient evoked otoacoustic emissions were recorded before and after autologous serum application. Apoptotic cells were identified in the organ of Corti, spiral limbus and spiral ganglion by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling ('TUNEL') method. RESULTS Transient evoked otoacoustic emission responses at 1, 1.4 and 2.8 kHz improved without significance after autologous serum application in group A (p > 0.05). A significantly protective effect of autologous serum was determined at 4 kHz in group B (p < 0.05). There were significantly fewer apoptotic cells at the spiral limbus in the therapeutic and protective groups compared to the control group (p < 0.05). CONCLUSION Autologous serum may offer protection against ototoxicity-induced hearing loss, but it cannot restore hearing. Immunohistochemically, autologous serum significantly decreases activation of the intrinsic pathway of pro-apoptotic signalling in mesenchymal cells compared to neurons and neurosensory cells.
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An Evaluation of the Protective Effects of Thymoquinone on Amikacin-Induced Ototoxicity in Rats. Clin Exp Otorhinolaryngol 2015; 8:312-9. [PMID: 26622947 PMCID: PMC4661244 DOI: 10.3342/ceo.2015.8.4.312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 09/28/2014] [Accepted: 10/20/2014] [Indexed: 01/27/2023] Open
Abstract
Objectives In this study we investigated the probable protective effects of thymoquinone on amikacin-induced ototoxicity in rats. Methods Thirty-two healthy rats were divided into four groups (amikacin, amikacin+thymoquinone, thymoquinone, and no treatment). Thymoquinone was fed to the rats via oral gavage in a dose of 40 mg/kg/day throughout the study period of 14 days. Amikacin was given by the intramuscular route in a dose of 600 mg/kg/day. Audiological assessment was conducted by the distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) tests, administered to all rats at the beginning of the study, and also on days 7 and 15. Biochemical parameters were calculated at the termination of the study to evaluate the oxidative status. Results There were significant decreases in DPOAE values and significant increases in ABR thresholds of the amikacin group on days 7 and 15, as compared to the amikacin+thymoquinone group. While ABR thresholds of the amikacin group increased significantly on days 7 and 15 as compared to their initial values, there were no significant differences between the initial and the 7th and 15th day values of ABR thresholds in the amikacin+thymoquinone group. Total oxidant status and oxidative stress index values of the amikacin+thymoquinone group were significantly lower than those of the amikacin group. Total antioxidant status values of the amikacin+thymoquinone group were significantly higher than those of the amikacin group. Conclusion Our study has demonstrated that the ototoxic effect brought forth by amikacin could be overcome with the concurrent use of thymoquinone.
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Aksoy F, Dogan R, Ozturan O, Yildirim YS, Veyseller B, Yenigun A, Ozturk B. Betahistine exacerbates amikacin ototoxicity. Ann Otol Rhinol Laryngol 2014; 124:280-7. [PMID: 25358613 DOI: 10.1177/0003489414557020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Betahistine augments cochlear blood flow and is currently used as an efficient therapeutic agent. Amikacin is used in a wide range of areas, but its ototoxic effect continues to be problematic. This study investigates the effect of betahistine on amikacin-induced ototoxicity. METHODS Thirty-two healthy rats were randomized to 4 groups of 8 rats in each group (amikacin, amikacin+betahistine, betahistine, and no treatment). Amikacin was administered intramuscularly to groups 1 and 2 for 14 days. Betahistine was delivered by oral gavage to groups 2 and 3 for 21 days. Distortion-product otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) tests were conducted on all rats. RESULTS There were significant decreases in the DPOAE levels and significant increases in the ABR thresholds of the amikacin and amikacin+betahistine groups on the 7th, 14th, and 21st days, as compared to their basal values. The DPOAE levels of the amikacin+betahistine group significantly decreased on days 7, 14, and 21, and the ABR thresholds significantly increased on the same days, as compared to the amikacin group. CONCLUSION Our study implies that amikacin's ototoxic effects are augmented by the concurrent use of betahistine. Experimental and clinical research, supported by histopathological studies, is needed to affirm our findings.
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Affiliation(s)
- Fadlullah Aksoy
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Remzi Dogan
- Bayrampasa State Hospital, Department of Otorhinolaryngology, Bayrampasa, Istanbul, Turkey
| | - Orhan Ozturan
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Yavuz Selim Yildirim
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Bayram Veyseller
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Alper Yenigun
- Karaman State Hospital, Department of Otorhinolaryngology, Karaman, Turkey
| | - Burak Ozturk
- Bezmialem Vakif University, Faculty of Health Sciences, Department of Audiology, Fatih, Istanbul, Turkey
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Aksoy F, Dogan R, Ozturan O, Eren SB, Veyseller B, Pektas A, Hüseyinbas Ö. Protective effect of trimetazidine on amikacin-induced ototoxicity in rats. Int J Pediatr Otorhinolaryngol 2014; 78:663-9. [PMID: 24582075 DOI: 10.1016/j.ijporl.2014.01.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 01/20/2014] [Accepted: 01/22/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Aminoglycoside antibiotics are known to have ototoxic effects and may induce sensorineural hearing loss. This study investigated the protective effect of trimetazidine, which has antioxidant and cytoprotective properties, against amikacin ototoxicity. METHODS Thirty-two male rats were divided into four groups - amikacin, amikacin + trimetazidine, trimetazidine, and control groups. Trimetazidine, 10 mg/kg per day, was given for 14 days by oral gavage. Amikacin, 600 mg/kg per day, was also given for 14 days, by the intramuscular route. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) tests were applied to the rats for hearing assessment. At the termination of the study, the biochemical parameters were calculated to evaluate the oxidative status. RESULTS The DPOAE values of the amikacin group were significantly lower on the 7th and 14th days than those of the trimetazidine + amikacin group and there was an increase in the ABR thresholds. The ABR thresholds for the amikacin group on the 7th and 14th days were significantly higher than the levels on the first day of the study, while there was no significant increase in those values in the trimetazidine + amikacin group. The total oxidant status (TOS) and oxidant status index (OSI) values of the amikacin group were significantly higher than those of the trimetazidine + amikacin group. The total antioxidant status (TAS) values of the amikacin group were lower than those of the trimetazidine + amikacin group. CONCLUSIONS The audiologic tests and biochemical parameters investigated in this study both point to the protective effect of trimetazidine against amikacin-induced ototoxicity.
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Affiliation(s)
- Fadlullah Aksoy
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Remzi Dogan
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
| | - Orhan Ozturan
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Sabri Baki Eren
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Bayram Veyseller
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Alev Pektas
- Bezmialem Vakif University, Faculty of Health Sciences, Department of Audiology, Fatih, Istanbul, Turkey
| | - Önder Hüseyinbas
- Bezmialem Vakif University, Research Center, Fatih, Istanbul, Turkey
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Kent A, Turner MA, Sharland M, Heath PT. Aminoglycoside toxicity in neonates: something to worry about? Expert Rev Anti Infect Ther 2014; 12:319-31. [PMID: 24455994 DOI: 10.1586/14787210.2014.878648] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Toxicity has limited the use of aminoglycosides and adult studies report high rates of both ototoxicity and nephrotoxicity. Conversely paediatric studies have shown lower rates and extended interval dosing may have reduced toxicity further. We review the animal and human evidence for aminoglycoside toxicity in neonates including mechanisms, measurement and rates of toxicity; and differences between aminoglycosides and dosing regimens. We discuss genetic susceptibility and the impact of other synergistic effects.
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Affiliation(s)
- Alison Kent
- Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St. George's, University of London, London, UK
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