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Thakur NS, Rus I, Herbert A, Zallocchi M, Chakrabarty B, Joshi AD, Lomeo J, Agrahari V. Crosslinked-hybrid nanoparticle embedded in thermogel for sustained co-delivery to inner ear. J Nanobiotechnology 2024; 22:482. [PMID: 39135039 PMCID: PMC11321169 DOI: 10.1186/s12951-024-02686-z] [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: 05/20/2024] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
Treatment-induced ototoxicity and accompanying hearing loss are a great concern associated with chemotherapeutic or antibiotic drug regimens. Thus, prophylactic cure or early treatment is desirable by local delivery to the inner ear. In this study, we examined a novel way of intratympanically delivered sustained nanoformulation by using crosslinked hybrid nanoparticle (cHy-NPs) in a thermoresponsive hydrogel i.e. thermogel that can potentially provide a safe and effective treatment towards the treatment-induced or drug-induced ototoxicity. The prophylactic treatment of the ototoxicity can be achieved by using two therapeutic molecules, Flunarizine (FL: T-type calcium channel blocker) and Honokiol (HK: antioxidant) co-encapsulated in the same delivery system. Here we investigated, FL and HK as cytoprotective molecules against cisplatin-induced toxic effects in the House Ear Institute - Organ of Corti 1 (HEI-OC1) cells and in vivo assessments on the neuromast hair cell protection in the zebrafish lateral line. We observed that cytotoxic protective effect can be enhanced by using FL and HK in combination and developing a robust drug delivery formulation. Therefore, FL-and HK-loaded crosslinked hybrid nanoparticles (FL-cHy-NPs and HK-cHy-NPs) were synthesized using a quality-by-design approach (QbD) in which design of experiment-central composite design (DoE-CCD) following the standard least-square model was used for nanoformulation optimization. The physicochemical characterization of FL and HK loaded-NPs suggested the successful synthesis of spherical NPs with polydispersity index < 0.3, drugs encapsulation (> 75%), drugs loading (~ 10%), stability (> 2 months) in the neutral solution, and appropriate cryoprotectant selection. We assessed caspase 3/7 apopototic pathway in vitro that showed significantly reduced signals of caspase 3/7 activation after the FL-cHy-NPs and HK-cHy-NPs (alone or in combination) compared to the CisPt. The final formulation i.e. crosslinked-hybrid-nanoparticle-embedded-in-thermogel was developed by incorporating drug-loaded cHy-NPs in poloxamer-407, poloxamer-188, and carbomer-940-based hydrogel. A combination of artificial intelligence (AI)-based qualitative and quantitative image analysis determined the particle size and distribution throughout the visible segment. The developed formulation was able to release the FL and HK for at least a month. Overall, a highly stable nanoformulation was successfully developed for combating treatment-induced or drug-induced ototoxicity via local administration to the inner ear.
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Affiliation(s)
- Neeraj S Thakur
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, 1110 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Iulia Rus
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, 1110 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Aidan Herbert
- DigiM Solution LLC, 500 West Cummings Park, Suite 3650, Woburn, MA, 01801, USA
| | - Marisa Zallocchi
- Department of Biomedical Sciences, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Brototi Chakrabarty
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, 1110 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Aditya D Joshi
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, 1110 North Stonewall Avenue, Oklahoma City, OK, 73117, USA
| | - Joshua Lomeo
- DigiM Solution LLC, 500 West Cummings Park, Suite 3650, Woburn, MA, 01801, USA
| | - Vibhuti Agrahari
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, 1110 North Stonewall Avenue, Oklahoma City, OK, 73117, USA.
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Kita A, Kedeshian K, Hong M, Hoffman L. An in vitro model for postoperative cranial nerve dysfunction and a proposed method of rehabilitation with N-acetylcysteine microparticles. Eur Arch Otorhinolaryngol 2024; 281:3805-3812. [PMID: 38649541 PMCID: PMC11211122 DOI: 10.1007/s00405-024-08622-z] [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: 02/23/2024] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE When operating near cranial motor nerves, transient postoperative weakness of target muscles lasting weeks to months is often observed. As nerves are typically intact at a procedure's completion, paresis is hypothesized to result from a combination of neurapraxia and axonotmesis. As both neurapraxia and axonotmesis involve Schwann cell injury and require remyelination, we developed an in vitro RSC96 Schwann cell model of injury using hydrogen peroxide (H2O2) to induce oxidative stress and investigated the efficacy of candidate therapeutic agents to promote RSC96 viability. As a first step in developing a long-term local administration strategy, the most promising of these agents was incorporated into sustained-release microparticles and investigated for bioactivity using this assay. METHODS The concentration of H2O2 which reduced viability by 50% was determined to establish a standard for inducing oxidative stress in RSC96 cultures. Fresh cultures were then co-dosed with H2O2 and the potential therapeutics melatonin, N-acetylcysteine, resveratrol, and 4-aminopyridine. Schwann cell viability was evaluated and the most efficacious agent, N-acetylcysteine, was encapsulated into microparticles. Eluted samples of N-acetylcysteine from microparticles was evaluated for retained bioactivity. RESULTS 100 µM N-acetylcysteine improved the viability of Schwann cells dosed with H2O2. 100 µM Microparticle-eluted N-acetylcysteine also enhanced Schwann cell viability. CONCLUSION We developed a Schwann cell culture model of iatrogenic nerve injury and used this to identify N-acetylcysteine as an agent to promote recovery. N-acetylcysteine was packaged into microparticles and demonstrated promise as a locally administrable agent to reduce oxidative stress in Schwann cells.
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Affiliation(s)
- Ashley Kita
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA.
| | - Katherine Kedeshian
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
| | - Michelle Hong
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
| | - Larry Hoffman
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
- Vestibular Neuroscience Laboratory, Brain Research Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Zavala-Valencia AC, Velasco-Hidalgo L, Martínez-Avalos A, Castillejos-López M, Torres-Espíndola LM. Effect of N-Acetylcysteine on Cisplatin Toxicity: A Review of the Literature. Biologics 2024; 18:7-19. [PMID: 38250216 PMCID: PMC10799624 DOI: 10.2147/btt.s438150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024]
Abstract
N-acetylcysteine (NAC) is a membrane-permeable cysteine precursor capable of enhancing the intracellular cysteine pool, enhancing cellular glutathione (GSH) synthesis, and thus potentiating the endogenous antioxidant mechanism. Late administration of NAC after cisplatin has been shown in different in vivo studies to reduce the side effects caused by various toxicities at different levels without affecting the antitumor efficacy of platinum, improving total and enzymatic antioxidant capacity and decreasing oxidative stress markers. These characteristics provide NAC with a rationale as a potentially effective chemo protectant in cisplatin-based therapeutic cycles. NAC represents a potential candidate as a chemoprotective agent to decrease toxicities secondary to cisplatin treatment. It suggests that it could be used in clinical trials, whereby the effective dose, timing, and route should be adjusted to optimize chemoprotection. This review provides an overview of the effect of NAC on cisplatin toxicity, a drug widely used in the clinic in adults and children.
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Affiliation(s)
- Angeles Citlali Zavala-Valencia
- Laboratory of Pharmacology, National Institute of Pediatrics, Mexico City, Mexico
- Iztacala Faculty of Higher Studies, Tlalnepantla, México
| | | | | | - Manuel Castillejos-López
- Hospital Epidemiology and Infectology Unit, National Institute of Respiratory Diseases Ismael Cosío Villegas, Mexico City, Mexico
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Correa-Morales JE, Giraldo-Moreno S, Mantilla-Manosalva N, Cuellar-Valencia L, Borja-Montes OF, Bedoya-Muñoz LJ, Iriarte-Aristizábal MF, Quintero-Muñoz E, Zuluaga-Liberato AM. Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review. Clin Otolaryngol 2024; 49:1-15. [PMID: 37818931 DOI: 10.1111/coa.14106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/04/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients. METHODS Four databases were searched up to 1 November 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles' quality was assessed via two grading scales. RESULTS Nineteen randomised controlled trials and five quasi-experimental studies with 1673 patients were analysed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins and D-methionine) showed mild benefits in preventing cisplatin-induced ototoxicity. Only one trial assessed corticoids as a potential treatment. Overall, only six trials were deemed with a low risk of bias. The majority of studies inadequately documented intervention-related adverse effects, thereby limiting safety conclusions. CONCLUSIONS Current interventions have mild benefits in preventing cisplatin-induced ototoxicity in adult cancer patients. Sodium thiosulphate is the most promising intervention as a preventive strategy. Rigorous, high-quality research is warranted, encompassing an evaluation of all potential symptoms and innovative treatment modalities.
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Affiliation(s)
- Juan Esteban Correa-Morales
- Palliative Care Program, Universidad de La Sabana, Bogotá, Colombia
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Nidia Mantilla-Manosalva
- Palliative Care Program, Universidad de La Sabana, Bogotá, Colombia
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Laura Cuellar-Valencia
- Palliative Care Program, Universidad de La Sabana, Bogotá, Colombia
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Lennis Jazmin Bedoya-Muñoz
- Palliative Care Program, Universidad de La Sabana, Bogotá, Colombia
- Instituto Nacional de Cancerología, Bogotá, Colombia
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Tan WJT, Vlajkovic SM. Molecular Characteristics of Cisplatin-Induced Ototoxicity and Therapeutic Interventions. Int J Mol Sci 2023; 24:16545. [PMID: 38003734 PMCID: PMC10671929 DOI: 10.3390/ijms242216545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
Cisplatin is a commonly used chemotherapeutic agent with proven efficacy in treating various malignancies, including testicular, ovarian, cervical, breast, bladder, head and neck, and lung cancer. Cisplatin is also used to treat tumors in children, such as neuroblastoma, osteosarcoma, and hepatoblastoma. However, its clinical use is limited by severe side effects, including ototoxicity, nephrotoxicity, neurotoxicity, hepatotoxicity, gastrointestinal toxicity, and retinal toxicity. Cisplatin-induced ototoxicity manifests as irreversible, bilateral, high-frequency sensorineural hearing loss in 40-60% of adults and in up to 60% of children. Hearing loss can lead to social isolation, depression, and cognitive decline in adults, and speech and language developmental delays in children. Cisplatin causes hair cell death by forming DNA adducts, mitochondrial dysfunction, oxidative stress, and inflammation, culminating in programmed cell death by apoptosis, necroptosis, pyroptosis, or ferroptosis. Contemporary medical interventions for cisplatin ototoxicity are limited to prosthetic devices, such as hearing aids, but these have significant limitations because the cochlea remains damaged. Recently, the U.S. Food and Drug Administration (FDA) approved the first therapy, sodium thiosulfate, to prevent cisplatin-induced hearing loss in pediatric patients with localized, non-metastatic solid tumors. Other pharmacological treatments for cisplatin ototoxicity are in various stages of preclinical and clinical development. This narrative review aims to highlight the molecular mechanisms involved in cisplatin-induced ototoxicity, focusing on cochlear inflammation, and shed light on potential antioxidant and anti-inflammatory therapeutic interventions to prevent or mitigate the ototoxic effects of cisplatin. We conducted a comprehensive literature search (Google Scholar, PubMed) focusing on publications in the last five years.
