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Teraoka M, Hato N, Inufusa H, You F. Role of Oxidative Stress in Sensorineural Hearing Loss. Int J Mol Sci 2024; 25:4146. [PMID: 38673731 PMCID: PMC11050000 DOI: 10.3390/ijms25084146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Hearing is essential for communication, and its loss can cause a serious disruption to one's social life. Hearing loss is also recognized as a major risk factor for dementia; therefore, addressing hearing loss is a pressing global issue. Sensorineural hearing loss, the predominant type of hearing loss, is mainly due to damage to the inner ear along with a variety of pathologies including ischemia, noise, trauma, aging, and ototoxic drugs. In addition to genetic factors, oxidative stress has been identified as a common mechanism underlying several cochlear pathologies. The cochlea, which plays a major role in auditory function, requires high-energy metabolism and is, therefore, highly susceptible to oxidative stress, particularly in the mitochondria. Based on these pathological findings, the potential of antioxidants for the treatment of hearing loss has been demonstrated in several animal studies. However, results from human studies are insufficient, and future clinical trials are required. This review discusses the relationship between sensorineural hearing loss and reactive oxidative species (ROS), with particular emphasis on age-related hearing loss, noise-induced hearing loss, and ischemia-reperfusion injury. Based on these mechanisms, the current status and future perspectives of ROS-targeted therapy for sensorineural hearing loss are described.
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Affiliation(s)
- Masato Teraoka
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan;
| | - Naohito Hato
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan;
| | - Haruhiko Inufusa
- Division of Anti-Oxidant Research, Life Science Research Center, Gifu University, Yanagito 1-1, Gifu 501-1194, Japan; (H.I.); (F.Y.)
| | - Fukka You
- Division of Anti-Oxidant Research, Life Science Research Center, Gifu University, Yanagito 1-1, Gifu 501-1194, Japan; (H.I.); (F.Y.)
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Angeli SI, Brown CS, Holcomb MA, Velandia SL, Eshraghi AA, Chiossone-Kerdel JA, Hoffer ME, Sanchez C, Telischi FF. Functional Hearing Preservation in Cochlear Implantation: The Miami Cocktail Effect. Otol Neurotol 2024; 45:376-385. [PMID: 38361325 DOI: 10.1097/mao.0000000000004134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To investigate if pharmacological treatment with prednisone and L-N-acetylcysteine (STE + NAC) influence functional hearing preservation in cochlear implant (CI) surgery. STUDY DESIGNS Preimplantation and postimplantation longitudinal case-control study. SETTING Tertiary referral center. PATIENTS Pediatric and adult recipients of CI with preimplantation functional hearing defined as an average of air-conducted thresholds at 125, 250, and 500 Hz (low-frequency pure-tone average [LFPTA]) <80 dB. INTERVENTIONS Preimplantation and postimplantation audiometry. Weight-adjusted oral prednisone and L-N-acetylcysteine starting 2 days before surgery (Miami cocktail). Prednisone was continued for 3 days and L-N-acetylcysteine for 12 days after surgery, respectively. Cochlear implantation with conventional length electrodes. MAIN OUTCOME MEASURES Proportion of patients with LFPTA <80 dB, and LFPTA change at 1-year postimplantation. RESULTS All 61 patients received intratympanic and intravenous dexamethasone intraoperatively, with 41 patients receiving STE + NAC and 20 patients not receiving STE + NAC. At 1-year postimplantation, the proportion of functional hearing preservation was 83% in the STE + NAC group compared with 55% of subjects who did not receive STE + NAC ( p = 0.0302). The median LFPTA change for STE + NAC-treated and not treated subjects was 8.33 dB (mean, 13.82 ± 17.4 dB) and 18.34 dB (mean, 26.5 ± 23.4 dB), respectively ( p = 0.0401, Wilcoxon rank test). Perioperative STE + NAC treatment resulted in 10 dB of LFPTA better hearing than when not receiving this treatment. Better low-frequency preimplantation hearing thresholds were predictive of postimplantation functional hearing. No serious side effects were reported. CONCLUSION Perioperative STE + NAC, "The Miami Cocktail," was safe and superior to intraoperative steroids alone in functional hearing preservation 1-year after cochlear implantation.
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Affiliation(s)
| | | | - Meredith A Holcomb
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Sandra L Velandia
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Adrien A Eshraghi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | | | | | - Chrisanda Sanchez
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Fred F Telischi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Kouka M, Bevern N, Bitter J, Guntinas-Lichius O. N-Acetylcysteine combined with prednisolone treatment shows better hearing outcome than treatment with prednisolone alone for patients with idiopathic sudden sensorineural hearing loss: a retrospective observational study. Eur Arch Otorhinolaryngol 2024; 281:107-116. [PMID: 37392235 PMCID: PMC10764364 DOI: 10.1007/s00405-023-08097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES Internationally, corticosteroids are still the mainstay treatment for patients with idiopathic sudden sensorineural hearing loss (ISSHL). This is a retrospective monocentric study investing the impact of adding N-acetylcysteine (NAC) to prednisolone treatment on patients with ISSHL at a tertiary university otorhinolaryngology department. METHODS 793 patients (median age 60 years; 50.9% women) with a new diagnosis of ISSHL from 2009 to 2015 were included in the study. 663 patients received NAC administration in addition to standard tapered prednisolone treatment. Univariate and multivariable analysis were performed to identify independent factors regarding negative prognosis of hearing recovery. RESULTS Mean initial ISSHL and hearing gain after treatment in 10-tone pure tone audiometry (PTA) were 54.8 ± 34.5 dB and 15.2 ± 21.2 dB, respectively. In univariate analysis, treatment with prednisolone and NAC was associated with a positive prognosis of hearing recovery in the Japan classification in 10-tone PTA. In multivariable analysis on Japan classification in 10-tone PTA including all significant factors from univariate analysis, negative prognosis of hearing recovery were age > median (odds ratio [OR] 1.648; 95% confidence interval [CI] 1.139-2.385; p = 0.008), diseased opposite ear (OR 3.049; CI 2.157-4.310; p < 0.001), pantonal ISSHL (OR 1.891; CI 1.309-2.732; p = 0.001) and prednisolone alone without NAC treatment (OR 1.862; CI 1.200-2.887; p = 0.005). CONCLUSIONS Prednisolone treatment combined with NAC resulted in better hearing outcomes in patients with ISSHL than treatment without NAC.
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Affiliation(s)
- Mussab Kouka
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Nils Bevern
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Julia Bitter
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Tan WJT, Song L. Role of mitochondrial dysfunction and oxidative stress in sensorineural hearing loss. Hear Res 2023; 434:108783. [PMID: 37167889 DOI: 10.1016/j.heares.2023.108783] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
Sensorineural hearing loss (SNHL) can either be genetically inherited or acquired as a result of aging, noise exposure, or ototoxic drugs. Although the precise pathophysiological mechanisms underlying SNHL remain unclear, an overwhelming body of evidence implicates mitochondrial dysfunction and oxidative stress playing a central etiological role. With its high metabolic demands, the cochlea, particularly the sensory hair cells, stria vascularis, and spiral ganglion neurons, is vulnerable to the damaging effects of mitochondrial reactive oxygen species (ROS). Mitochondrial dysfunction and consequent oxidative stress in cochlear cells can be caused by inherited mitochondrial DNA (mtDNA) mutations (hereditary hearing loss and aminoglycoside-induced ototoxicity), accumulation of acquired mtDNA mutations with age (age-related hearing loss), mitochondrial overdrive and calcium dysregulation (noise-induced hearing loss and cisplatin-induced ototoxicity), or accumulation of ototoxic drugs within hair cell mitochondria (drug-induced hearing loss). In this review, we provide an overview of our current knowledge on the role of mitochondrial dysfunction and oxidative stress in the development of SNHL caused by genetic mutations, aging, exposure to excessive noise, and ototoxic drugs. We also explore the advancements in antioxidant therapies for the different forms of acquired SNHL that are being evaluated in preclinical and clinical studies.
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Affiliation(s)
- Winston J T Tan
- Department of Surgery (Otolaryngology), Yale University School of Medicine, New Haven, CT, 06510, USA; Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand.
| | - Lei Song
- Department of Surgery (Otolaryngology), Yale University School of Medicine, New Haven, CT, 06510, USA; Department of Otolaryngology - Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, China; Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, China.
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Pisani A, Paciello F, Montuoro R, Rolesi R, Galli J, Fetoni AR. Antioxidant Therapy as an Effective Strategy against Noise-Induced Hearing Loss: From Experimental Models to Clinic. Life (Basel) 2023; 13:life13041035. [PMID: 37109564 PMCID: PMC10144536 DOI: 10.3390/life13041035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Cochlear redox unbalance is the main mechanism of damage involved in the pathogenesis of noise-induced-hearing loss. Indeed, the increased free radical production, in conjunction with a reduced efficacy of the endogenous antioxidant system, plays a key role in cochlear damage induced by noise exposure. For this reason, several studies focused on the possibility to use exogenous antioxidant to prevent or attenuate noise-induce injury. Thus, several antioxidant molecules, alone or in combination with other compounds, have been tested in both experimental and clinical settings. In our findings, we tested the protective effects of several antioxidant enzymes, spanning from organic compounds to natural compounds, such as nutraceuticals of polyphenols. In this review, we summarize and discuss the strengths and weaknesses of antioxidant supplementation focusing on polyphenols, Q-Ter, the soluble form of CoQ10, Vitamin E and N-acetil-cysteine, which showed great otoprotective effects in different animal models of noise induced hearing loss and which has been proposed in clinical trials.
