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Graham AS, Ben-Azu B, Tremblay MÈ, Torre P, Senekal M, Laughton B, van der Kouwe A, Jankiewicz M, Kaba M, Holmes MJ. A review of the auditory-gut-brain axis. Front Neurosci 2023; 17:1183694. [PMID: 37600010 PMCID: PMC10435389 DOI: 10.3389/fnins.2023.1183694] [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: 03/10/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Hearing loss places a substantial burden on medical resources across the world and impacts quality of life for those affected. Further, it can occur peripherally and/or centrally. With many possible causes of hearing loss, there is scope for investigating the underlying mechanisms involved. Various signaling pathways connecting gut microbes and the brain (the gut-brain axis) have been identified and well established in a variety of diseases and disorders. However, the role of these pathways in providing links to other parts of the body has not been explored in much depth. Therefore, the aim of this review is to explore potential underlying mechanisms that connect the auditory system to the gut-brain axis. Using select keywords in PubMed, and additional hand-searching in google scholar, relevant studies were identified. In this review we summarize the key players in the auditory-gut-brain axis under four subheadings: anatomical, extracellular, immune and dietary. Firstly, we identify important anatomical structures in the auditory-gut-brain axis, particularly highlighting a direct connection provided by the vagus nerve. Leading on from this we discuss several extracellular signaling pathways which might connect the ear, gut and brain. A link is established between inflammatory responses in the ear and gut microbiome-altering interventions, highlighting a contribution of the immune system. Finally, we discuss the contribution of diet to the auditory-gut-brain axis. Based on the reviewed literature, we propose numerous possible key players connecting the auditory system to the gut-brain axis. In the future, a more thorough investigation of these key players in animal models and human research may provide insight and assist in developing effective interventions for treating hearing loss.
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Affiliation(s)
- Amy S. Graham
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
| | - Benneth Ben-Azu
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Département de Médecine Moléculaire, Université Laval, Québec City, QC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
- Neurology and Neurosurgery Department, McGill University, Montreal, QC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada
- Institute for Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Peter Torre
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, United States
| | - Marjanne Senekal
- Department of Human Biology, Division of Physiological Sciences, University of Cape Town, Cape Town, South Africa
| | - Barbara Laughton
- Family Clinical Research Unit, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Andre van der Kouwe
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Marcin Jankiewicz
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
| | - Mamadou Kaba
- Department of Pathology, Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Martha J. Holmes
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- ImageTech, Simon Fraser University, Surrey, BC, Canada
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Roy P, Chandra M, Mishra A, Verma V, Sawlani KK, Singh HP, Kumar S, Saxena S, Singh AB, Pandey S, Usman K, Kumar P, Himanshu D. Otological and Visual Implications of Diabetes Mellitus in North Indian Population. Indian J Otolaryngol Head Neck Surg 2019; 71:1639-1651. [PMID: 31750230 PMCID: PMC6841803 DOI: 10.1007/s12070-019-01705-y] [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: 01/17/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022] Open
Abstract
The worldwide population of diabetic patients is increasing alarmingly with India claiming number one position. It causes irreversible damage to cochlear hair cells, vestibular apparatus, visual pathway, nephrons, nerves, if not checked in time. A total of 188 patients of diabetes mellitus were included in this prospective study. The patients underwent routine anamnesis, hearing handicap inventory and dizziness handicap inventory assessment along with clinical examination for audiological, vestibular, neurological and ophthalmological (fundoscopy) status. In our study a sensorineural hearing loss, retinopathy, neuropathy, vestibulopathy was seen in diabetic patients.