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Affiliation(s)
- Winston J. T. Tan
- Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand;
- Eisdell Moore Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Srdjan M. Vlajkovic
- Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand;
- Eisdell Moore Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
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Božić DD, Ćirković I, Milovanović J, Bufan B, Folić M, Savić Vujović K, Pavlović B, Jotić A. In Vitro Antibiofilm Effect of N-Acetyl-L-cysteine/Dry Propolis Extract Combination on Bacterial Pathogens Isolated from Upper Respiratory Tract Infections. Pharmaceuticals (Basel) 2023; 16:1604. [PMID: 38004469 PMCID: PMC10674846 DOI: 10.3390/ph16111604] [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: 10/07/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Bacterial biofilms play an important role in the pathogenesis of chronic upper respiratory tract infections. In addition to conventional antimicrobial therapy, N-acetyl-L-cysteine (NAC) and propolis are dietary supplements that are often recommended as supportive therapy for upper respiratory tract infections. However, no data on the beneficial effect of their combination against bacterial biofilms can be found in the scientific literature. Therefore, the aim of our study was to investigate the in vitro effect of N-acetyl-L-cysteine (NAC) and dry propolis extract in fixed combinations (NAC/dry propolis extract fixed combination) on biofilm formation by bacterial species isolated from patients with chronic rhinosinusitis, chronic otitis media, and chronic adenoiditis. The prospective study included 48 adults with chronic rhinosinusitis, 29 adults with chronic otitis media, and 33 children with chronic adenoiditis. Bacteria were isolated from tissue samples obtained intraoperatively and identified using the MALDI-TOF Vitek MS System. The antimicrobial activity, synergism, and antibiofilm effect of NAC/dry propolis extract fixed combination were studied in vitro. A total of 116 different strains were isolated from the tissue samples, with staphylococci being the most frequently isolated in all patients (57.8%). MICs of the NAC/dry propolis extract fixed combination ranged from 1.25/0.125 to 20/2 mg NAC/mg propolis. A synergistic effect (FICI ≤ 0.5) was observed in 51.7% of strains. The majority of isolates from patients with chronic otitis media were moderate biofilm producers and in chronic adenoiditis they were weak biofilm producers, while the same number of isolates in patients with chronic rhinosinusitis were weak and moderate biofilm producers. Subinhibitory concentrations of the NAC/propolis combination ranging from 0.625-0.156 mg/mL to 10-2.5 mg/mL of NAC combined with 0.062-0.016 mg/mL to 1-0.25 mg/mL of propolis inhibited biofilm formation in all bacterial strains. Suprainhibitory concentrations ranging from 2.5-10 mg/mL to 40-160 mg/mL of NAC in combination with 0.25-1 mg/mL to 4-16 mg/mL of propolis completely eradicated the biofilm. In conclusion, the fixed combination of NAC and dry propolis extract has a synergistic effect on all stages of biofilm formation and eradication of the formed biofilm in bacteria isolated from upper respiratory tract infections.
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Affiliation(s)
- Dragana D. Božić
- Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia;
| | - Ivana Ćirković
- Institute of Microbiology and Immunology, Dr Subotića 1, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
| | - Jovica Milovanović
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Biljana Bufan
- Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia;
| | - Miljan Folić
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Katarina Savić Vujović
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Dr Subotica 1, 11129 Belgrade, Serbia
| | - Bojan Pavlović
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Ana Jotić
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; (J.M.); (M.F.); (K.S.V.); (B.P.); (A.J.)
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
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Rybak LP, Alberts I, Patel S, Al Aameri RFH, Ramkumar V. Effects of natural products on cisplatin ototoxicity and chemotherapeutic efficacy. Expert Opin Drug Metab Toxicol 2023; 19:635-652. [PMID: 37728555 DOI: 10.1080/17425255.2023.2260737] [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: 03/30/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Cisplatin is a very effective chemotherapeutic agent against a variety of solid tumors. Unfortunately, cisplatin causes permanent sensorineural hearing loss in at least two-thirds of patients treated. There are no FDA approved drugs to prevent this serious side effect. AREAS COVERED This paper reviews various natural products that ameliorate cisplatin ototoxicity. These compounds are strong antioxidants and anti-inflammatory agents. This review includes mostly preclinical studies but also discusses a few small clinical trials with natural products to minimize hearing loss from cisplatin chemotherapy in patients. The interactions of natural products with cisplatin in tumor-bearing animal models are highlighted. A number of natural products did not interfere with cisplatin anti-tumor efficacy and some agents actually potentiated cisplatin anti-tumor activity. EXPERT OPINION There are a number of natural products or their derivatives that show excellent protection against cisplatin ototoxicity in preclinical studies. There is a need to insure uniform standards for purity of drugs derived from natural sources and to ensure adequate pharmacokinetics and safety of these products. Natural products that protect against cisplatin ototoxicity and augment cisplatin's anti-tumor effects in multiple studies of tumor-bearing animals are most promising for advancement to clinical trials. The most promising natural products include honokiol, sulforaphane, and thymoquinone.
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Affiliation(s)
- Leonard P Rybak
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ian Alberts
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Shree Patel
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Raheem F H Al Aameri
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Vickram Ramkumar
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL, USA
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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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Hong MK, Echanique KA, Hoffman LF, Kita AE. Designing a Prolonged Method of Therapeutic Delivery to Support Rehabilitation From Ototoxic Damage in a Schwann Cell Model. Otol Neurotol 2023; 44:373-381. [PMID: 36791364 PMCID: PMC10038897 DOI: 10.1097/mao.0000000000003839] [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] [Indexed: 02/17/2023]
Abstract
HYPOTHESIS The ototoxicity of gentamicin and cisplatin can be evaluated with a Schwann cell model to screen for otoprotective agents that can be encapsulated into poly (lactic-co-glycolic acid) (PLGA) microparticles for drug delivery to the inner ear. BACKGROUND Aminoglycosides and cisplatin are widely prescribed but known to cause ototoxicity. There is strong evidence that compromise to Schwann cells ensheathing inner ear afferent neurons results in inner ear dysfunction mimicking drug-induced ototoxicity. There is a need for a model for ototoxic demyelination to screen medications for protective potential and to subsequently target and tune the delivery of any promising agents. METHODS RT4-D6P2T rat schwannoma cells were used as a Schwann cell model to assess gentamicin and cisplatin toxicity and to screen for protective agents. Cell viability was evaluated with the MTT cell proliferation assay. N -acetylcysteine (NAC) was encapsulated into a PLGA microparticle, and its elution profile was determined. RESULTS The estimated 50% lethal concentration dose for gentamicin was 805.6 μM, which was 46-fold higher than that for cisplatin (17.5 μM). In several trials, cells dosed with NAC and cisplatin demonstrated a 22.6% ( p < 0.001) increase in cell viability when compared with cisplatin alone. However, this protective effect was not consistent across all trials. NAC was encapsulated into a PLGA microparticle and elution plateaued at 5 days. CONCLUSION When dosed at their respective therapeutic ranges, cisplatin is more likely than gentamicin to induce damage to the Schwann cell model. Although NAC demonstrates an uncertain role in protecting against cisplatin-induced Schwann cell cytotoxicity, this study establishes a method to screen for other otoprotective medications to encapsulate into a tunable microparticle for localized drug delivery.
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Affiliation(s)
- Michelle K Hong
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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Hsieh CY, Lin JN, Kang TY, Wen YH, Yu SH, Wu CC, Wu HP. Otoprotective Effects of Fucoidan Reduce Cisplatin-Induced Ototoxicity in Mouse Cochlear UB/OC-2 Cells. Int J Mol Sci 2023; 24:ijms24043561. [PMID: 36834972 PMCID: PMC9959567 DOI: 10.3390/ijms24043561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
Cisplatin is a widely used standard chemotherapy for various cancers. However, cisplatin treatment is associated with severe ototoxicity. Fucoidan is a complex sulfated polysaccharide mainly derived from brown seaweeds, and it shows multiple bioactivities such as antimicrobial, anti-inflammatory, anticancer, and antioxidant activities. Despite evidence of the antioxidant effects of fucoidan, research on its otoprotective effects remains limited. Therefore, the present study investigated the otoprotective effects of fucoidan in vitro using the mouse cochlear cell line UB/OC-2 to develop new strategies to attenuate cisplatin-induced ototoxicity. We quantified the cell membrane potential and analyzed regulators and cascade proteins in the apoptotic pathway. Mouse cochlear UB/OC-2 cells were pre-treated with fucoidan before cisplatin exposure. The effects on cochlear hair cell viability, mitochondrial function, and apoptosis-related proteins were determined via flow cytometry, Western blot analysis, and fluorescence staining. Fucoidan treatment reduced cisplatin-induced intracellular reactive oxygen species production, stabilized mitochondrial membrane potential, inhibited mitochondrial dysfunction, and successfully protected hair cells from apoptosis. Furthermore, fucoidan exerted antioxidant effects against oxidative stress by regulating the Nrf2 pathway. Therefore, we suggest that fucoidan may represent a potential therapeutic agent for developing a new otoprotective strategy.