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Affiliation(s)
- Anna Pisani
- Department of Otolaryngology Head and Neck Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Fabiola Paciello
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Raffaele Montuoro
- Department of Otolaryngology Head and Neck Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rolando Rolesi
- Department of Otolaryngology Head and Neck Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Jacopo Galli
- Department of Otolaryngology Head and Neck Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Anna Rita Fetoni
- Department of Neuroscience, Reproductive Sciences and Dentistry-Audiology Section, University of Naples Federico II, 80131 Naples, Italy
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Natarajan N, Batts S, Stankovic KM. Noise-Induced Hearing Loss. J Clin Med 2023; 12:2347. [PMID: 36983347 PMCID: PMC10059082 DOI: 10.3390/jcm12062347] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/22/2023] Open
Abstract
Noise-induced hearing loss (NIHL) is the second most common cause of sensorineural hearing loss, after age-related hearing loss, and affects approximately 5% of the world's population. NIHL is associated with substantial physical, mental, social, and economic impacts at the patient and societal levels. Stress and social isolation in patients' workplace and personal lives contribute to quality-of-life decrements which may often go undetected. The pathophysiology of NIHL is multifactorial and complex, encompassing genetic and environmental factors with substantial occupational contributions. The diagnosis and screening of NIHL are conducted by reviewing a patient's history of noise exposure, audiograms, speech-in-noise test results, and measurements of distortion product otoacoustic emissions and auditory brainstem response. Essential aspects of decreasing the burden of NIHL are prevention and early detection, such as implementation of educational and screening programs in routine primary care and specialty clinics. Additionally, current research on the pharmacological treatment of NIHL includes anti-inflammatory, antioxidant, anti-excitatory, and anti-apoptotic agents. Although there have been substantial advances in understanding the pathophysiology of NIHL, there remain low levels of evidence for effective pharmacotherapeutic interventions. Future directions should include personalized prevention and targeted treatment strategies based on a holistic view of an individual's occupation, genetics, and pathology.
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Affiliation(s)
- Nirvikalpa Natarajan
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Shelley Batts
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
- Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA 94305, USA
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White K, Someya S. The roles of NADPH and isocitrate dehydrogenase in cochlear mitochondrial antioxidant defense and aging. Hear Res 2023; 427:108659. [PMID: 36493529 DOI: 10.1016/j.heares.2022.108659] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 11/04/2022] [Accepted: 11/23/2022] [Indexed: 11/26/2022]
Abstract
Hearing loss is the third most prevalent chronic health condition affecting older adults. Age-related hearing loss affects one in three adults over 65 years of age and is caused by both extrinsic and intrinsic factors, including genetics, aging, and exposure to noise and toxins. All cells possess antioxidant defense systems that play an important role in protecting cells against these factors. Reduced nicotinamide adenine dinucleotide phosphate (NADPH) serves as a co-factor for antioxidant enzymes such as glutathione reductase and thioredoxin reductase and is produced by glucose-6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, isocitrate dehydrogenase 1 (IDH1) or malic enzyme 1 in the cytosol, while in the mitochondria, NADPH is generated from mitochondrial transhydrogenase, glutamate dehydrogenase, malic enzyme 3 or IDH2. There are three isoforms of IDH: cytosolic IDH1, and mitochondrial IDH2 and IDH3. Of these, IDH2 is thought to be the major supplier of NADPH to the mitochondrial antioxidant defense system. The NADP+/NADPH and NAD+/NADH couples are essential for maintaining a large array of biological processes, including cellular redox state, and energy metabolism, mitochondrial function. A growing body of evidence indicates that mitochondrial dysfunction contributes to age-related structural or functional changes of cochlear sensory hair cells and neurons, leading to hearing impairments. In this review, we describe the current understanding of the roles of NADPH and IDHs in cochlear mitochondrial antioxidant defense and aging.
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Affiliation(s)
- Karessa White
- Charlie Brigade Support Medical Company, 2/1 ABCT, United States Army, Fort Riley, KS, USA
| | - Shinichi Someya
- Department of Physiology and Aging, University of Florida, Gainesville, Florida, USA.
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Hullfish H, Roldan LP, Hoffer ME. The Use of Antioxidants in the Prevention and Treatment of Noise-Induced Hearing Loss. Otolaryngol Clin North Am 2022; 55:983-991. [PMID: 36088150 DOI: 10.1016/j.otc.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
As of today, there are no therapeutic measures for the prevention or treatment of noise-induced hearing loss (NIHL). The current preventative measures, including avoidance and personal protective hearing equipment, do not appear to be sufficient because there is an increasing number of people with NIHL, especially in the adolescent population. Therefore, we must find a therapy that prevents the impact of noise on hearing. Antioxidants are a promising option in preventing the damaging effects of noise by targeting free radicals but further studies are needed to confirm their efficacy in humans.
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Affiliation(s)
- Haley Hullfish
- Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Miami, FL 33136, USA.
| | - Luis P Roldan
- Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Miami, FL 33136, USA
| | - Michael E Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Miami, FL 33136, USA; Department of Neurological Surgery, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Miami, FL 33136, USA
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Kishimoto-Urata M, Urata S, Fujimoto C, Yamasoba T. Role of Oxidative Stress and Antioxidants in Acquired Inner Ear Disorders. Antioxidants (Basel) 2022; 11:antiox11081469. [PMID: 36009187 PMCID: PMC9405327 DOI: 10.3390/antiox11081469] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Oxygen metabolism in the mitochondria is essential for biological activity, and reactive oxygen species (ROS) are produced simultaneously in the cell. Once an imbalance between ROS production and degradation (oxidative stress) occurs, cells are damaged. Sensory organs, especially those for hearing, are constantly exposed during daily life. Therefore, almost all mammalian species are liable to hearing loss depending on their environment. In the auditory pathway, hair cells, spiral ganglion cells, and the stria vascularis, where mitochondria are abundant, are the main targets of ROS. Excessive generation of ROS in auditory sensory organs is widely known to cause sensorineural hearing loss, and mitochondria-targeted antioxidants are candidates for treatment. This review focuses on the relationship between acquired hearing loss and antioxidant use to provide an overview of novel antioxidants, namely medicines, supplemental nutrients, and natural foods, based on clinical, animal, and cultured-cell studies.
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Chen SL, Ho CY, Chin SC. Effects of oral N-acetylcysteine combined with oral prednisolone on idiopathic sudden sensorineural hearing loss. Medicine (Baltimore) 2022; 101:e29792. [PMID: 35777063 PMCID: PMC9239607 DOI: 10.1097/md.0000000000029792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Idiopathic sudden sensorineural hearing loss (ISSNHL) is an acute condition that presents with sudden hearing loss, for which steroids remain the main treatment. N-acetylcysteine (NAC), as a precursor of glutathione, can reduce the production of reactive oxygen species to protect hair cells in the inner ear from damage. However, data regarding the therapeutic outcomes of oral steroid combined with oral NAC for ISSNHL are still limited. This study was performed to investigate this issue. METHODS Between June 2016 and October 2021, 219 patients (219 ears) diagnosed with ISSNHL and treated with oral prednisolone were enrolled in this retrospective study. Oral NAC was prescribed to 94 of these patients (NAC group) but not to the remaining 125 patients (non-NAC group). The clinical and audiological findings were assessed. RESULTS The NAC group showed a mean hearing level gain of 29.5 ± 21.8 dB, speech reception threshold (SRT) gain of 26.2 ± 34.4 dB, and speech discrimination score (SDS) gain of 25.5 ± 30.4%. Although the NAC group had better mean hearing level, SRT, and SDS gains than the non-NAC group, the differences were not statistically significant (all P > .05). The only significant difference between the NAC and non-NAC groups was the posttreatment pure tone audiometry (PTA) thresholds at 8 kHz, which were 54.2 ± 24.4 and 60.9 ± 34.1 dB, respectively (P = .046). CONCLUSIONS This study demonstrated the effect of oral steroid combined with oral NAC for ISSNHL. Both the NAC and non-NAC groups showed obvious improvement in all PTA thresholds, as well as mean hearing level, SRT, and SDS gains. The NAC group showed significantly better PTA performance at a high frequency (8 kHz) than the non-NAC group. Therefore, for oral treatment of ISSNHL, we advocate concurrent use of oral prednisolone and oral NAC.
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Affiliation(s)
- Shih-Lung Chen
- Department of Otorhinolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Shih-Lung Chen, MD, Department of Otorhinolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Shin Street, Kwei-Shan, Taoyuan, Taiwan, 333 (e-mail: )
| | - Chia-Ying Ho
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shy-Chyi Chin
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
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Le Prell CG. Prevention of Noise-Induced Hearing Loss Using Investigational Medicines for the Inner Ear: Previous Trial Outcomes Should Inform Future Trial Design. Antioxid Redox Signal 2022; 36:1171-1202. [PMID: 34346254 PMCID: PMC9221155 DOI: 10.1089/ars.2021.0166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 11/13/2022]
Abstract
Significance: Noise-induced hearing loss (NIHL) is an important public health issue resulting in decreased quality of life for affected individuals, and significant costs to employers and governmental agencies. Recent Advances: Advances in the mechanistic understanding of NIHL have prompted a growing number of proposed, in-progress, and completed clinical trials for possible protections against NIHL via antioxidants and other drug agents. Thirty-one clinical trials evaluating prevention of either temporary or permanent NIHL were identified and are reviewed. Critical Issues: This review revealed little consistency in the noise-exposed populations in which drugs are evaluated or the primary outcomes used to measure NIHL prevention. Changes in pure-tone thresholds were the most common primary outcomes; specific threshold metrics included both average hearing loss and incidence of significant hearing loss. Changes in otoacoustic emission (OAE) amplitude were relatively common secondary outcomes. Extended high-frequency (EHF) hearing and speech-in-noise perception are commonly adversely affected by noise exposure but are not consistently included in clinical trials assessing prevention of NIHL. Future Directions: Multiple criteria are available for monitoring NIHL, but the specific criterion to be used to define clinically significant otoprotection remains a topic of discussion. Audiogram-based primary outcome measures can be combined with secondary outcomes, including OAE amplitude, EHF hearing, speech-in-noise testing, tinnitus surveys, and patient-reported outcomes. Standardization of test protocols for the above primary and secondary outcomes, and associated reporting criterion for each, would facilitate clinical trial design and comparison of results across investigational drug agents. Antioxid. Redox Signal. 36, 1171-1202.