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Affiliation(s)
- Prateek Roy
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | - Manish Chandra
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | - Anupam Mishra
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | | | | | - H. P. Singh
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | - Sunil Kumar
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | | | - A. B. Singh
- Department of ENT Head Neck Surgery, KGMU, Lucknow, India
| | | | | | - Pramod Kumar
- Department of Ophthalmology, KGMU, Lucknow, India
| | - D. Himanshu
- Department of Medicine, KGMU, Lucknow, India
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Susceptibility of Diabetic Mice to Noise Trauma. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7601232. [PMID: 29619376 PMCID: PMC5830016 DOI: 10.1155/2018/7601232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/26/2017] [Accepted: 01/17/2018] [Indexed: 02/07/2023]
Abstract
Diabetes can lead to many end-organ complications. However, the association between diabetes and hearing loss is not well understood. Here, we investigated the effect of noise exposure on diabetic mice compared with wild-type mice. Hearing threshold shifts, histopathologic changes in the cochlea, and inflammatory responses were evaluated over time. After noise exposure, more severe hearing threshold shifts, auditory hair cell loss, and synaptopathies were notable in diabetic mice compared with wild-type mice. Moreover, increased inflammatory responses and reactive oxygen species production were observed in the ears of diabetic mice. The results demonstrated that diabetic mice are more susceptible to noise trauma.
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Risk of developing sudden sensorineural hearing loss in diabetic patients: a population-based cohort study. Otol Neurotol 2013; 33:1482-8. [PMID: 23064384 DOI: 10.1097/mao.0b013e318271397a] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To explore the risk of development of sudden sensorineural hearing loss (SSHL) among diabetes mellitus patients. STUDY DESIGN A retrospective cohort study. SETTING Population-based study of Taiwan National Health Insurance Research Database. PATIENTS Approximately 26,556 newly diagnosed diabetic patients and 26,556 comparison subjects without diabetes mellitus were selected from claims made during 2000 to 2004. MAIN OUTCOME MEASURES The incidence of sudden sensorineural hearing loss (SSHL) at the end of 2009 was determined. RESULTS The incidence of SSHL was 1.54-fold higher in the diabetic group compared with the nondiabetic group (1.29 versus 0.78 per 1,000 person-years), and using Cox proportional hazard regressions, the adjusted hazard ratio (HR) was 1.592 (95% confidence interval [CI], 1.295-1.957). The risk of developing SSHL increased substantially to an HR of 2.060 (95% CI, 1.051-4.037), for patients who required triple antidiabetic medication compared with diabetic patients treated with a single antidiabetic drug. An increased risk of developing SSHL, with adjusted HRs of 1.574 (95% CI, 1.091-2.271) and 2.842 (95% CI, 1.880-4.295), was observed in diabetic patients with newly diagnosed comorbidities of retinopathy or retinopathy combined with renal insufficiency, which are both expected to reflect the severity of diabetes. CONCLUSION Diabetes mellitus was significantly associated with an increased risk of developing SSHL. Coronary heart disease or retinopathy comorbidities in diabetic patients seemed to be associated with an increased risk of developing SSHL. The risk of developing SSHL increased with the severity of diabetes.
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Chasens ER, Enock M, DiNardo M. Reducing a Barrier to Diabetes Education. DIABETES EDUCATOR 2010; 36:956-64. [PMID: 20935281 DOI: 10.1177/0145721710383442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Recent research suggests that hearing loss, a frequent problem for aging adults, is more prevalent in people with diabetes. Hearing impairment affects a patient’s learning. This article reviews the anatomy and physiology involved in hearing, describes common causes of hearing loss in people with diabetes, and describes how hearing loss is diagnosed and treated. Two simple tests the diabetes educator can use to screen for hearing loss are described, and interventions that improve communication with patients with difficulty hearing are explained. Conclusions Hearing loss can negatively affect a patient’s ability to actively participate in diabetes education. Diabetes educators have a responsibility to learn how to communicate better with their patients who have a hearing impairment. Diabetes educators are uniquely positioned to improve the health status of their patients by identifying persons who need referral for further evaluation of their hearing.
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Affiliation(s)
- Eileen R. Chasens
- University of Pittsburgh, School of Nursing, Pittsburgh,
Pennsylvania,
| | - Marilyn Enock
- A Better Hearing Experience, Pittsburgh, Pennsylvania
| | - Monica DiNardo
- University of Pittsburgh, School of Nursing, Pittsburgh,
Pennsylvania
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