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Affiliation(s)
- Cheng-Yu Hsieh
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Jia-Ni Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Ting-Ya Kang
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Yu-Hsuan Wen
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970473, Taiwan
| | - Szu-Hui Yu
- Department of Music, Tainan University of Technology, Tainan 710302, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100225, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100225, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300195, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Correspondence:
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Guthrie OW, Spankovich C. Emerging and established therapies for chemotherapy-induced ototoxicity. J Cancer Surviv 2023; 17:17-26. [PMID: 36637631 DOI: 10.1007/s11764-022-01317-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Ototoxicity is considered a dose-limiting side effect of some chemotherapies. Hearing loss, in particular, can have significant implications for the quality of life for cancer survivors. Here, we review therapeutic approaches to mitigating ototoxicity related to chemotherapy. METHODS Literature review. CONCLUSIONS Numerous otoprotection strategies are undergoing active investigation. However, numerous challenges exist to confer adequate protection while retaining the anti-cancer efficacy of the chemotherapy. IMPLICATIONS FOR CANCER SURVIVORS Ototoxicity can have significant implications for cancer survivors, notably those receiving cisplatin. Clinical translation of multiple otoprotection approaches will aid in limiting these consequences.
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Affiliation(s)
- O'neil W Guthrie
- Cell & Molecular Pathology Laboratory, Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ, USA
| | - Christopher Spankovich
- Department of Otolaryngology Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
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12
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Lee S, Choi S, Park SH, Im GJ, Chang J. Transcriptomic Analysis of the Effect of Metformin against Cisplatin-Induced Ototoxicity: A Potential Mechanism of Metformin-Mediated Inhibition of Thioredoxin-Interacting Protein (Txnip) Gene Expression. Curr Issues Mol Biol 2022; 45:286-310. [PMID: 36661507 PMCID: PMC9857533 DOI: 10.3390/cimb45010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
Ototoxicity is the drug-induced damage of the inner ear, causing bilateral irreversible sensorineural hearing loss. Cisplatin is a widely used chemotherapeutic agent which causes ototoxicity as its side effect. Pretreatment with metformin prior to the application of cisplatin significantly decreased the late apoptosis and attenuated the cisplatin-induced increase in ROS. To understand the molecular mechanisms that are involved in the preventive effect of metformin, we evaluated the change of gene expression induced by cisplatin at several different time points (0 h, 6 h, 15 h, 24 h and 48 h) and the alteration of gene expression according to pretreatment with metformin in HEI-OC1 cells through microarray analysis. Cisplatin exposure induced a total of 89 DEGs (differentially expressed genes) after 6 h, with a total of 433 DEGs after 15 h, a total of 941 DEGs after 24 h, and a total of 2764 DEGs after 48 h. When cells were pretreated with metformin for 24 h, we identified a total of 105 DEGs after 6 h of cisplatin exposure, a total of 257 DEGs after 15 h, a total of 1450 DEGs after 24 h, and a total of 1463 DEGs after 48 h. The analysis was performed based on the gene expression, network analyses, and qRT-PCR, and we identified several genes (CSF2, FOS, JUN, TNFα, NFκB, Txnip, ASK1, TXN2, ATF3, TP53, IL6, and IGF1) as metformin-related preventive biomarkers in cisplatin ototoxicity.
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Affiliation(s)
- Sehee Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Sun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
| | - Seok Hyun Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
| | - Gi Jung Im
- Department of Otorhinolaryngology-Head & Neck Surgery, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Jiwon Chang
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
- Correspondence: or ; Tel.: +82-2-6960-1270
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13
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Noman A, Mukherjee S, Le TN. Manipulating the Blood Labyrinth Barrier with Mannitol to Prevent Cisplatin-Induced Hearing Loss. Hear Res 2022; 426:108646. [DOI: 10.1016/j.heares.2022.108646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/10/2022] [Accepted: 11/04/2022] [Indexed: 11/08/2022]
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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: 19] [Impact Index Per Article: 9.5] [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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15
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Domingo IK, Latif A, Bhavsar AP. Pro-Inflammatory Signalling PRRopels Cisplatin-Induced Toxicity. Int J Mol Sci 2022; 23:7227. [PMID: 35806229 PMCID: PMC9266867 DOI: 10.3390/ijms23137227] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Cisplatin is a platinum-based chemotherapeutic that has long since been effective against a variety of solid-cancers, substantially improving the five-year survival rates for cancer patients. Its use has also historically been limited by its adverse drug reactions, or cisplatin-induced toxicities (CITs). Of these reactions, cisplatin-induced nephrotoxicity (CIN), cisplatin-induced peripheral neuropathy (CIPN), and cisplatin-induced ototoxicity (CIO) are the three most common of several CITs recognised thus far. While the anti-cancer activity of cisplatin is well understood, the mechanisms driving its toxicities have only begun to be defined. Most of the literature pertains to damage caused by oxidative stress that occurs downstream of cisplatin treatment, but recent evidence suggests that the instigator of CIT development is inflammation. Cisplatin has been shown to induce pro-inflammatory signalling in CIN, CIPN, and CIO, all of which are associated with persisting markers of inflammation, particularly from the innate immune system. This review covered the hallmarks of inflammation common and distinct between different CITs, the role of innate immune components in development of CITs, as well as current treatments targeting pro-inflammatory signalling pathways to conserve the use of cisplatin in chemotherapy and improve long-term health outcomes of cancer patients.
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Affiliation(s)
| | | | - Amit P. Bhavsar
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB T6G 2E1, Canada; (I.K.D.); (A.L.)
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16
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King REC, Ong KMC. Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1748637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Background Cisplatin is a commonly used chemotherapeutic drug that is associated with irreversible hearing loss. A number of antioxidants have been investigated for prevention, but data have so far been inconclusive.
Objective The objective of this study was to assess the efficacy of various antioxidant therapies in preventing hearing loss among adult patients treated with cisplatin.
Methodology We searched for controlled clinical trials evaluating various antioxidants as prevention against cisplatin-induced hearing loss in adults. The primary outcome is the proportion of patients with hearing loss. Secondary outcomes include audiometric threshold shifts, tinnitus, tumor response, adverse events, and quality of life.
Results Thirteen randomized trials comprising of nine antioxidant therapies were included. Only coenzyme Q with multivitamins demonstrated significant benefit in preventing cisplatin-induced hearing loss (relative risk: 0.15, 95% confidence interval: 0.04–0.58) in a small study, while data for the rest of the agents were inconclusive. Audiometric threshold shifts were significantly lower in the intervention arm for aspirin, vitamin E, and transtympanic dexamethasone. The available data on tumor response was inconclusive, with no definite evidence of diminished tumor response noted. Adverse events noted include mild ear pain particularly for transtympanic therapies. There was no data available on quality of life.
Conclusion The current available evidence is so far insufficient to establish any benefit for antioxidant therapies for the prevention of cisplatin-induced hearing loss. More high-quality studies are needed to fill in the identified gaps in knowledge.
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Affiliation(s)
- Rich Ericson C. King
- Department of Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines
- Division of Medical Oncology, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Kimberly Mae C. Ong
- Department of Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines, Manila, Philippines
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Wang W, Chen E, Ding X, Lu P, Chen J, Ma P, Lu L. N-acetylcysteine protect inner hair cells from cisplatin by alleviated celluar oxidative stress and apoptosis. Toxicol In Vitro 2022; 81:105354. [PMID: 35346799 DOI: 10.1016/j.tiv.2022.105354] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/24/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022]
Abstract
Cisplatin is a well-known platinum-based chemotherapy drug widely used to treat a variety of malignant tumors. However, cisplatin has serious side-effects include nephrotoxicity and ototoxicity, Cisplatin chemotherapy causes permanent hearing loss at least 40% of treated patients. Our results showed that 20 mM N-acetylcysteine (NAC) can completely protect 50 μM cisplatin-induced hair cell loss in rat cochlear culture and protects against cisplatin-induced hair cell loss in zebrafish in vivo. The fluorescence intensity of mitochondrial ROS significantly increased after the cultures were treated with 15 μM cisplatin for 48 h and was decreased in the group treated with 15 μM cisplatin add 20 mM NAC. In addition, the number of TUNEL positive hair cells was increased after the cultures were treated with 15 μM cisplatin for 48 h and there are null in cisplatin and NAC co-treated group.
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Affiliation(s)
- Weilong Wang
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Erfang Chen
- Department of Otolaryngology Head & Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Xuerui Ding
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Peiheng Lu
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Jiawei Chen
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Pengwei Ma
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Lianjun Lu
- Department of Otolaryngology Head & Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
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18
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Chen BC, Lin LJ, Lin YC, Lee CF, Hsu WC. Optimal N-acetylcysteine concentration for intratympanic injection to prevent cisplatin-induced ototoxicity in guinea pigs. Acta Otolaryngol 2022; 142:127-131. [PMID: 35287541 DOI: 10.1080/00016489.2022.2038796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cisplatin is a chemotherapy drug that can induce sensorineural hearing loss. At present, no otoprotective agent is approved for use. OBJECTIVES This study investigated the optimal concentration of intratympanic N-acetylcysteine (NAC) to prevent cisplatin-induced ototoxicity in a guinea pig model. MATERIALS AND METHODS Guinea pigs (n = 64) were treated with a single intratympanic injection containing different NAC concentrations or saline (control) 3 days prior to intraperitoneal injection with cisplatin. The threshold change in the auditory brainstem response was assessed. RESULTS Four weeks after intraperitoneal cisplatin injection, only the group that received 2% NAC exhibited significant otoprotection (p < .05) compared with the control. Otoprotection was observed at all the frequencies tested (1k, 2k, 4k, and 8k Hz). The 2% NAC group also exhibited significant otoprotection (p < .05) compared with the other NAC groups (at 1k, 2k, 4k, and 8k Hz). The 4% NAC group exhibited significantly reduced hearing capacity (p < .05) in the fourth week compared with controls. CONCLUSIONS AND SIGNIFICANCE Intratympanic NAC administration is an efficient and safe means of preventing cisplatin-induced ototoxicity. In our animal model, the optimal intratympanic NAC concentration was 2%; concentrations of 4% loss of otoprotection.