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Affiliation(s)
- Colleen G. Le Prell
- Department of Speech, Language, and Hearing Science, University of Texas at Dallas, Richardson, Texas, USA
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Wu F, Hill K, Fang Q, He Z, Zheng H, Wang X, Xiong H, Sha SH. Traumatic-noise-induced hair cell death and hearing loss is mediated by activation of CaMKKβ. Cell Mol Life Sci 2022; 79:249. [PMID: 35438341 PMCID: PMC9844253 DOI: 10.1007/s00018-022-04268-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/14/2022] [Accepted: 03/20/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The Ca2+/calmodulin-dependent protein kinase kinases (CaMKKs) are serine/threonine-directed protein kinases that are activated following increases in intracellular calcium, playing a critical role in neuronal signaling. Inner-ear-trauma-induced calcium overload in sensory hair cells has been well documented in the pathogenesis of traumatic noise-induced hair cell death and hearing loss, but there are no established pharmaceutical therapies available due to a lack of specific therapeutic targets. In this study, we investigated the activation of CaMKKβ in the inner ear after traumatic noise exposure and assessed the prevention of noise-induced hearing loss (NIHL) with RNA silencing. RESULTS Treatment with short hairpin RNA of CaMKKβ (shCaMKKβ) via adeno-associated virus transduction significantly knocked down CaMKKβ expression in the inner ear. Knockdown of CaMKKβ significantly attenuated noise-induced hair cell loss and hearing loss (NIHL). Additionally, pretreatment with naked CaMKKβ small interfering RNA (siCaMKKβ) attenuated noise-induced losses of inner hair cell synapses and OHCs and NIHL. Furthermore, traumatic noise exposure activates CaMKKβ in OHCs as demonstrated by immunolabeling for p-CaMKI. CaMKKβ mRNA assessed by fluorescence in-situ hybridization and immunolabeling for CaMKKβ in OHCs also increased after the exposure. Finally, pretreatment with siCaMKKβ diminished noise-induced activation of AMPKα in OHCs. CONCLUSIONS These findings demonstrate that traumatic-noise-induced OHC loss and hearing loss occur primarily via activation of CaMKKβ. Targeting CaMKKβ is a key strategy for prevention of noise-induced hearing loss. Furthermore, our data suggest that noise-induced activation of AMPKα in OHCs occurs via the CaMKKβ pathway.
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Affiliation(s)
- Fan Wu
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA.,Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kayla Hill
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA
| | - Qiaojun Fang
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA.,School of Life Sciences and Technology, Southeast University, Nanjing 210096, China
| | - Zuhong He
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA
| | - Hongwei Zheng
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA
| | - Xianren Wang
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA
| | - Hao Xiong
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA
| | - Su-Hua Sha
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA.,Correspondence should be addressed to: Dr. Su-Hua Sha • Department of Pathology and Laboratory Medicine • Medical University of South Carolina • Walton Research Building, Room 403-E • 39 Sabin Street, Charleston, SC 29425, USA. Telephone: 843-792-8324; Fax: 843-792-0368;
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Klamkam P, Pagcharoenpol R, Treesaranuwattana T, Silpsrikul P, Jaruchinda P, Wasuwat P, Suwannahitatorn P. A clinical trial of nicergoline to prevent temporary threshold shift. Laryngoscope Investig Otolaryngol 2022; 7:515-522. [PMID: 35434325 PMCID: PMC9008157 DOI: 10.1002/lio2.746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 01/10/2023] Open
Abstract
Objective To evaluate the effectiveness of nicergoline to prevent temporary threshold shift (TTS) in military personnel. Study Design A randomized control trial. Methods Two hundred and twenty‐four participants were enrolled. Nicergoline 30 mg twice daily intake was prescribed to the study group (n = 119) for 3 weeks. The placebo was prescribed to the control group (n = 105) for 3 weeks, as well. Audiometric thresholds were measured at baseline and within 24 h after the participants attended a 1‐day weapons firing practice. During the firing practice, all participants had to wear foam earplugs. The TTS was assessed by using a variety of published significant threshold shift (STS) definitions. Additionally, the effects of the treatment group on the magnitude of pre‐ to postexposure threshold shifts were estimated. Tinnitus and other adverse effects of the medication were recorded. Results The incidence of STS was 65.4% from the study group and 75% from the control group. The negative STS (thresholds improved) was 68.6% from the study group and 44.7% from the control group. The positive STS (thresholds worsened) from the study group and the control group was 31.4% and 55.3%, respectively. The effect of treatment in participants receiving nicergoline demonstrated significant coefficients (change in dB) in both ears (p = .001). The mean different threshold of participants receiving nicergoline showed negative STS in all tested frequencies without statistical significance. However, the mean different threshold of participants receiving a placebo showed positive STS with statistical significance. Additionally, there were 16 ears detecting a warning sign of permanent hearing loss. These participants from the control group presented a longer duration of tinnitus (p = .042). Moreover, the serious adverse effects of nicergoline were considerably low. Conclusion The study results suggest that nicergoline may attenuate noise‐related TTS and tinnitus, and justify further investigation on the effectiveness of this drug as an otoprotectant. Level of Evidence 2
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Affiliation(s)
- Pana Klamkam
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | - Rongrat Pagcharoenpol
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | | | - Pichayen Silpsrikul
- Medical Battalion, Support Regiment, Marines Division Royal Thai Navy Sattahip Chonburi Thailand
| | - Pariyanan Jaruchinda
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | - Piyalarp Wasuwat
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
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Martin MJ, Spitzmaul G, Lassalle V. Novel insights and perspectives for the diagnosis and treatment of hearing loss through the implementation of magnetic nanotheranostics. ChemMedChem 2022; 17:e202100685. [PMID: 34978134 DOI: 10.1002/cmdc.202100685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/29/2021] [Indexed: 11/06/2022]
Abstract
Hearing loss (HL) is a sensory disability that affects 5% of the world's population. HL predominantly involves damage and death to the cochlear cells. Currently, there is no cure or specific medications for HL. Furthermore, the arrival of therapeutic molecules to the inner ear represents a challenge due to the limited blood supply to the sensory cells and the poor penetration of the blood-cochlear barrier. Superparamagnetic iron oxide nanoparticles (SPIONs) perfectly coordinate with the requirements for controlled drug delivery along with magnetic resonance imaging (MRI) diagnostic and monitoring capabilities. Besides, they are suitable tools to be applied to HL, expecting to be more effective and non-invasive. So far, the published literature only refers to some preclinical studies of SPIONs for HL management. This contribution aims to provide an integrated view of the best options and strategies that can be considered for future research punctually in the field of magnetic nanotechnology applied to HL.
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Affiliation(s)
- Maria Julia Martin
- INQUISUR: Instituto de Quimica del Sur, Departamento de Química, Universidad Nacional del Sur (CONICET-UNS), Alem 1253, 8000, Bahía Blanca, ARGENTINA
| | - Guillermo Spitzmaul
- Universidad Nacional del Sur Departamento de Biología Bioquímica y Farmacia: Universidad Nacional del Sur Departamento de Biologia Bioquimica y Farmacia, Departamento de Biología, Bioquímica Y farmacia, Camino La Carrindanga Km 7, 8000, Bahía Blanca, ARGENTINA
| | - Verónica Lassalle
- INQUISUR: Instituto de Quimica del Sur, Química, Av Alem 1253, 8000, Bahía Blanca, ARGENTINA
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Campbell KCM, Cosenza N, Meech R, Buhnerkempe M, Qin J, Rybak L, Fox DJ. D-methionine immediate and continued rescue after noise exposure does not prevent temporary threshold shift but alters cochlear and serum antioxidant levels. Int J Audiol 2021; 61:769-777. [PMID: 34369249 DOI: 10.1080/14992027.2021.1959659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Determine if D-methionine (D-met) rescue prevents temporary threshold shift (TTS) from steady-state or impulse noise and determine D-met's impact on serum and cochlear antioxidant levels. DESIGN D-met at 50, 100 or 200 mg/kg/doses were administered 0, 6 and 18 hours-post noise. ABRs at baseline and 24 hours post-noise measured TTS. Serum (SOD, CAT, GR, GPx) and cochlear (GSH, GSSG) antioxidant levels measured physiological influence. Three control groups, with impulse or steady-state or without noise, were saline-injected. STUDY SAMPLE Ten Chinchillas/group. RESULTS D-met rescue did not significantly reduce TTS or impact serum CAT, SOD, GPx or GR levels vs. noise-exposed control groups, but TTS was greater in all groups relative to no-noise controls. D-met significantly elevated CAT at 50 mg/kg vs. steady-state controls and SOD at 200 mg/kg vs. impulse noise controls. D-met significantly reduced cochlear GSH/GSSG ratios in the 100 mg/kg D-met group vs. impulse noise controls. CONCLUSIONS While D-met rescue has reduced permanent threshold shift in previous studies, it did not reduce TTS in this study. However, D-met rescue did alter selective serum and cochlear oxidative state changes 24 hours post-noise relative to controls. Results demonstrate TTS studies do not always predict PTS protection in otoprotectant experimental designs.
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Affiliation(s)
- Kathleen C M Campbell
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Nicole Cosenza
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Robert Meech
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Michael Buhnerkempe
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Jun Qin
- Department of Computer and Electrical Engineering, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Leonard Rybak
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Daniel J Fox
- Department of Clinical Research, Springfield Clinic, Springfield, IL, USA
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Association Analysis of Candidate Gene Polymorphisms and Audiometric Measures of Noise-Induced Hearing Loss in Young Musicians. Otol Neurotol 2021; 41:e538-e547. [PMID: 32176153 DOI: 10.1097/mao.0000000000002615] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study aimed to investigate the association between candidate genetic variants and audiometric measures of noise-induced hearing loss (NIHL) in young musicians. METHODS The study analyzed a database by Phillips et al. (Feasibility of a bilateral 4000-6000 Hz notch as a phenotype for genetic association analysis. Int J Audiol 2015;54:645-52.) which included behavioral hearing thresholds, distortion-product otoacoustic emissions (DPOAE), tympanometric, and genetic data of 166 participants meeting the inclusion criteria. Nineteen single nucleotide polymorphisms (SNPs) in 13 cochlear genes previously associated with NIHL in factory workers were included in the present investigation. The average hearing threshold at 3000 and 4000 Hz (AHT) and average DPOAE signal to noise ratio (DPOAE SNR) in both ears were calculated. RESULTS The regression analyses showed that two SNPs- one in KCNE1 (rs2070358) and the other in CAT (rs12273124) revealed a statistically significant relationship with DPOAE SNR in both ears. Two SNPs in MYH14 and one in GJB4 revealed a significant association with DPOAE SNR in the left ear. Two SNPs in HSP70, one in CDH23 and one in KCNJ10 showed significant association with DPOAE SNR in the right ear. None of the included SNPs showed association with AHT in both ears. CONCLUSIONS A genetic variant in KCNE1 was associated with the strength of the cochlear amplifier as assessed by DPOAE SNR. Musicians carrying causal genetic variants to NIHL might exhibit changes in their auditory functions early in the lifespan even when most subjects had their hearing thresholds within normal limits. These participants are likely to show the clinical manifestation of NIHL in the future if no preventive measures are applied.
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Abbasi M, Pourrajab B, Tokhi MO. Protective effects of vitamins/antioxidants on occupational noise-induced hearing loss: A systematic review. J Occup Health 2021; 63:e12217. [PMID: 33788342 PMCID: PMC8011460 DOI: 10.1002/1348-9585.12217] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/20/2021] [Accepted: 02/14/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Occupational noise-induced hearing loss (NIHL) due to industrial, military, and other job -related noise exposure can cause harmful health issues to occupied workers, but may also be potentially preventable. Vitamins/antioxidant have been studied as therapeutic strategies to prevent and/or delay the risks of human diseases as well as NIHL .So, this study was conducted to systematically review the protective effects of vitamins/antioxidants on occupational NIHL. METHODS Online databases including PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, and Google Scholar were systematically searched up to 12 January 2021. Based on 6336 potentially relevant records identified through the initial search in the databases, 12 full-text publications were retrieved, one of which can be viewed as two separate trials, because it has studied the effects of two different antioxidants (ginseng and NAC) on NIHL, separately. RESULTS A review of the studies shows that vitamin B12, folic acid, and N-acetylcysteine (NAC) have a considerable protective effect on NIHL. However, these protective effects are not yet specified in different frequencies. The findings regarding the protective effects of other antioxidants are inconsistent in this field. CONCLUSION Vitamin B12, folic acid, and NAC may have a protective effect as an antioxidant on reducing occupational hearing loss. For a conclusive evidence of vitamin/antioxidant protective therapies, future studies with precise criteria for noise exposure and similar outcome parameters are required.
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Affiliation(s)
- Milad Abbasi
- Social Determinants of Health Research CenterSaveh University of Medical SciencesSavehIran
| | - Behnaz Pourrajab
- Department of NutritionSchool of Public HealthIran University of Medical SciencesTeheranIran
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Chen KH, Su SB, Chen KT. An overview of occupational noise-induced hearing loss among workers: epidemiology, pathogenesis, and preventive measures. Environ Health Prev Med 2020; 25:65. [PMID: 33129267 PMCID: PMC7603754 DOI: 10.1186/s12199-020-00906-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/20/2022] Open
Abstract
Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the world. The goal of this study was to review the epidemiology, pathogenesis, and preventive measures of ONIHL among workers and provide evidence for the implementation of control measures. Literature studies were identified from the MEDLINE, PubMed, Embase, Web of Science, and Google Scholar using the search terms “noise-induced hearing loss” “prevalence”, “pathogenesis”, and “preventive measures”. The articles reviewed in this report were limited from 2000 to 2020. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the current status of ONIHL among workers. The mechanism of ONIHL among workers is a complex interaction between environmental and host factors (both genetic and acquired factors). The outcomes of noise exposure are different among individual subjects. Clinical trials are currently underway to evaluate the treatment effect of antioxidants on ONIHL. Noise exposure may contribute to temporary or permanent threshold shifts; however, even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are an important preventive measure in reducing the morbidity of ONIHL among workers.
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Affiliation(s)
- Kou-Huang Chen
- School of Mechanical and Electronic Engineering, Sanming University, Sanming, 365, Fujian Province, China
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, 710, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (managed by Show Chwan Medical Care Corporation), No. 670, Chongde Road, East District, Tainan, 701, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
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GSTM1 null and GSTT1 null: predictors of cisplatin-caused acute ototoxicity measured by DPOAEs. J Mol Med (Berl) 2020; 98:963-971. [PMID: 32435918 PMCID: PMC7343745 DOI: 10.1007/s00109-020-01921-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023]
Abstract
Preventing the ototoxicity caused by cisplatin is a major issue yet to be overcome. Useful preventive treatments will soon be available. Consequently, the next step is to filter out those patients who are more prone to develop ototoxicity. The aim of this study was to prospectively evaluate potential predictive markers of acute ototoxicity as determined by measures of distortion product otoacoustic emissions (DPOAEs). A total of 118 patients from our previous DPOAE analysis were put under evaluation. Ototoxic cases were divided according to unilateral (n = 45) or bilateral (n = 23) involvement. The clinicopathological characteristics, hearing test results, germline GSTT1, GSTM1, and GSTP1 polymorphisms, and common laboratory parameters were included in the new analysis. Univariate and multivariate statistical tests were applied. According to multivariate logistic regression, the only independent predictor of unilateral ototoxicity (vs. non-affected) was a GSTM1 null genotype (OR = 4.52; 95%CI = 1.3-16.3), while for bilateral damage, the GSTT1 null genotype (OR = 4.76; 1.4-16) was a predictor. The higher starting serum urea level was characteristic of bilateral ototoxicity; however, the only independent marker of bilateral (vs. unilateral) ototoxicity was the presence of GSTT1 null genotype (OR = 2.44; 1.23-4.85). Different processes, involving the GSTM1 and GSTT1 genotypes, respectively, govern the development of acute unilateral and bilateral ototoxicities. Further research is needed to clarify these processes. Based on the above findings, patients whom are at risk may be selected for otoprotective therapies. KEY MESSAGES: The acute ototoxicity was determined by DPOAE in 118 testicular cancer patients. GSTM1 null was the only marker of unilateral ototoxicity (vs. non-affected). The only marker of bilateral hearing loss (vs. non-affected) was the GSTT1 null. GSTT1 null was also the marker of bilateral vs. unilateral ototoxicity. A high-risk group may be selected for new, individualized otoprotective treatment.
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Mühlmeier G, Schweikert A, Schramm S, Burkart M, Tisch M. [Study protocol of the monocentric prospective randomized placebo-controlled double-blind phase II study to explore the protective effects of the ginkgo biloba extract EGb 761® from temporary noise-induced hearing loss]. HNO 2020; 68:272-277. [PMID: 31915883 DOI: 10.1007/s00106-019-00807-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hearing loss is frequently induced by occupational noise exposure and leads to rising hearing thresholds as well as reduced otoacoustic emissions (OAE), mostly caused by metabolic hair cell decompensation. OBJECTIVE Primary endpoint is the increase in average pure tone thresholds after noise exposure, secondary endpoints are loss of distortion product and click-evoked OAE as well as reduction of their contralateral suppression. PARTICIPANTS AND METHODS The present study design describes the verification of the anti-oxidant and neuroprotective properties of EGb 761® by evaluation of cochlear protection from noise impact as well as its safety and tolerance in 202 healthy male participants distributed equally to verum and placebo groups in a double-blind manner. Participants were assessed, medicated, exposed to noise, and then examined at timepoints up to 10 min and 4 weeks thereafter. CONCLUSION This summary of the verification study protocol highlights the complexity of diligent and precise planning according to the European Medicines Agency criteria for controlled trials (EudraCT). Key points are the intervention rationale, definitions of in- and exclusion criteria, estimation of subject numbers, and examination method setting in terms of optimum endpoint description.
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Affiliation(s)
- G Mühlmeier
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
| | - A Schweikert
- Klinik für HNO-Heilkunde, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - S Schramm
- Klinik und Poliklinik für Innere Medizin, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - M Burkart
- Medical Affairs, Dr. Willmar Schwabe GmbH & Co. KG, Ettlingen, Deutschland
| | - M Tisch
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
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Le Prell CG, Hammill TL, Murphy WJ. Noise-induced hearing loss and its prevention: Integration of data from animal models and human clinical trials. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:4051. [PMID: 31795668 PMCID: PMC7195863 DOI: 10.1121/1.5132951] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Animal models have been used to gain insight into the risk of noise-induced hearing loss (NIHL) and its potential prevention using investigational new drug agents. A number of compounds have yielded benefit in pre-clinical (animal) models. However, the acute traumatic injury models commonly used in pre-clinical testing are fundamentally different from the chronic and repeated exposures experienced by many human populations. Diverse populations that are potentially at risk and could be considered for enrollment in clinical studies include service members, workers exposed to occupational noise, musicians and other performing artists, and children and young adults exposed to non-occupational (including recreational) noise. Both animal models and clinical populations were discussed in this special issue, followed by discussion of individual variation in vulnerability to NIHL. In this final contribution, study design considerations for NIHL otoprotection in pre-clinical and clinical testing are integrated and broadly discussed with evidence-based guidance offered where possible, drawing on the contributions to this special issue as well as other existing literature. The overarching goals of this final paper are to (1) review and summarize key information across contributions and (2) synthesize information to facilitate successful translation of otoprotective drugs from animal models into human application.