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Affiliation(s)
- Bo-Cheng Chen
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Medical Foundation, Hualien, Taiwan
| | - Lian-Jie Lin
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Medical Foundation, Hualien, Taiwan
| | - Yi-Chen Lin
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Medical Foundation, Hualien, Taiwan
| | - Chia-Fone Lee
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Medical Foundation, Hualien, Taiwan
- Department of otolaryngology Head and Neck Surgery, School of Medicine, Chi University, Hualien, Taiwan
| | - Wei-Chung Hsu
- Department of Otolaryngology, Head and Neck Surgery, National Taiwan, University Hospital, Taipei, Taiwan
- Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
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19
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Li Z, Yao Q, Tian Y, Jiang Y, Xu M, Wang H, Xiong Y, Fang J, Lu W, Yu D, Shi H. Trehalose protects against cisplatin-induced cochlear hair cell damage by activating TFEB-mediated autophagy. Biochem Pharmacol 2021; 197:114904. [PMID: 34971589 DOI: 10.1016/j.bcp.2021.114904] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 02/05/2023]
Abstract
Cisplatin is a widely used chemotherapeutic agent for the treatment of various tumors, but its side effects limit its application. Ototoxicity, a major adverse effect of cisplatin, causes irreversible sensorineural hearing loss. Unfortunately, there are no effective approaches to protect against this damage. Autophagy has been shown to exert beneficial effects in various diseases models. However, the role of autophagy in cisplatin-induced ototoxicity has been not well elucidated. In this study, we aimed to investigate whether the novel autophagy activator trehalose could prevent cisplatin-induced damage in the auditory cell line HEI-OC1 and mouse cochlear explants and to further explore its mechanisms. Our data demonstrated that trehalose alleviated cisplatin-induced hair cell (HC) damage by inhibiting apoptosis, attenuating oxidative stress and rescuing mitochondrial dysfunction. Additionally, trehalose significantly enhanced autophagy levels in HCs, and inhibiting autophagy with 3-methyladenine (3-MA) abolished these protective effects. Mechanistically, we showed that the effect of trehalose was attributed to increased nuclear translocation of transcription factor EB (TFEB), and this effect could be mimicked by TFEB overexpression and inhibited by TFEB gene silencing or treatment with cyclosporin A (CsA), a calcineurin inhibitor. Taken together, our findings suggest that trehalose and autophagy play a role in protecting against cisplatin-induced ototoxicity and that pharmacological enhancement of TFEB-mediated autophagy is a potential treatment for cisplatin-induced damage in cochlear HCs and HEI-OC1 cells.
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Affiliation(s)
- Zhuangzhuang Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Qingxiu Yao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Yuxin Tian
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China; Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yumeng Jiang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Maoxiang Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Hui Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China; Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute and Otorhinolaryngology, Department of Affiliated Eye and ENT Hospital, Fudan University, China
| | - Yuanping Xiong
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jia Fang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Wen Lu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Dongzhen Yu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Haibo Shi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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20
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Duinkerken CW, de Weger VA, Dreschler WA, van der Molen L, Pluim D, Rosing H, Nuijen B, Hauptmann M, Beijnen JH, Balm AJM, de Boer JP, Burgers JA, Marchetti S, Schellens JHM, Zuur CL. Transtympanic Sodium Thiosulfate for Prevention of Cisplatin-Induced Ototoxicity: A Randomized Clinical Trial. Otol Neurotol 2021; 42:678-685. [PMID: 33710154 DOI: 10.1097/mao.0000000000003069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine safety, feasibility, and preliminary activity of transtympanic injection of sodium thiosulfate (STS) against cisplatin-induced hearing loss (CIHL).DESIGN Randomized controlled trial.SETTING Tertiary cancer hospital.PATIENTS Adults to be treated with high-dose cisplatin (≥ 75 mg/m2).INTERVENTION Selected by randomization, 0.1 M STS gel on one side and placebo gel on the other side was transtympanically applied to the middle ear 3 hours before cisplatin administration. After amendment, the placebo ear was left untreated. MAIN OUTCOME MEASURE Primary outcome was safety and feasibility. Secondary outcomes included pharmacokinetic analysis of systemic cisplatin and preliminary activity of STS. Clinically relevant CIHL was defined as a ≥ 10 dB threshold shift at pure-tone average 8-10-12.5 kHz (PTA8-12.5). Response to STS was defined as a threshold shift at PTA8-12.5 in the STS-treated ear of ≥ 10 dB smaller than the untreated ear. RESULTS Twelve patients were treated. Average CIHL at PTA8-12.5 was 12.7 dB in untreated ears and 8.8 dB SPL in STS-treated ears (p = 0.403). Four patients did not develop CIHL. Four out of eight patients with CIHL responded to STS: CIHL at PTA8-12.5 in STS-treated ears was 18.4 dB less compared to untreated ears (p = 0.068). Grade 1 adverse events were reported. Pharmacokinetic results were available for 11 patients. CONCLUSION Transtympanic application of STS was safe and feasible. Based on our pharmacokinetic analysis, we postulate that transtympanic STS does not interfere with the systemically available cisplatin. Our results provide a preliminary proof of concept for transtympanic application of STS in preventing CIHL and warrants further evaluation on a larger scale.
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Affiliation(s)
- Charlotte W Duinkerken
- Department of Head and Neck Surgery and Oncology, the Netherlands Cancer Institute, Amsterdam
- Department of Otolaryngology, Leiden University Medical Centre, Leiden
| | - Vincent A de Weger
- Division of Clinical Pharmacology
- Division of Pharmacology, the Netherlands Cancer Institute, Amsterdam
- Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar
| | | | - Lisette van der Molen
- Department of Head and Neck Surgery and Oncology, the Netherlands Cancer Institute, Amsterdam
| | - Dick Pluim
- Division of Pharmacology, the Netherlands Cancer Institute, Amsterdam
| | | | | | - Michael Hauptmann
- Department of Epidemiology and Biostatistics, the Netherlands Cancer Institute, Amsterdam, the Netherlands
- Institute of Biostatistics and Registry Research, Brandenburg Medical School, Neuruppin, Germany
| | - Jos H Beijnen
- Division of Clinical Pharmacology
- Department of Pharmacy and Pharmacology
| | - Alfons J M Balm
- Department of Head and Neck Surgery and Oncology, the Netherlands Cancer Institute, Amsterdam
- Department of Maxillofacial Surgery, Amsterdam University Medical Centre
| | | | - Jacobus A Burgers
- Department of Thoracic Oncology, the Netherlands Cancer Institute, Amsterdam
| | | | - Jan H M Schellens
- Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht
| | - Charlotte L Zuur
- Department of Head and Neck Surgery and Oncology, the Netherlands Cancer Institute, Amsterdam
- Department of Maxillofacial Surgery, Amsterdam University Medical Centre
- Cell Biology and Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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21
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Jaudoin C, Carré F, Gehrke M, Sogaldi A, Steinmetz V, Hue N, Cailleau C, Tourrel G, Nguyen Y, Ferrary E, Agnely F, Bochot A. Transtympanic injection of a liposomal gel loaded with N-acetyl-L-cysteine: A relevant strategy to prevent damage induced by cochlear implantation in guinea pigs? Int J Pharm 2021; 604:120757. [PMID: 34058306 DOI: 10.1016/j.ijpharm.2021.120757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 01/17/2023]
Abstract
Patients with residual hearing can benefit from cochlear implantation. However, insertion can damage cochlear structures and generate oxidative stress harmful to auditory cells. The antioxidant N-acetyl-L-cysteine (NAC) is a precursor of glutathione (GSH), a powerful endogenous antioxidant. NAC local delivery to the inner ear appeared promising to prevent damage after cochlear implantation in animals. NAC-loaded liposomal gel was specifically designed for transtympanic injection, performed both 3 days before and on the day of surgery. Hearing thresholds were recorded over 30 days in implanted guinea pigs with and without NAC. NAC, GSH, and their degradation products, N,N'-diacetyl-L-cystine (DiNAC) and oxidized glutathione (GSSG) were simultaneously quantified in the perilymph over 15 days in non-implanted guinea pigs. For the first time, endogenous concentrations of GSH and GSSG were determined in the perilymph. Although NAC-loaded liposomal gel sustained NAC release in the perilymph over 15 days, it induced hearing loss in both implanted and non-implanted groups with no perilymphatic GSH increase. Under physiological conditions, NAC appeared poorly stable within liposomes. As DiNAC was quantified at concentrations which were twice as high as NAC in the perilymph, it was hypothesized that DiNAC could be responsible for the adverse effects on hearing.