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Affiliation(s)
- Colleen G Le Prell
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas 75080, USA
| | - Tanisha L Hammill
- Department of Defense, Defense Health Agency, Falls Church, Virginia 22042, USA
| | - William J Murphy
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinanati, Ohio 45226-1998, USA
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Spankovich C, Le Prell CG. The role of diet in vulnerability to noise-induced cochlear injury and hearing loss. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:4033. [PMID: 31795697 DOI: 10.1121/1.5132707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The influence of dietary nutrient intake on the onset and trajectory of hearing loss during aging and in mediating protection from challenges such as noise is an important relationship yet to be fully appreciated. Dietary intake provides essential nutrients that support basic cellular processes related to influencing cellular stress response, immune response, cardiometabolic status, neural status, and psychological well-being. Dietary quality has been shown to alter risk for essentially all chronic health conditions including hearing loss and tinnitus. Evidence of nutrients with antioxidant, anti-inflammatory, and anti-ischemic properties, and overall healthy diet quality as otoprotective strategies are slowly accumulating, but many questions remain unanswered. In this article, the authors will discuss (1) animal models in nutritional research, (2) evidence of dietary nutrient-based otoprotection, and (3) consideration of confounds and limitations to nutrient and dietary study in hearing sciences. Given that there are some 60 physiologically essential nutrients, unraveling the intricate biochemistry and multitude of interactions among nutrients may ultimately prove infeasible; however, the wealth of available data suggesting healthy nutrient intake to be associated with improved hearing outcomes suggests the development of evidence-based guidance regarding diets that support healthy hearing may not require precise understanding of all possible interactions among variables. Clinical trials evaluating otoprotective benefits of nutrients should account for dietary quality, noise exposure history, and exercise habits as potential covariates that may influence the efficacy and effectiveness of test agents; pharmacokinetic measures are also encouraged.
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Affiliation(s)
- Christopher Spankovich
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA
| | - Colleen G Le Prell
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas 75080, USA
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Minich DM, Brown BI. A Review of Dietary (Phyto)Nutrients for Glutathione Support. Nutrients 2019; 11:E2073. [PMID: 31484368 PMCID: PMC6770193 DOI: 10.3390/nu11092073] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/23/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Abstract
Glutathione is a tripeptide that plays a pivotal role in critical physiological processes resulting in effects relevant to diverse disease pathophysiology such as maintenance of redox balance, reduction of oxidative stress, enhancement of metabolic detoxification, and regulation of immune system function. The diverse roles of glutathione in physiology are relevant to a considerable body of evidence suggesting that glutathione status may be an important biomarker and treatment target in various chronic, age-related diseases. Yet, proper personalized balance in the individual is key as well as a better understanding of antioxidants and redox balance. Optimizing glutathione levels has been proposed as a strategy for health promotion and disease prevention, although clear, causal relationships between glutathione status and disease risk or treatment remain to be clarified. Nonetheless, human clinical research suggests that nutritional interventions, including amino acids, vitamins, minerals, phytochemicals, and foods can have important effects on circulating glutathione which may translate to clinical benefit. Importantly, genetic variation is a modifier of glutathione status and influences response to nutritional factors that impact glutathione levels. This narrative review explores clinical evidence for nutritional strategies that could be used to improve glutathione status.
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Affiliation(s)
- Deanna M Minich
- Human Nutrition and Functional Medicine Graduate Program, University of Western States, 2900 NE 132nd Ave, Portland, OR 97230, USA.
| | - Benjamin I Brown
- BCNH College of Nutrition and Health, 116-118 Finchley Road, London NW3 5HT, UK
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Comparison of oral steroid regimens for acute acoustic trauma caused by gunshot noise exposure. The Journal of Laryngology & Otology 2019; 133:566-570. [DOI: 10.1017/s002221511900121x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundThere are no definite guidelines regarding the most adequate steroid regimens for acute acoustic trauma.ObjectiveTo elucidate the dose-dependent differing benefits of oral steroids on hearing improvement following acute acoustic trauma.MethodsTwenty-nine patients treated with oral steroids following a diagnosis of unilateral acute acoustic trauma were retrospectively reviewed. Patients were sorted into two groups with an oral steroid regimen. Group 1 received a 14-day course of treatment: 60 mg prednisolone daily for 10 days, tapering off over days 11–14. Group 2 received prednisolone for a total of 10 days: 60 mg for 5 days, tapering down each day for the remainder. Multivariable linear regression analysis was performed to evaluate the factors associated with the hearing gain.ResultsIn the multivariable regression (R2 = 0.51, p < 0.001), patients in group 1 showed more significant improvement in the degree of hearing gain compared to group 2 (p = 0.03).ConclusionAfter comparing the differing benefits of oral steroids on hearing improvement by dosage, we recommend a high dose of prednisolone (60 mg per day) for 10 days, tapering over the remaining 4 days, for better hearing recovery following acute acoustic trauma.
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Chang YS, Park H, Hong SH, Chung WH, Cho YS, Moon IJ. Predicting cochlear dead regions in patients with hearing loss through a machine learning-based approach: A preliminary study. PLoS One 2019; 14:e0217790. [PMID: 31158267 PMCID: PMC6546232 DOI: 10.1371/journal.pone.0217790] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/18/2019] [Indexed: 11/18/2022] Open
Abstract
We propose a machine learning (ML)-based model for predicting cochlear dead regions (DRs) in patients with hearing loss of various etiologies. Five hundred and fifty-five ears from 380 patients (3,770 test samples) diagnosed with sensorineural hearing loss (SNHL) were analyzed. A threshold-equalizing noise (TEN) test was applied to detect the presence of DRs. Data were collected on sex, age, side of the affected ear, hearing loss etiology, word recognition scores (WRS), and pure-tone thresholds at each frequency. According to the cause of hearing loss as diagnosed by the physician, we categorized the patients into six groups: 1) SNHL with unknown etiology; 2) sudden sensorineural hearing loss (SSNHL); 3) vestibular schwannoma (VS); 4) Meniere's disease (MD); 5) noise-induced hearing loss (NIHL); or 6) presbycusis or age-related hearing loss (ARHL). To develop a predictive model, we performed recursive partitioning and regression for classification, logistic regression, and random forest. The overall prevalence of one or more DRs in test ears was 20.36% (113 ears). Among the 3,770 test samples, the overall frequency-specific prevalence of DR was 6.7%. WRS, pure-tone thresholds at each frequency, disease type (VS or MD), and frequency information were useful for predicting DRs. Sex and age were not associated with detecting DRs. Based on these results, we suggest possible predictive factors for determining the presence of DRs. To improve the predictive power of the model, a more flexible model or more clinical features, such as the duration of hearing loss or risk factors for developing DRs, may be needed.
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Affiliation(s)
- Young-Soo Chang
- Department of Otorhinolaryngology–Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Heesung Park
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Republic of Korea
| | - Sung Hwa Hong
- Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Won-Ho Chung
- Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yang-Sun Cho
- Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Abstract
There is an urgent need for otoprotective drug agents. Prevention of noise-induced hearing loss continues to be a major challenge for military personnel and workers in a variety of industries despite the requirements that at-risk individuals use hearing protection devices such as ear plugs or ear muffs. Drug-induced hearing loss is also a major quality-of-life issue with many patients experiencing clinically significant hearing loss as a side effect of treatment with life-saving drug agents such as cisplatin and aminoglycoside antibiotics. There are no pharmaceutical agents approved by the United States Food and Drug Administration for the purpose of protecting the inner ear against damage, and preventing associated hearing loss (otoprotection). However, a variety of preclinical studies have suggested promise, with some supporting data from clinical trials now being available as well. Additional research within this promising area is urgently needed.
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Affiliation(s)
- Colleen G Le Prell
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
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Rosenhall U, Skoog B, Muhr P. Treatment of military acoustic accidents with N-Acetyl-L-cysteine (NAC). Int J Audiol 2019; 58:151-157. [DOI: 10.1080/14992027.2018.1543961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ulf Rosenhall
- Audiology Department, Habilitering & Hälsa, Region Västra Götaland, Gothenburg, Sweden
- Department of Health and Rehabilitation, Division of Audiology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Björn Skoog
- Armed Forces Centre for Defense Medicine, Gothenburg, Sweden
| | - Per Muhr
- Audiology Department, Habilitering & Hälsa, Region Västra Götaland, Gothenburg, Sweden
- Department of Clinical Science, Unit of Audiology, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Langguth B, Elgoyhen AB, Cederroth CR. Therapeutic Approaches to the Treatment of Tinnitus. Annu Rev Pharmacol Toxicol 2019; 59:291-313. [DOI: 10.1146/annurev-pharmtox-010818-021556] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Tinnitus is a highly prevalent condition that is associated with hearing loss in most cases. In the absence of external stimuli, phantom perceptions of sounds emerge from alterations in neuronal activity within central auditory and nonauditory structures. Pioneering studies using lidocaine revealed that tinnitus is susceptible to pharmacological interventions. However, lidocaine is not effective in all patients, and no other drug has been identified with clear efficacy for the long-term treatment of tinnitus. In this review, we present recent advances in tinnitus research, including more detailed knowledge of its pathophysiology and involved neurotransmitter systems. Moreover, we summarize results from animal and clinical treatment studies as well as from studies that identified tinnitus as a side effect of pharmacological treatments. Finally, we focus on challenges in the development of pharmacological compounds for the treatment of tinnitus, namely the limitations of available animal models and of standardized clinical research methodologies.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, and Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
| | - Ana Belen Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Héctor N. Torres,” Consejo Nacional de Investigaciones Científicas y Técnicas, 1428 Buenos Aires, Argentina
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, 1121 Buenos Aires, Argentina
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Abstract
Sensorineural hearing impairment is the most common sensory disorder and a major health and socio-economic issue in industrialized countries. It is primarily due to the degeneration of mechanosensory hair cells and spiral ganglion neurons in the cochlea via complex pathophysiological mechanisms. These occur following acute and/or chronic exposure to harmful extrinsic (e.g., ototoxic drugs, noise...) and intrinsic (e.g., aging, genetic) causative factors. No clinical therapies currently exist to rescue the dying sensorineural cells or regenerate these cells once lost. Recent studies have, however, provided renewed hope, with insights into the therapeutic targets allowing the prevention and treatment of ototoxic drug- and noise-induced, age-related hearing loss as well as cochlear cell degeneration. Moreover, genetic routes involving the replacement or corrective editing of mutant sequences or defected genes are showing promise, as are cell-replacement therapies to repair damaged cells for the future restoration of hearing in deaf people. This review begins by recapitulating our current understanding of the molecular pathways that underlie cochlear sensorineural damage, as well as the survival signaling pathways that can provide endogenous protection and tissue rescue. It then guides the reader through to the recent discoveries in pharmacological, gene and cell therapy research towards hearing protection and restoration as well as their potential clinical application.
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Affiliation(s)
- Jing Wang
- INSERM UMR 1051, Institute for Neurosciences of Montpellier, Montpellier, France; and University of Montpellier, Montpellier, France
| | - Jean-Luc Puel
- INSERM UMR 1051, Institute for Neurosciences of Montpellier, Montpellier, France; and University of Montpellier, Montpellier, France
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Factors Associated With the Benefits of Concurrent Administration of Intratympanic Steroid Injection With Oral Steroids in Patients With Acute Acoustic Trauma. Otol Neurotol 2018; 39:565-570. [DOI: 10.1097/mao.0000000000001784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ghelfi E, Grondin Y, Millet EJ, Bartos A, Bortoni M, Oliveira Gomes Dos Santos C, Trevino-Villarreal HJ, Sepulveda R, Rogers R. In vitro gentamicin exposure alters caveolae protein profile in cochlear spiral ligament pericytes. Proteome Sci 2018; 16:7. [PMID: 29760588 PMCID: PMC5938607 DOI: 10.1186/s12953-018-0132-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 02/04/2018] [Indexed: 12/20/2022] Open
Abstract
Background The aminoglycoside antibiotic gentamicin is an ototoxic drug and has been used experimentally to investigate cochlear damage induced by noise.We have investigated the changes in the protein profile associated with caveolae in gentamicin treated and untreated spiral ligament (SL) pericytes, specialized cells in the blood labyrinth barrier of the inner ear microvasculature. Pericytes from various microvascular beds express caveolae, protein and cholesterol rich microdomains, which can undergo endocytosis and transcytosis to transport small molecules in and out the cells. A different protein profile in transport-specialized caveolae may induce pathological changes affecting the integrity of the blood labyrinth barrier and ultimately contributing to hearing loss. Method Caveolae isolation from treated and untreated cells is achieved through ultracentrifugation of the lysates in discontinuous gradients. Mass spectrometry (LC-MS/MS) analysis identifies the proteins in the two groups. Proteins segregating with caveolae isolated from untreated SL pericytes are then compared to caveolae isolated from SL pericytes treated with the gentamicin for 24 h. Data are analyzed using bioinformatic tools. Results The caveolae proteome in gentamicin treated cells shows that 40% of total proteins are uniquely associated with caveolae during the treatment, and 15% of the proteins normally associated with caveolae in untreated cell are suppressed. Bioinformatic analysis of the data shows a decreased expression of proteins involved in genetic information processing, and an increase in proteins involved in metabolism, vesicular transport and signal transduction in gentamicin treated cells. Several Rab GTPases proteins, ubiquitous transporters, uniquely segregate with caveolae and are significantly enriched in gentamicin treated cells. Conclusion We report that gentamicin exposure modifies protein profile of caveolae from SL pericytes. We identified a pool of proteins which are uniquely segregating with caveolae during the treatment, mainly participating in metabolic and biosynthetic pathways, in transport pathways and in genetic information processing. Finally, we show for the first time proteins associated with caveolae SL pericytes linked to nonsyndromic hearing loss.
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Affiliation(s)
- Elisa Ghelfi
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
| | - Yohann Grondin
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
| | - Emil J Millet
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
| | - Adam Bartos
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
| | - Magda Bortoni
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
| | - Clara Oliveira Gomes Dos Santos
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA.,2Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo, Brazil
| | | | - Rosalinda Sepulveda
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA.,4Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Mexico
| | - Rick Rogers
- 1Harvard T.H. Chan School of Public Health, Department of Environmental Health, MIPS Program, Boston, MA USA
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García-Alcántara F, Murillo-Cuesta S, Pulido S, Bermúdez-Muñoz JM, Martínez-Vega R, Milo M, Varela-Nieto I, Rivera T. The expression of oxidative stress response genes is modulated by a combination of resveratrol and N-acetylcysteine to ameliorate ototoxicity in the rat cochlea. Hear Res 2017; 358:10-21. [PMID: 29304389 DOI: 10.1016/j.heares.2017.12.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 09/06/2017] [Accepted: 12/10/2017] [Indexed: 11/19/2022]
Abstract
Aminoglycoside antibiotics are used widely in medicine despite their ototoxic side-effects. Oxidative stress and inflammation are key mechanisms determining the extent and severity of the damage. Here we evaluate the protective effect of a treatment with resveratrol plus N-acetylcysteine on the ototoxic actions of kanamycin and furosemide in the rat. Resveratrol (10 mg/kg) and N-acetylcysteine (400 mg/kg) were administered together to Wistar rats on 5 consecutive days. The second day, a concentrated solution of kanamycin and furosemide was placed on the round window to induce ototoxicity. Hearing was assessed by recording auditory brainstem responses before and 5, 16 and 23 days after the beginning of the treatment. Cochlear samples were taken at day 5 (end of the treatment) and at day 23, and targeted PCR arrays or RT-qPCR were performed to analyze oxidative balance and inflammation related genes, respectively. In addition, the cytoarchitecture and the presence of apoptosis, oxidative stress and inflammation markers were evaluated in cochlear sections. Results indicate that administration of resveratrol plus N-acetylcysteine reduced the threshold shifts induced by ototoxic drugs at high frequencies (≈10 dB), although this protective effect fades after the cessation of the treatment. Gene expression analysis showed that the treatment modulated the expression of genes involved in the cellular oxidative (Gpx1, Sod1, Ccs and Noxa1) and inflammatory (Il1b, Il4, Mpo and Ncf) responses to injury. Thus, co-administration of resveratrol and NAC, routinely used individually in patients, could reduce the ototoxic secondary effects of aminoglycosides.
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Affiliation(s)
- Fernando García-Alcántara
- Príncipe de Asturias University Hospital, Universidad de Alcalá, Carretera Alcalá-Meco s/n, 28805, Alcalá de Henares, Madrid, Spain; Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Silvia Murillo-Cuesta
- Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Pedro Rico 6, 28029, Madrid, Spain.
| | - Sara Pulido
- Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain; Department of Biomedical Science, University of Sheffield, Western Bank, Sheffield, S3 7HF, United Kingdom.
| | - Jose M Bermúdez-Muñoz
- Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Raquel Martínez-Vega
- Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain.
| | - Marta Milo
- Department of Biomedical Science, University of Sheffield, Western Bank, Sheffield, S3 7HF, United Kingdom.
| | - Isabel Varela-Nieto
- Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Pedro Rico 6, 28029, Madrid, Spain.
| | - Teresa Rivera
- Príncipe de Asturias University Hospital, Universidad de Alcalá, Carretera Alcalá-Meco s/n, 28805, Alcalá de Henares, Madrid, Spain; Institute of Biomedical Research "Alberto Sols" (IIBM), Spanish National Research Council-Autonomous University of Madrid (CSIC-UAM), Arturo Duperier 4, 28029, Madrid, Spain; Centre for Biomedical Network Research in Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Monforte de Lemos, 3-5, 28029, Madrid, Spain.
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Souza MEDCAD, Costa KVTD, Vitorino PA, Bueno NB, Menezes PDL. Effect of antioxidant supplementation on the auditory threshold in sensorineural hearing loss: a meta-analysis. Braz J Otorhinolaryngol 2017; 84:368-380. [PMID: 28888754 PMCID: PMC9449190 DOI: 10.1016/j.bjorl.2017.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/12/2017] [Accepted: 07/18/2017] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at different stages of life; during pregnancy or childbirth, in childhood, adulthood or old age. It should be noted that aging is the most common cause of sensorineural hearing loss followed by noise-induced hearing loss, and both are closely related to the formation of reactive oxygen species. Dietary antioxidant supplementation has been employed as a therapeutic strategy to prevent and/or delay the risks of major human diseases. OBJECTIVE To assess randomized clinical trials to determine the effect of antioxidant supplementation on the auditory thresholds in patients of different age groups with sensorineural hearing loss. METHODS This systematic review consisted of a search in the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to the intervention (antioxidant supplementation), primary outcome (sensorineural hearing loss), as well as terms related to randomized clinical trials to improve search sensitivity. RESULTS Based on 977 potentially relevant records identified through the search in the databases, ten full-text publications were retrieved for further evaluation. The increase in threshold at the 4kHz frequency was statistically higher in the control group (1.89 [1.01-2.78], p<0.0001) when compared to the NAC group and the ginseng group, whereas at 6kHz, the threshold increase was higher in the control group (1.42 [-1.14-3.97], p=0.28), but no statistically significant differences were found between groups. CONCLUSION Ginseng was the antioxidant agent that showed the best effect in preventing auditory threshold worsening at the frequency of 4kHz, but not at 6kHz in patients with sensorineural hearing loss caused by exposure to high sound pressure levels. There was no improvement in the thresholds with vitamin E supplementation.