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Affiliation(s)
- Céline Jaudoin
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
| | - Fabienne Carré
- Inserm/Institut Pasteur, Institut de l'audition, Technologies et thérapie génique pour la surdité, 63 rue de Charenton, 75012 Paris, France.
| | - Maria Gehrke
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
| | - Audrey Sogaldi
- UMS IPSIT, SAMM, Faculté de Pharmacie, Université Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
| | - Vincent Steinmetz
- Université Paris-Saclay, CNRS, Institut de Chimie des Substances Naturelles, UPR 2301, 91198 Gif-sur-Yvette, France.
| | - Nathalie Hue
- Université Paris-Saclay, CNRS, Institut de Chimie des Substances Naturelles, UPR 2301, 91198 Gif-sur-Yvette, France.
| | - Catherine Cailleau
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
| | - Guillaume Tourrel
- Oticon Medical/Neurelec SAS, Research & Technology Department, 2720 chemin Saint-Bernard, Vallauris, France.
| | - Yann Nguyen
- Inserm/Institut Pasteur, Institut de l'audition, Technologies et thérapie génique pour la surdité, 63 rue de Charenton, 75012 Paris, France; Sorbonne Université, AP-HP, GHU Pitié-Salpêtrière, DMU ChIR, Service ORL, GRC Robotique et Innovation Chirurgicale, 47-83, boulevard de l'hôpital, 75013 Paris, France.
| | - Evelyne Ferrary
- Inserm/Institut Pasteur, Institut de l'audition, Technologies et thérapie génique pour la surdité, 63 rue de Charenton, 75012 Paris, France.
| | - Florence Agnely
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
| | - Amélie Bochot
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 5 rue J-B Clément, 92296 Châtenay-Malabry, France.
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Tang Q, Wang X, Jin H, Mi Y, Liu L, Dong M, Chen Y, Zou Z. Cisplatin-induced ototoxicity: Updates on molecular mechanisms and otoprotective strategies. Eur J Pharm Biopharm 2021; 163:60-71. [PMID: 33775853 DOI: 10.1016/j.ejpb.2021.03.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
Cisplatin is a highly effective antitumor drug generally used in the treatment of solid malignant tumors. However, cisplatin causes severe side effects such as bone marrow depression, nephrotoxicity, and ototoxicity, thus limiting its clinical application. The incidence of ototoxicity induced by cisplatin ranges from 20% to 70%, and it usually manifests as a progressive, bilateral and irreversible hearing loss. Although the etiology of cisplatin-induced ototoxicity remains unclear, an increasing body of evidence suggests that the ototoxicity of cisplatin is mainly related to the production of reactive oxygen species and activation of apoptotic pathway in cochlear tissues. Many drugs have been well proved to protect cisplatin-induced hearing loss in vitro and in vivo. However, the anti-tumor effect of cisplatin is also weakened by systemic administration of those drugs for hearing protection, especially antioxidants. Therefore, establishing a local administration strategy contributes to the otoprotection without affecting the effect of cisplatin. This review introduces the pathology of ototoxicity caused by cisplatin, and focuses on recent developments in the mechanisms and protective strategies of cisplatin-induced ototoxicity.
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Affiliation(s)
- Qing Tang
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China
| | - Xianren Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Huan Jin
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China
| | - Yanjun Mi
- Department of Medical Oncology, Xiamen Key Laboratory of Antitumor Drug Transformation Research and Thoracic Tumor Diagnosis & Treatment, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Lingfeng Liu
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China
| | - Mengyuan Dong
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China
| | - Yibing Chen
- Genetic and Prenatal Diagnosis Center, Department of Gynecology and Obstetrics, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
| | - Zhengzhi Zou
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China; Guangzhou Key Laboratory of Spectral Analysis and Functional Probes, College of Biophotonics, South China Normal University, Guangzhou 510631, China.
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Bai X, Chen S, Xu K, Jin Y, Niu X, Xie L, Qiu Y, Liu XZ, Sun Y. N-Acetylcysteine Combined With Dexamethasone Treatment Improves Sudden Sensorineural Hearing Loss and Attenuates Hair Cell Death Caused by ROS Stress. Front Cell Dev Biol 2021; 9:659486. [PMID: 33816510 PMCID: PMC8014036 DOI: 10.3389/fcell.2021.659486] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a common emergency in the world. Increasing evidence of imbalance of oxidant–antioxidant were found in SSNHL patients. Steroids combined with antioxidants may be a potential strategy for the treatment of SSNHL. In cochlear explant experiment, we found that N-acetylcysteine (NAC) combined with dexamethasone can effectively protect hair cells from oxidative stress when they were both at ineffective concentrations alone. A clinic trial was designed to explore whether oral NAC combined with intratympanic dexamethasone (ITD) as a salvage treatment has a better therapeutic effect. 41 patients with SSNHL were randomized to two groups. 23 patients in control group received ITD therapy alone, while 18 patient s in NAC group were treated with oral NAC and ITD. The patients were followed-up on day 1st (initiation of treatment) and day 14th. Overall, there was no statistical difference in final pure-tone threshold average (PTA) improvement between those two groups. However, a significant hearing gain at 8,000 Hz was observed in NAC group. Moreover, the hearing recovery rates of NAC group is much higher than that in control group. These results demonstrated that oral NAC in combination with ITD therapy is a more effective therapy for SSNHL than ITD alone.
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Affiliation(s)
- Xue Bai
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sen Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Xu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Jin
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xun Niu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Le Xie
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Qiu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Zhou Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Cortés Fuentes IA, Burotto M, Retamal MA, Frelinghuysen M, Caglevic C, Gormaz JG. Potential use of n-3 PUFAs to prevent oxidative stress-derived ototoxicity caused by platinum-based chemotherapy. Free Radic Biol Med 2020; 160:263-276. [PMID: 32827639 DOI: 10.1016/j.freeradbiomed.2020.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Platinum-based compounds are widely used for the treatment of different malignancies due to their high effectiveness. Unfortunately, platinum-based treatment may lead to ototoxicity, an often-irreversible side effect without a known effective treatment and prevention plan. Platinum-based compound-related ototoxicity results mainly from the production of toxic levels of reactive oxygen species (ROS) rather than DNA-adduct formation, which has led to test strategies based on direct ROS scavengers to ameliorate hearing loss. However, favorable clinical results have been associated with several complications, including potential interactions with chemotherapy efficacy. To understand the contribution of the different cytotoxic mechanisms of platinum analogues on malignant cells and auditory cells, the particular susceptibility and response of both kinds of cells to molecules that potentially interfere with these mechanisms, is fundamental to develop innovative strategies to prevent ototoxicity without affecting antineoplastic effects. The n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) have been tried in different clinical settings, including with cancer patients. Nevertheless, their use to decrease cisplatin-induced ototoxicity has not been explored to date. In this hypothesis paper, we address the mechanisms of platinum compounds-derived ototoxicity, focusing on the differences between the effects of these compounds in neoplastic versus auditory cells. We discuss the basis for a strategic use of n-3 PUFAs to potentially protect auditory cells from platinum-derived injury without affecting neoplastic cells and chemotherapy efficacy.
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Affiliation(s)
- Ignacio A Cortés Fuentes
- Otorhinolaryngology Service, Hospital Barros Luco-Trudeau, San Miguel, Santiago, Chile; Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Mauricio Burotto
- Oncology Department, Clínica Universidad de Los Andes, Santiago, Chile; Bradford Hill, Clinical Research Center, Santiago, Chile
| | - Mauricio A Retamal
- Universidad Del Desarrollo, Centro de Fisiología Celular e Integrativa, Facultad de Medicina Clínica Alemana, Santiago, Chile.
| | | | - Christian Caglevic
- Cancer Research Department, Fundación Arturo López Pérez, Santiago, Chile
| | - Juan G Gormaz
- Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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25
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Mukherjea D, Dhukhwa A, Sapra A, Bhandari P, Woolford K, Franke J, Ramkumar V, Rybak L. Strategies to reduce the risk of platinum containing antineoplastic drug-induced ototoxicity. Expert Opin Drug Metab Toxicol 2020; 16:965-982. [PMID: 32757852 DOI: 10.1080/17425255.2020.1806235] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Cisplatin is a highly effective chemotherapeutic agent against a variety of solid tumors in adults and in children. Unfortunately, a large percentage of patients suffer permanent sensorineural hearing loss. Up to 60% of children and at least 50% of adults suffer this complication that seriously compromises their quality of life. Hearing loss is due to damage to the sensory cells in the inner ear. The mechanisms of cochlear damage are still being investigated. However, it appears that inner ear damage is triggered by reactive oxygen species (ROS) formation and inflammation 34. AREAS COVERED We discuss a number of potential therapeutic targets that can be addressed to provide hearing protection. These strategies include enhancing the endogenous antioxidant pathways, heat shock proteins, G protein coupled receptors and counteracting ROS and reactive nitrogen species, and blocking pathways that produce inflammation, including TRPV1 and STAT1 36. EXPERT OPINION Numerous potential protective agents show promise in animal models by systemic or local administration. However, clinical trials have not shown much efficacy to date with the exception of sodium thiosulfate. There is an urgent need to discover safe and effective protective agents that do not interfere with the efficacy of cisplatin against tumors yet preserve hearing 151.
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Affiliation(s)
| | - Asmita Dhukhwa
- Springfield Combined Laboratory Facility, Novear Therapeutics LLC ., Springfield, IL, USA
| | - Amit Sapra
- Department of Internal Medicine, SIU School of Medicine , Springfield, IL, USA
| | - Priyanka Bhandari
- Department of Internal Medicine, SIU School of Medicine , Springfield, IL, USA
| | - Katlyn Woolford
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
| | - Jacob Franke
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
| | - Vickram Ramkumar
- Department of Pharmacology, SIU School of Medicine , Springfield, IL, USA
| | - Leonard Rybak
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
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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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27
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Romano A, Capozza MA, Mastrangelo S, Maurizi P, Triarico S, Rolesi R, Attinà G, Fetoni AR, Ruggiero A. Assessment and Management of Platinum-Related Ototoxicity in Children Treated for Cancer. Cancers (Basel) 2020; 12:E1266. [PMID: 32429551 PMCID: PMC7281210 DOI: 10.3390/cancers12051266] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023] Open
Abstract
Platinum compounds are a group of chemotherapeutic agents included in many pediatric and adult oncologic treatment protocols. The main platinum compounds are cisplatin, carboplatin, and oxaliplatin. Their use in clinical practice has greatly improved long-term survival of pediatric patients, but they also cause some toxic effects: ototoxicity, myelosuppression, nephrotoxicity, and neurotoxicity. Hearing damage is one of the main toxic effects of platinum compounds, and it derives from the degeneration of hair cells of the ear, which, not having self-renewal capacity, cannot reconstitute themselves. Hearing loss from platinum exposure is typically bilateral, sensorineural, and permanent, and it is caused by the same mechanisms with which platinum acts on neoplastic cells. According to available data from the literature, the optimal timing for the audiological test during and after treatment with platinum compounds is not well defined. Moreover, no substances capable of preventing the onset of hearing loss have been identified.
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Affiliation(s)
- Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Michele Antonio Capozza
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Silvia Triarico
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Rolando Rolesi
- Otolaryngology Division, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (R.R.); (A.R.F.)
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
| | - Anna Rita Fetoni
- Otolaryngology Division, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (R.R.); (A.R.F.)
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, 00168 Rome, Italy; (A.R.); (M.A.C.); (S.M.); (P.M.); (S.T.); (G.A.)
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28
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Gausterer JC, Saidov N, Ahmadi N, Zhu C, Wirth M, Reznicek G, Arnoldner C, Gabor F, Honeder C. Intratympanic application of poloxamer 407 hydrogels results in sustained N-acetylcysteine delivery to the inner ear. Eur J Pharm Biopharm 2020; 150:143-155. [DOI: 10.1016/j.ejpb.2020.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/20/2020] [Accepted: 03/04/2020] [Indexed: 01/06/2023]
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Clinical trials evaluating transtympanic otoprotectants for cisplatin-induced ototoxicity: what do we know so far? Eur Arch Otorhinolaryngol 2020; 277:2413-2422. [PMID: 32358651 DOI: 10.1007/s00405-020-06003-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cisplatin (CDDP) chemotherapy can cause serious side effects including irreversible and progressive hearing loss. Studies have aimed to assess potential protective strategies; however, systemic treatments have presented variable results, and potential interactions with CDDP have limited clinical trials. METHODS A review of the literature was performed in order to evaluate clinical trials that have studied a transtympanic approach as an otoprotectant strategy. RESULTS Six clinical trials were included. While a transtympanic approach can limit side effects and avoid interactions with CDDP, recurrent issues have been expressed including which otoprotectant to test, time delays between CDDP treatment and transtympanic injections, side effects such as pain and dizziness, concentrations, and number of injections. Clinical trials have used sodium thiosulfate, N-acetylcysteine and dexamethasone. CONCLUSIONS While a transtympanic approach seems like an attractive strategy, further research is needed to clarify which is the optimal otoprotectant, its dosage, and the number of injections.
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30
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Freyer DR, Brock PR, Chang KW, Dupuis LL, Epelman S, Knight K, Mills D, Phillips R, Potter E, Risby D, Simpkin P, Sullivan M, Cabral S, Robinson PD, Sung L. Prevention of cisplatin-induced ototoxicity in children and adolescents with cancer: a clinical practice guideline. THE LANCET. CHILD & ADOLESCENT HEALTH 2020; 4:141-150. [PMID: 31866182 PMCID: PMC7521149 DOI: 10.1016/s2352-4642(19)30336-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 01/19/2023]
Abstract
Despite ototoxicity being a prevalent consequence of cisplatin chemotherapy, little guidance exists on interventions to prevent this permanent and progressive adverse event. To develop a clinical practice guideline for the prevention of cisplatin-induced ototoxicity in children and adolescents with cancer, we convened an international, multidisciplinary panel of experts and patient advocates to update a systematic review of randomised trials for the prevention of cisplatin-induced ototoxicity. The systematic review identified 27 eligible adult and paediatric trials that evaluated amifostine, sodium diethyldithiocarbamate or disulfiram, systemic sodium thiosulfate, intratympanic therapies, and cisplatin infusion duration. Regarding systemic sodium thiosulfate, the panel made a strong recommendation for administration in non-metastatic hepatoblastoma, a weak recommendation for administration in other non-metastatic cancers, and a weak recommendation against its routine use in metastatic cancers. Amifostine, sodium diethyldithiocarbamate, and intratympanic therapy should not be routinely used. Cisplatin infusion duration should not be altered as a means to reduce ototoxicity. Further research to determine the safety of sodium thiosulfate in patients with metastatic cancer is encouraged.
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Affiliation(s)
- David R Freyer
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA; Departments of Pediatrics and Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Penelope R Brock
- Department of Haematology and Oncology, Great Ormond Street Hospital, London, UK
| | - Kay W Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Sidnei Epelman
- Department of Pediatric Oncology, Casa de Saude Santa Marcelina, Sao Paolo, Brazil
| | - Kristin Knight
- Pediatric Audiology, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR, USA
| | - Denise Mills
- Division of Haematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada; Pediatric Oncology Group of Ontario, Toronto, ON, Canada
| | - Robert Phillips
- Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK; Centre for Reviews and Dissemination, University of York, York, UK
| | - Emma Potter
- Division of Oncology, Royal Marsden Hospital, London, UK
| | | | | | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, ON, Canada
| | | | - Lillian Sung
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Division of Haematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
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31
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Gonçalves MS, Silveira AFD, Murashima ADAB, Rossato M, Hippolito MA. Otoprotection Mechanisms Against Oxidative Stress Caused by Cisplatin. Int Arch Otorhinolaryngol 2020; 24:e47-e52. [PMID: 31929833 PMCID: PMC6952293 DOI: 10.1055/s-0039-1698782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/07/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction
Cisplatin damages the auditory system and is related to the generation of free radicals. Glutathione peroxidase is an endogenous free radicals remover.
Objective
To investigate the mechanisms involved in otoprotection by N-acetylcysteine through the expression of glutathione peroxidase in outer hair cells from rats treated with cisplatin.
Methods
Male Wistar rats were intraperitoneally injected with cisplatin (8 mg/Kg) and/or received oral administration by gavage of N-acetylcysteine (300 mg/Kg) for 3 consecutive days. On the 4
th
day, the animals were euthanized and beheaded. The tympanic bullae were removed and prepared for scanning electron microscopy and immunofluorescence.
Results
Among the groups exposed to ototoxic doses of cisplatin, there was an increase in glutathione peroxidase immunostaining in two groups, the one exposed to cisplatin alone, and the group exposed to both cisplatin and N-acetylcysteine.
Conclusion
The expression of glutathione peroxidase in the outer hair cells of rats exposed to cisplatin showed the synthesis of this enzyme under cellular toxicity conditions.
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Affiliation(s)
| | | | - Adriana de Andrade Batista Murashima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirao Preto, SP, Brazil
| | - Maria Rossato
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirao Preto, SP, Brazil
| | - Miguel Angelo Hippolito
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirao Preto, SP, Brazil
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Abstract
PURPOSE Platinum-derived chemotherapy is one of the cornerstones in the treatment of central nervous system tumors in children. We aimed to assess the incidence of hearing loss in children after the exposure to platinum drugs. MATERIAL AND METHODS Retrospective study of prospectively collected data on children consecutively diagnosed with brain tumors and treated with platinum derivatives at a tertiary referral hospital between January 2006 and December 2015. We analyzed multiples variables, such as: age at diagnosis, tumor location, hydrocephalus, platinum drug type, radiotherapy, and follow-up time. The final sample size was 51 patients. RESULTS The median age at diagnosis was 6 years. The median overall follow-up time was 75 months. The incidence of ototoxicity was 23.5%. Rates of hearing loss with carboplatinum were lower than with cisplatinum. A statistically significant association occurred between the presence of hydrocephalus, radiotherapy exposure, infratentorial tumor location, and ototoxicity after treatment with platinum derivatives. CONCLUSIONS Childhood central nervous system tumors nowadays exhibit improved cure and survival rates. However, the ototoxicity resulting from the chemotherapy treatment may accompany patients for the rest of their lives. This study reveals that this occurrence is not negligible, and the association of radiotherapy and the presence of hydrocephalus can be potentiating factors.
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33
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Domarecka E, Skarzynska M, Szczepek AJ, Hatzopoulos S. Use of zebrafish larvae lateral line to study protection against cisplatin-induced ototoxicity: A scoping review. Int J Immunopathol Pharmacol 2020; 34:2058738420959554. [PMID: 33084473 PMCID: PMC7786420 DOI: 10.1177/2058738420959554] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022] Open
Abstract
AIM The present review aimed to consolidate and analyze the recent information about the use of zebrafish in studies concerning cisplatin-induced ototoxicity and otoprotection. MATERIAL AND METHODS The PubMed, Web of Science, and Scopus databanks were searched using the following MESH terms: zebrafish, cisplatin, ototoxicity. The identified publications were screened according to inclusion and exclusion criteria and the 26 qualifying manuscripts were included in the full-text analysis. The experimental protocols, including cisplatin concentrations, the exposure duration and the outcome measurements used in zebrafish larvae studies, were evaluated and the reported knowledge was summarized. RESULTS Twenty-six substances protecting from cisplatin-induced toxicity were identified with the use of zebrafish larvae. These substances include quinine, salvianolic acid B, berbamine 6, benzamil, quercetin, dexmedetomidine, dexamethsanone, quinoxaline, edaravone, apocynin, dimethyl sulfoxide, KR-22335, SRT1720, ORC-13661, 3-MA, D-methionine, mdivi-1, FUT-175, rapamycin, Z-LLF-CHO, ATX, NAC, CYM-5478, CHCP1, CHCP2 and leupeptin. The otoprotective effects of compounds were attributed to their anti-ROS, anti-apoptotic and cisplatin uptake-blocking properties. The broadest range of protection was achieved when the experimental flow used preconditioning with an otoprotective compound and later a co-incubation with cisplatin. Protection against a high concentration of cisplatin was observed only in protocols using short exposure times (4 and 6 h). CONCLUSIONS The data extracted from the selected papers confirm that despite the differences between the human and the zebra fish hearing thresholds (as affected by cisplatin), the sensory cells of zebrafish and larval zebrafish are a valuable tool which could be used: (i) for the discovery of novel otoprotective substances and compounds; (ii) to screen their side effects and (iii) to extend the knowledge on the mechanisms of cisplatin-induced inner ear damage. For future studies, the development of a consensus experimental protocol is highly recommended.