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Affiliation(s)
| | | | - Paulo Augusto Vitorino
- Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Laboratório de Audição e Tecnologia (LATEC), Maceió, AL, Brazil
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HPN-07, a free radical spin trapping agent, protects against functional, cellular and electrophysiological changes in the cochlea induced by acute acoustic trauma. PLoS One 2017; 12:e0183089. [PMID: 28832600 PMCID: PMC5568441 DOI: 10.1371/journal.pone.0183089] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/28/2017] [Indexed: 11/29/2022] Open
Abstract
Oxidative stress is considered a major cause of the structural and functional changes associated with auditory pathologies induced by exposure to acute acoustic trauma AAT). In the present study, we examined the otoprotective effects of 2,4-disulfophenyl-N-tert-butylnitrone (HPN-07), a nitrone-based free radical trap, on the physiological and cellular changes in the auditory system of chinchilla following a six-hour exposure to 4 kHz octave band noise at 105 dB SPL. HPN-07 has been shown to suppress oxidative stress in biological models of a variety of disorders. Our results show that administration of HPN-07 beginning four hours after acoustic trauma accelerated and enhanced auditory/cochlear functional recovery, as measured by auditory brainstem responses (ABR), distortion product otoacoustic emissions (DPOAE), compound action potentials (CAP), and cochlear microphonics (CM). The normally tight correlation between the endocochlear potential (EP) and evoked potentials of CAP and CM were persistently disrupted after noise trauma in untreated animals but returned to homeostatic conditions in HPN-07 treated animals. Histological analyses revealed several therapeutic advantages associated with HPN-07 treatment following AAT, including reductions in inner and outer hair cell loss; reductions in AAT-induced loss of calretinin-positive afferent nerve fibers in the spiral lamina; and reductions in fibrocyte loss within the spiral ligament. These findings support the conclusion that early intervention with HPN-07 following an AAT efficiently blocks the propagative ototoxic effects of oxidative stress, thereby preserving the homeostatic and functional integrity of the cochlea.
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Abstract
OBJECTIVE To critically review and evaluate the proposed mechanisms and documented results of the therapeutics currently in active clinical drug trials for the treatment of sensorineural hearing loss. DATA SOURCES US National Institutes of Health (NIH) Clinical Trials registry, MEDLINE/PubMed. STUDY SELECTION & DATA EXTRACTION A review of the NIH Clinical Trials registry identified candidate hearing loss therapies, and supporting publications were acquired from MEDLINE/PubMed. Proof-of-concept, therapeutic mechanisms, and clinical outcomes were critically appraised. DATA SYNTHESIS Twenty-two active clinical drug trials registered in the United States were identified, and six potentially therapeutic molecules were reviewed. Of the six molecules reviewed, four comprised mechanisms pertaining to mitigating oxidative stress pathways that presumably lead to inner ear cell death. One remaining therapy sought to manipulate the cell death cascade, and the last remaining therapy was a novel cell replacement therapy approach to introduce a transcription factor that promotes hair cell regeneration. CONCLUSION A common theme in recent clinical trials registered in the United States appears to be the targeting of cell death pathways and influence of oxidant stressors on cochlear sensory neuroepithelium. In addition, a virus-delivered cell replacement therapy would be the first of its kind should it prove safe and efficacious. Significant challenges for bringing these bench-to-bedside therapies to market remain. It is never assured that results in non-human animal models translate to effective therapies in the setting of human biology. Moreover, as additional processes are described in association with hearing loss, such as an immune response and loss of synaptic contacts, additional pathways for targeting become available.
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Affiliation(s)
- Matthew G. Crowson
- Division of Head & Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Ronna Hertzano
- Department of Otorhinolaryngology Head & Neck Surgery, Anatomy and Neurobiology and Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD USA
| | - Debara Tucci
- Division of Head & Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC USA
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Le TN, Straatman LV, Lea J, Westerberg B. Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options. J Otolaryngol Head Neck Surg 2017; 46:41. [PMID: 28535812 PMCID: PMC5442866 DOI: 10.1186/s40463-017-0219-x] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/15/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure tone threshold testing. Noise-induced damage to the cochlea is traditionally considered to be associated with symmetrical mild to moderate hearing loss with associated tinnitus; however, there is a significant number of patients with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well. MAIN BODY Recent epidemiology and animal studies have provided further insight into the pathophysiology, clinical findings, social and economic impacts of noise-induced hearing loss. Furthermore, it is recently shown that acoustic trauma is associated with vestibular dysfunction, with associated dizziness that is not always measurable with current techniques. Deliberation of the prevalence, treatment and prevention of noise-induced hearing loss is important and timely. Currently, prevention and protection are the first lines of defence, although promising protective effects are emerging from multiple different pharmaceutical agents, such as steroids, antioxidants and neurotrophins. CONCLUSION This review provides a comprehensive update on the pathophysiology, investigations, prevalence of asymmetry, associated symptoms, and current strategies on the prevention and treatment of noise-induced hearing loss.
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Affiliation(s)
- Trung N. Le
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Louise V. Straatman
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Jane Lea
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Brian Westerberg
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
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Skvarc DR, Dean OM, Byrne LK, Gray L, Lane S, Lewis M, Fernandes BS, Berk M, Marriott A. The effect of N-acetylcysteine (NAC) on human cognition - A systematic review. Neurosci Biobehav Rev 2017; 78:44-56. [PMID: 28438466 DOI: 10.1016/j.neubiorev.2017.04.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 12/15/2022]
Abstract
Oxidative stress, neuroinflammation and neurogenesis are commonly implicated as cognitive modulators across a range of disorders. N-acetylcysteine (NAC) is a glutathione precursor with potent antioxidant, pro-neurogenesis and anti-inflammatory properties and a favourable safety profile. A systematic review of the literature specifically examining the effect of NAC administration on human cognition revealed twelve suitable articles for inclusion: four examining Alzheimer's disease; three examining healthy participants; two examining physical trauma; one examining bipolar disorder, one examining schizophrenia, and one examining ketamine-induced psychosis. Heterogeneity of studies, insufficiently powered studies, infrequency of cognition as a primary outcome, heterogeneous methodologies, formulations, co-administered treatments, administration regimes, and assessment confounded the drawing of firm conclusions. The available data suggested statistically significant cognitive improvements following NAC treatment, though the paucity of NAC-specific research makes it difficult to determine if this effect is meaningful. While NAC may have a positive cognitive effect in a variety of contexts; larger, targeted studies are warranted, specifically evaluating its role in other clinical disorders with cognitive sequelae resulting from oxidative stress and neuroinflammation.
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Affiliation(s)
- David R Skvarc
- School of Psychology, Deakin University, Melbourne, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, Melbourne, Australia
| | - Laura Gray
- Deakin University, School of Medicine, Geelong, Australia
| | - Stephen Lane
- Deakin University, School of Medicine, Geelong, Australia; Biostatistics Unit, Barwon Health, Geelong, Australia
| | - Matthew Lewis
- School of Psychology, Deakin University, Melbourne, Australia; Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Caulfield, Australia
| | - Brisa S Fernandes
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Andrew Marriott
- Department of Anaesthesia, Perioperative Medicine & Pain Management, Barwon Health, Geelong, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia.
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Bhatt IS, Guthrie O. Analysis of audiometric notch as a noise-induced hearing loss phenotype in US youth: data from the National Health And Nutrition Examination Survey, 2005–2010. Int J Audiol 2017. [DOI: 10.1080/14992027.2017.1278799] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ishan S. Bhatt
- Department of Communication Sciences & Disorders, Northern Arizona University, Flagstaff, AZ, USA and
| | - O’neil Guthrie
- Department of Communication Sciences & Disorders, Northern Arizona University, Flagstaff, AZ, USA and
- Director of the Cell & Molecular Pathology Laboratory, Northern Arizona University, Flagstaff, AZ, USA
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Abstract
CONCLUSION Like NAC ameliorates hearing loss from acoustic trauma in the inner ear, NAC may also rescue hearing loss from sudden deafness confined to the inner ear. OBJECTIVE This study assesses the effect of N-acetyl-L-cysteine (NAC) as a single therapy for sudden deafness. METHODS Thirty-five sudden deafness patients with neither systemic disorders nor central signs in electronystagmography were treated with NAC alone and assigned to Group A. For comparison, another 35 sudden deafness patients treated by corticosteroids and plasma expander were assigned to Group B. There were no significant differences between the two groups in terms of age, sex, laterality, and pre-treatment mean hearing level. All patients underwent an inner ear test battery comprising audiometry, and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests. RESULTS Groups A and B did not significantly differ in the pre-treatment mean hearing level, and percentages of abnormal oVEMP, cVEMP, and caloric tests, indicating that the involvement severity of sudden deafness between the two groups was similar. However, Group A (43 ± 27 dB) showed significantly greater mean hearing gain than Group B (21 ± 28 dB), and Group A (91%) revealed better improved rate of hearing than Group B (57%).
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Sha SH, Schacht J. Emerging therapeutic interventions against noise-induced hearing loss. Expert Opin Investig Drugs 2016; 26:85-96. [PMID: 27918210 DOI: 10.1080/13543784.2017.1269171] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Noise-induced hearing loss (NIHL) due to industrial, military, and recreational noise exposure is a major, but also potentially preventable cause of acquired hearing loss. For the United States it is estimated that 26 million people (15% of the population) between the ages of 20 and 69 have a high-frequency NIHL at a detriment to the quality of life of the affected individuals and great economic cost to society. Areas covered: This review outlines the pathology and pathophysiology of hearing loss as seen in humans and animal models. Results from molecular studies are presented that have provided the basis for therapeutic strategies successfully applied to animals. Several compounds emerging from these studies (mostly antioxidants) are now being tested in field trials. Expert opinion: Although no clinically applicable intervention has been approved yet, recent trials are encouraging. In order to maximize protective therapies, future work needs to apply stringent criteria for noise exposure and outcome parameters. Attention needs to be paid not only to permanent NIHL due to death of sensory cells but also to temporary effects that may show delayed consequences. Existing results combined with the search for efficacious new therapies should establish a viable treatment within a decade.