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Affiliation(s)
- Ewa Domarecka
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Magda Skarzynska
- Institute of Sensory Organs, Kajetany, Poland
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Santos NAGD, Ferreira RS, Santos ACD. Overview of cisplatin-induced neurotoxicity and ototoxicity, and the protective agents. Food Chem Toxicol 2019; 136:111079. [PMID: 31891754 DOI: 10.1016/j.fct.2019.111079] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022]
Abstract
Cisplatin has dramatically improved the survival rate of cancer patients, but it has also increased the prevalence of hearing and neurological deficits in this population. Cisplatin induces ototoxicity, peripheral (most prevalent) and central (rare) neurotoxicity. This review addresses the ototoxicity and the neurotoxicity associated with cisplatin-based chemotherapy, providing an integrated view of the potential protective agents that have been evaluated in vitro, in vivo and in clinical trials, their targets and mechanisms of protection and their effects on the antitumor activity of cisplatin. So far, the findings are insufficient to support the use of any oto- or neuroprotective agent before, during or after cisplatin chemotherapy. Despite their promising effects in vitro and in animal studies, many agents have not been evaluated in clinical trials. Additionally, the clinical trials have limitations concerning the sample size, controls, measurement, heterogeneous groups, several arms of treatment, short follow-up or no blinding. Besides that, for most agents, the effects on the antitumor activity of cisplatin have not been evaluated in tumor-bearing animals, which discourages clinical trials. Further well-designed randomized controlled clinical trials are necessary to definitely demonstrate the effectiveness of the oto- or neuroprotective agents proposed by animal and in vitro studies.
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Affiliation(s)
- Neife Aparecida Guinaim Dos Santos
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rafaela Scalco Ferreira
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio Cardozo Dos Santos
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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Jun Y, Youn CK, Jo ER, Cho SI. In vitro inhibitory activity of N-acetylcysteine on tympanostomy tube biofilms from methicillin-resistant Staphylococcus aureus and quinolone-resistant Pseudomonas aeruginosa. Int J Pediatr Otorhinolaryngol 2019; 126:109622. [PMID: 31404783 DOI: 10.1016/j.ijporl.2019.109622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/05/2019] [Accepted: 08/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Biofilm formation in tympanostomy tubes causes persistent and refractory otorrhea. In the present study, we investigated the in vitro antibiofilm activity of N-acetylcysteine (NAC) against biofilm formation by methicillin-resistant Staphylococcus aureus (MRSA) and quinolone-resistant Pseudomonas aeruginosa (QRPA). METHODS We examined the antibiofilm activity of NAC against biofilms produced by MRSA and QRPA strains using in vitro biofilm formation assay, adhesion assay, and biofilm eradication assay. Additionally, the antibiofilm activity of different concentrations of NAC against tympanostomy-tube biofilms from MRSA and QRPA strains was compared using a scanning electron microscope. RESULTS The adhesion of MRSA and QRPA strains decreased significantly in a concentration-dependent manner after treatment with varying amounts of NAC. Treatment with NAC inhibited biofilm formation of both MRSA and QRPA strains and increased eradication of preformed mature biofilm produced by MRSA and QRPA. Besides, NAC exhibited significant eradication-activity against tympanostomy-tube biofilms produced by MRSA and QRPA strains. CONCLUSIONS Our results show potent inhibition of MRSA and QRPA biofilm after treatment with NAC. NAC shows potential for the treatment of biofilms and refractory post-tympanostomy tube otorrhea resulting from MRSA and QRPA infection.
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Affiliation(s)
- Yonghyun Jun
- Department of Anatomy, Chosun University College of Medicine, Gwangju, South Korea
| | - Cha Kyung Youn
- Department of Premedical Science, Chosun University College of Medicine, Gwangju, South Korea
| | - Eu-Ri Jo
- Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
| | - Sung Il Cho
- Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea.
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Freyer DR, Brock P, Knight K, Reaman G, Cabral S, Robinson PD, Sung L. Interventions for cisplatin-induced hearing loss in children and adolescents with cancer. THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:578-584. [PMID: 31160205 PMCID: PMC7521148 DOI: 10.1016/s2352-4642(19)30115-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 01/19/2023]
Abstract
The identification of preventive interventions that are safe and effective for cisplatin-induced ototoxicity is important, especially in children because hearing loss can impair speech-language acquisition development. Previous randomised trials assessed systemic drugs such as amifostine, sodium diethyldithiocarbamate or disulfiram, and sodium thiosulfate. Amifostine, sodium diethyldithiocarbamate, and disulfiram did not show hearing preservation. Paediatric trials assessing sodium thiosulfate showed efficacy in terms of hearing protection. The SIOPEL 6 trial consisted solely of patients with localised hepatoblastoma and no effects on survival were shown. In the ACCL0431 trial, which included heterogeneous patients, a post-hoc analysis showed significantly worse overall survival among patients who had disseminated disease receiving sodium thiosulfate than among controls, but not among those with localised disease. Intratympanically administered drugs have mainly been assessed in adults and include N-acetylcysteine and dexamethasone. Inconsistent effects of these drugs were identified but these studies were limited by design, small sample size, and statistical approach. Future studies of systemic drugs will need to consider the measurement of disease outcomes through study design and sample size, and ototoxicity endpoints should be harmonised to enhance comparability between trials.
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Affiliation(s)
- David R Freyer
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA; Departments of Pediatrics and Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Penelope Brock
- Department of Haematology and Oncology, Great Ormond Street Hospital, London, UK
| | - Kristin Knight
- Division of Pediatric Audiology, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR, USA
| | - Gregory Reaman
- Division of Oncology, Children's National Health System, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, ON, Canada
| | | | - Lillian Sung
- Division of Haematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
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Patel J, Szczupak M, Rajguru S, Balaban C, Hoffer ME. Inner Ear Therapeutics: An Overview of Middle Ear Delivery. Front Cell Neurosci 2019; 13:261. [PMID: 31244616 PMCID: PMC6580187 DOI: 10.3389/fncel.2019.00261] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022] Open
Abstract
There are a variety of methods to access the inner ear and many of these methods depend on utilizing the middle ear as a portal. In this approach the middle ear can be used as a passive receptacle, as part of an active drug delivery system, or simply as the most convenient way to access the inner ear directly in human subjects. The purpose of this volume is to examine some of the more cutting-edge approaches to treating the middle ear. Before considering these therapies, this manuscript provides an overview of some therapies that have been delivered through the middle ear both in the past and at the current time. This manuscript also serves as a review of many of the methods for accessing the inner ear that directly utilize or pass though the middle ear. This manuscript provides the reader a basis for understanding middle ear delivery, the basis of delivery of medicines via cochlear implants, and examines the novel approach of using hypothermia as a method of altering the responses of the inner ear to damage.
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Affiliation(s)
- Jaimin Patel
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Mikhaylo Szczupak
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Suhrud Rajguru
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
| | - Carey Balaban
- Department of Otolaryngology and Biomedical Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Michael E. Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
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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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Rybak LP, Mukherjea D, Ramkumar V. Mechanisms of Cisplatin-Induced Ototoxicity and Prevention. Semin Hear 2019; 40:197-204. [PMID: 31036996 DOI: 10.1055/s-0039-1684048] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Cisplatin is a highly effective antineoplastic agent used to treat solid tumors. Unfortunately, the administration of this drug leads to significant side effects, including ototoxicity, nephrotoxicity, and neurotoxicity. This review addresses the mechanisms of cisplatin-induced ototoxicity and various strategies tested to prevent this distressing adverse effect. The molecular pathways underlying cisplatin ototoxicity are still being investigated. Cisplatin enters targeted cells in the cochlea through the action of several transporters. Once it enters the cochlea, cisplatin is retained for months to years. It can cause DNA damage, inhibit protein synthesis, and generate reactive oxygen species that can lead to inflammation and apoptosis of outer hair cells, resulting in permanent hearing loss. Strategies to prevent cisplatin ototoxicity have utilized antioxidants, transport inhibitors, G-protein receptor agonists, and anti-inflammatory agents. There are no FDA-approved drugs to prevent cisplatin ototoxicity. It is critical that potential protective agents do not interfere with the antitumor efficacy of cisplatin.
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Affiliation(s)
- Leonard P Rybak
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.,Division of Otolaryngology, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Debashree Mukherjea
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.,Division of Otolaryngology, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Vickram Ramkumar
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois
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Fujimoto C, Yamasoba T. Mitochondria-Targeted Antioxidants for Treatment of Hearing Loss: A Systematic Review. Antioxidants (Basel) 2019; 8:E109. [PMID: 31022870 PMCID: PMC6523236 DOI: 10.3390/antiox8040109] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/22/2023] Open
Abstract
Mitochondrial dysfunction is associated with the etiologies of sensorineural hearing loss, such as age-related hearing loss, noise- and ototoxic drug-induced hearing loss, as well as hearing loss due to mitochondrial gene mutation. Mitochondria are the main sources of reactive oxygen species (ROS) and ROS-induced oxidative stress is involved in cochlear damage. Moreover, the release of ROS causes further damage to mitochondrial components. Antioxidants are thought to counteract the deleterious effects of ROS and thus, may be effective for the treatment of oxidative stress-related diseases. The administration of mitochondria-targeted antioxidants is one of the drug delivery systems targeted to mitochondria. Mitochondria-targeted antioxidants are expected to help in the prevention and/or treatment of diseases associated with mitochondrial dysfunction. Of the various mitochondria-targeted antioxidants, the protective effects of MitoQ and SkQR1 against ototoxicity have been previously evaluated in animal models and/or mouse auditory cell lines. MitoQ protects against both gentamicin- and cisplatin-induced ototoxicity. SkQR1 also provides auditory protective effects against gentamicin-induced ototoxicity. On the other hand, decreasing effect of MitoQ on gentamicin-induced cell apoptosis in auditory cell lines has been controversial. No clinical studies have been reported for otoprotection using mitochondrial-targeted antioxidants. High-quality clinical trials are required to reveal the therapeutic effect of mitochondria-targeted antioxidants in terms of otoprotection in patients.