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Affiliation(s)
- Su-Hua Sha
- a Department of Pathology and Laboratory Medicine , Medical University of South Carolina , Charleston , SC , USA
| | - Jochen Schacht
- b Kresge Hearing Research Institute , University of Michigan , Ann Arbor , MI , USA
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Bhatt I, Phillips S, Richter S, Tucker D, Lundgren K, Morehouse R, Henrich V. A polymorphism in human estrogen-related receptor beta (ESRRβ) predicts audiometric temporary threshold shift. Int J Audiol 2016; 55:571-9. [DOI: 10.1080/14992027.2016.1192693] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ishan Bhatt
- Communication Sciences & Disorders, Northern Arizona University, Flagstaff, USA,
| | - Susan Phillips
- Department of Communication Sciences & Disorders, The University of North Carolina at Greensboro, Greensboro, USA,
| | - Scott Richter
- Department of Mathematics and Statistics, The University of North Carolina at Greensboro, Greensboro, USA,
| | - Denise Tucker
- Department of Communication Sciences & Disorders, The University of North Carolina at Greensboro, Greensboro, USA,
| | - Kristine Lundgren
- Department of Communication Sciences & Disorders, The University of North Carolina at Greensboro, Greensboro, USA,
| | - Robin Morehouse
- Communication Sciences & Disorders, Appalachian State University, Boone, USA, and
| | - Vincent Henrich
- Center for Biotechnology, Genomics & Health Research, The University of North Carolina at Greensboro, Greensboro, USA
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Le Prell CG, Fulbright A, Spankovich C, Griffiths SK, Lobarinas E, Campbell KCM, Antonelli PJ, Green GE, Guire K, Miller JM. Dietary supplement comprised of β-carotene, vitamin C, vitamin E, and magnesium: failure to prevent music-induced temporary threshold shift. AUDIOLOGY AND NEUROTOLOGY EXTRA 2016; 6:20-39. [PMID: 27990155 DOI: 10.1159/000446600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study examined potential prevention of music-induced temporary threshold shift (TTS) in normal-hearing participants. A dietary supplement composed of β-carotene, vitamins C and E, and magnesium was assessed using a randomized, placebo-controlled, double-blind study design. Dosing began 3 days prior to the music exposure with the final dose consumed approximately 30-min pre-exposure. There were no group differences in post-exposure TTS or music-induced decreases in distortion product otoacoustic emission (DPOAE) amplitude. Transient tinnitus was more likely to be reported by the treatment group, but there were no group differences in perceived loudness or bothersomeness. All subjects were monitored until auditory function returned to pre-exposure levels. Taken together, this supplement had no effect on noise-induced changes in hearing. Recommendations for future clinical trials are discussed.
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Affiliation(s)
- C G Le Prell
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Tex
| | - A Fulbright
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
| | - C Spankovich
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Miss
| | - S K Griffiths
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
| | - E Lobarinas
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Tex
| | - K C M Campbell
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Ill
| | - P J Antonelli
- Department of Otolaryngology, University of Florida, Gainesville, Fla
| | - G E Green
- Department of Otolaryngology, University of Michigan, Ann Arbor, Mich
| | - K Guire
- Department of Biostatistics, University of Michigan, Ann Arbor, Mich
| | - J M Miller
- Department of Otolaryngology, University of Michigan, Ann Arbor, Mich
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Doosti A, Lotfi Y, Bakhshi E. Effects of Hyperlipidemia on Noise Induced Hearing Loss (NIHL). Indian J Otolaryngol Head Neck Surg 2016; 68:211-3. [PMID: 27340639 DOI: 10.1007/s12070-015-0855-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022] Open
Abstract
Likelihood of developing noise induced hearing loss (NIHL) is affected by some factors such as genes, nutrition and healthy hearing habits. We investigated this study to determine the effect of hyperlipidemia on NIHL. In a case-control study, 144 workers who exposed to continuous noise more than 85 dBA (88-89 dBA) from a textile factory in Tehran were examined. Serum Blood test results as index for dyslipidemi, were collected and audiometry tests were carried out to analyze the association of hyperlipidemian and NIHL. The mean ±SD of Cholesterol level for NIHL and control were 188.19 (28.46) and 159.00 (26.66) mg/dL respectively. Also the mean ±SD of Triglyceride level for NIHL and control were 203.75 (53.92) and 105.00 (30.50) mg/dL consecutively. After adjusting odds ratio (OR) for NIHL, only hypertriglyceridemia had association with NIHL. (aOR = 1.07; 95 % CI 1.04-1.10), and there wasn't any relation between hypercholestomia and NIHL (aOR = 1.02; 95 % CI 0.99-1.05). Workers with hypertriglyceridemia are at increased risk for NIHL. In factories with elevated noise levels, besides hearing conservation programs, attention to blood serum level of workers and healthy diet are proposed to help in preserving hearing threshold.
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Affiliation(s)
- Afsaneh Doosti
- Audiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yones Lotfi
- Audiology Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Enayatollah Bakhshi
- Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Velenjak, P.O. Box: 1985713834, Tehran, Iran
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Pharmacological agents used for treatment and prevention in noise-induced hearing loss. Eur Arch Otorhinolaryngol 2016; 273:4089-4101. [DOI: 10.1007/s00405-016-3936-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/10/2016] [Indexed: 12/20/2022]
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Kranzer K, Elamin WF, Cox H, Seddon JA, Ford N, Drobniewski F. A systematic review and meta-analysis of the efficacy and safety ofN-acetylcysteine in preventing aminoglycoside-induced ototoxicity: implications for the treatment of multidrug-resistant TB. Thorax 2015; 70:1070-7. [DOI: 10.1136/thoraxjnl-2015-207245] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/18/2015] [Indexed: 11/03/2022]
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High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study. Sci Rep 2015; 5:13341. [PMID: 26293121 PMCID: PMC4544016 DOI: 10.1038/srep13341] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/21/2015] [Indexed: 11/23/2022] Open
Abstract
Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.
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Yang CH, Schrepfer T, Schacht J. Age-related hearing impairment and the triad of acquired hearing loss. Front Cell Neurosci 2015; 9:276. [PMID: 26283913 PMCID: PMC4515558 DOI: 10.3389/fncel.2015.00276] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 07/06/2015] [Indexed: 02/03/2023] Open
Abstract
Understanding underlying pathological mechanisms is prerequisite for a sensible design of protective therapies against hearing loss. The triad of age-related, noise-generated, and drug-induced hearing loss displays intriguing similarities in some cellular responses of cochlear sensory cells such as a potential involvement of reactive oxygen species (ROS) and apoptotic and necrotic cell death. On the other hand, detailed studies have revealed that molecular pathways are considerably complex and, importantly, it has become clear that pharmacological protection successful against one form of hearing loss will not necessarily protect against another. This review will summarize pathological and pathophysiological features of age-related hearing impairment (ARHI) in human and animal models and address selected aspects of the commonality (or lack thereof) of cellular responses in ARHI to drugs and noise.
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Affiliation(s)
- Chao-Hui Yang
- Department of Otolaryngology, Kresge Hearing Research Institute, University of Michigan Ann Arbor, MI, USA ; Division of Otology, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Thomas Schrepfer
- Department of Otolaryngology, Kresge Hearing Research Institute, University of Michigan Ann Arbor, MI, USA
| | - Jochen Schacht
- Department of Otolaryngology, Kresge Hearing Research Institute, University of Michigan Ann Arbor, MI, USA
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Abstract
PURPOSE OF REVIEW Up to 30 million workers in the United States are exposed to potentially detrimental levels of noise. Although reliable medications for minimizing or reversing noise-induced hearing loss (NIHL) are not currently available, NIHL is entirely preventable. The purpose of this article is to review the epidemiology and pathophysiology of occupational NIHL. We will focus on at-risk populations and discuss prevention programs. Current prevention programs focus on reducing inner ear damage by minimizing environmental noise production and through the use of personal hearing protective devices. RECENT FINDINGS NIHL is the result of a complex interaction between environmental factors and patient factors, both genetic and acquired. The effects of noise exposure are specific to an individual. Trials are currently underway evaluating the role of antioxidants in protection from, and even reversal of, NIHL. SUMMARY Occupational NIHL is the most prevalent occupational disease in the United States. Occupational noise exposures may contribute to temporary or permanent threshold shifts, although even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are paramount in reducing hearing loss as a result of occupational exposures.
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Phillips SL, Richter SJ, Teglas SL, Bhatt IS, Morehouse RC, Hauser ER, Henrich VC. Feasibility of a bilateral 4000-6000 Hz notch as a phenotype for genetic association analysis. Int J Audiol 2015; 54:645-52. [PMID: 25938503 DOI: 10.3109/14992027.2015.1030512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Noise-induced hearing loss (NIHL) is a worldwide health problem and a growing concern among young people. Although some people appear to be more susceptible to NIHL, genetic association studies lack a specific phenotype. We tested the feasibility of a bilateral 4000-6000 Hz audiometric notch as a phenotype for identifying genetic contributions to hearing loss in young adults. DESIGN A case-control-control study was conducted to examine selected SNPs in 52 genes previously associated with hearing loss and/or expressed in the cochlea. A notch was defined as a minimum of a 15-dB drop at 4000-6000 Hz from the previous best threshold with a 5-dB 'recovery' at 8000 Hz. STUDY SAMPLE Participants were 252 individuals of European descent taken from a population of 640 young adults who are students of classical music. Participants were grouped as No-notch (NN), Unilateral Notch (UN), or Bilateral Notch (BN). RESULTS The strongest evidence of a genetic association with the 4000-6000 Hz notch was a nonsynonymous SNP variant in the ESRR- gene (rs61742642:C> T, P386S). Carriers of the minor allele accounted for 26% of all bilateral losses. CONCLUSION This study indicates that the 4000-6000 Hz bilateral notch is a feasible phenotype for identifying genetic susceptibility to hearing loss.
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Affiliation(s)
- Susan L Phillips
- a * Communication Sciences & Disorders, University of North Carolina at Greensboro , USA
| | - Scott J Richter
- b Math & Statistics, University of North Carolina at Greensboro , USA
| | - Sandra L Teglas
- c Music Research Institute, University of North Carolina at Greensboro , USA
| | - Ishan S Bhatt
- d Communication Sciences & Disorders, Northern Arizona University , Flagstaff , USA
| | - Robin C Morehouse
- e Communication Sciences & Disorders, Appalachian State University , Boone USA
| | | | - Vincent C Henrich
- g Center for Biotechnology, Genomics & Health Research, University of North Carolina at Greensboro , USA
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