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Affiliation(s)
- Chisato Fujimoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
- Department of Otolaryngology, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan.
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Rolland V, Meyer F, Guitton MJ, Bussières R, Philippon D, Bairati I, Leclerc M, Côté M. A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer. J Otolaryngol Head Neck Surg 2019; 48:4. [PMID: 30651130 PMCID: PMC6335693 DOI: 10.1186/s40463-019-0327-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. Methods Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m2 at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE. On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment. For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables. Results Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically (p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz. Conclusions Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes. Trial registration ClinicalTrials.gov, NTC02281006, Registered 3 November 2014.
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Affiliation(s)
- Viannique Rolland
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - François Meyer
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Laval University Cancer Research Center, Quebec City, Canada
| | - Matthieu J Guitton
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,CERVO Brain Research Center, Quebec City, QC, Canada
| | - Richard Bussières
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - Daniel Philippon
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - Isabelle Bairati
- Laval University Cancer Research Center, Quebec City, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Mathieu Leclerc
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Department of Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Mathieu Côté
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada. .,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada.
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Ostroumova OD, Chikh EV, Rebrova EV, Ryazanova AY, Pereverzev AP. [Drug-induced hearing loss as a manifestation of drug-induced ototoxicity]. Vestn Otorinolaringol 2019; 84:72-80. [PMID: 31579063 DOI: 10.17116/otorino20198404172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ability of drugs to have an ototoxic effect has been studied for a long time, however, the true prevalence of this undesirable phenomenon is unknown, which is due to the use of various audiological protocols, a wide range of reactions to drugs in different ethnic groups, and most importantly, the lack of caution with regard to otological symptoms due to their reversibility or lack of immediate threat to life. Drug-induced ototoxicity is a functional disorder of the inner ear (cochlea and/or vestibular apparatus) or eighth pair of cranial nerves. Pharmacotherapy, associated with the development of ototoxic drug reactions, may remain undervalued for a long time, often until irreversible hearing impairment is formed. The most frequently prescribed drugs that cause ototoxic phenomena include anticancer drugs, antibacterial drugs of the aminoglycoside group, loop diuretics, calcium channel blockers, non-steroidal anti-inflammatory drugs, antimalarial drugs, salicylates, etc. Monitoring the degree of hearing impairment before and during therapy is important in preventing the development of drug-induced ototoxicity and makes it possible to consider alternative treatment regimens in a timely manner. It is in this connection that the role of participation in the appointment of rational pharmacotherapy to patients with a potential risk of developing otological phenomena of a clinical pharmacologist and audiologist undoubtedly increases.
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Affiliation(s)
- O D Ostroumova
- Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia, 119991; Federal State Budgetary Educational Institution of Higher Education 'N.I. Pirogov Russian National Research Medical University' of the Ministry of Health of the Russian Federation
| | - E V Chikh
- Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia, 119991
| | - E V Rebrova
- Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia, 119991
| | - A Yu Ryazanova
- Russian Clinical and Research Center of Gerontology, Moscow, Russia, 129226 ,Department of Clinical Pharmacology and Intensive Therapy with the course of clinical pharmacology of CVF, clinical allergology of the Volgograd State Medical University, Volgograd, Russia, 400131
| | - A P Pereverzev
- Federal State Budgetary Educational Institution of Higher Education 'N.I. Pirogov Russian National Research Medical University' of the Ministry of Health of the Russian Federation
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Alibakhshi T, Khodayar MJ, Khorsandi L, Rashno M, Zeidooni L. Protective effects of zingerone on oxidative stress and inflammation in cisplatin-induced rat nephrotoxicity. Biomed Pharmacother 2018; 105:225-232. [DOI: 10.1016/j.biopha.2018.05.085] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 12/24/2022] Open
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Tillinger JA, Gupta C, Ila K, Ahmed J, Mittal J, Van De Water TR, Eshraghi AA. l-N-acetylcysteine protects outer hair cells against TNFα initiated ototoxicity in vitro. Acta Otolaryngol 2018. [PMID: 29513056 DOI: 10.1080/00016489.2018.1440086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present study is aimed at determining the efficacy and exploring the mechanisms by which l-N-acetylcysteine (l-NAC) provides protection against tumor necrosis factor-alpha (TNFα)-induced oxidative stress damage and hair cell loss in 3-day-old rat organ of Corti (OC) explants. Previous work has demonstrated a high level of oxidative stress in TNFα-challenged OC explants. TNFα can potentially play a significant role in hair cell loss following an insult to the inner ear. l-NAC has shown to provide effective protection against noise-induced hearing loss in laboratory animals but mechanisms of this otoprotective effect are not well-defined. DESIGN Rat OC explants were exposed to either: (1) saline control (N = 12); (2) TNFα (2 μg/ml, N = 12); (3) TNFα+l-NAC (5 mM, N = 12); (4) TNFα+l-NAC (10 mM, N = 12); or (5) l-NAC (10 mM, N = 12). Outer hair cell (OHC) density, levels of reactive oxygen species (ROS), lipid peroxidation of cell membranes, gluthathione activity, and mitochondrial viability were assayed. RESULTS l-NAC (5 and 10 mM) provided protection for OHCs from ototoxic level of TNFα in OC explants. Groups treated with TNFα+l-NAC (5 mM) showed a highly significant reduction of both ROS (p < 0.01) and 4-hydroxy-2-nonenal immunostaining (p < 0.001) compared to TNFα-challenged explants. Total glutathione levels were low in TNFα-challenged explants compared to control and TNFα+l-NAC (5 mM) treated explants (p < 0.001). CONCLUSIONS l-NAC is a promising treatment for protecting auditory HCs from TNFα-induced oxidative stress and subsequent loss via programmed cell death.
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Affiliation(s)
- Joshua A. Tillinger
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Chhavi Gupta
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Kadri Ila
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Jamal Ahmed
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Jeenu Mittal
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Thomas R. Van De Water
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Adrien A. Eshraghi
- Department of Otolaryngology, Hearing Research Laboratory, Miller School of Medicine University of Miami, Miami, FL, USA
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Brown AL, Foster KL, Lupo PJ, Peckham-Gregory EC, Murray JC, Okcu MF, Lau CC, Rednam SP, Chintagumpala M, Scheurer ME. DNA methylation of a novel PAK4 locus influences ototoxicity susceptibility following cisplatin and radiation therapy for pediatric embryonal tumors. Neuro Oncol 2018; 19:1372-1379. [PMID: 28444219 DOI: 10.1093/neuonc/nox076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Ototoxicity is a common adverse side effect of platinum chemotherapy and cranial radiation therapy; however, individual susceptibility is highly variable. Therefore, our objective was to conduct an epigenome-wide association study to identify differentially methylated cytosine-phosphate-guanine (CpG) sites associated with ototoxicity susceptibility among cisplatin-treated pediatric patients with embryonal tumors. Methods Samples were collected for a discovery cohort (n = 62) and a replication cohort (n = 18) of medulloblastoma and primitive neuroectodermal tumor patients. Posttreatment audiograms were evaluated using the International Society of Paediatric Oncology (SIOP) Boston Ototoxicity Scale. Genome-wide associations between CpG methylation and ototoxicity were examined using multiple linear regression, controlling for demographic and treatment factors. Results The mean cumulative dose of cisplatin was 330 mg/m2 and the mean time from end of therapy to the last available audiogram was 6.9 years. In the discovery analysis of 435233 CpG sites, 6 sites were associated with ototoxicity grade (P < 5 × 10-5) after adjusting for confounders. Differential methylation at the top CpG site identified in the discovery cohort (cg14010619, PAK4 gene) was replicated (P = 0.029) and reached genome-wide significance (P = 2.73 × 10-8) in a combined analysis. These findings were robust to a sensitivity analysis evaluating other potential confounders. Conclusions We identified and replicated a novel CpG methylation loci (cg14010619) associated with ototoxicity severity. Methylation at cg14010619 may modify PAK4 activity, which has been implicated in cisplatin resistance in malignant cell lines.
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Affiliation(s)
- Austin L Brown
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Kayla L Foster
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Philip J Lupo
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Erin C Peckham-Gregory
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Jeffrey C Murray
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - M Fatih Okcu
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Ching C Lau
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Surya P Rednam
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Murali Chintagumpala
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Michael E Scheurer
- Department of Pediatrics Hematology-Oncology Section, Baylor College of Medicine, Houston, Texas; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas; Department of Hematology & Oncology, Cook Children's Medical Center, Fort Worth, Texas
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Hammill TL, Campbell KC. Protection for medication-induced hearing loss: the state of the science. Int J Audiol 2018; 57:S67-S75. [PMID: 29688112 DOI: 10.1080/14992027.2018.1455114] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This review will summarise the current state of development of pharmaceutical interventions (prevention or treatment) for medication-induced ototoxicity. DESIGN Currently published literature was reviewed using PubMed and ClinicalTrials.gov to summarise the current state of the science. Details on the stage of development in the market pipeline are provided, along with evidence for clinical safety and efficacy reported. STUDY SAMPLE This review includes reports from 44 articles and clinical trial reports regarding agents in clinical or preclinical trials, having reached approved Investigational New Drug status with the Federal Drug Administration. RESULTS Vitamins and antioxidants are the most common agents currently evaluated for drug-induced ototoxicity intervention by targeting the oxidative stress pathway that leads to cochlear cell death and hearing loss. However, other strategies, including steroid treatment and reduction of ototoxic properties of the primary drugs, are discussed. CONCLUSIONS Retention of hearing during and after a life threatening illness is a major quality-of-life issue for patients receiving ototoxic drugs and their families. The agents discussed herein, while not mature enough at this point, offer great promise towards that goal. This review will provide a knowledge base for hearing providers to inquiries about such options from patients and interdisciplinary care teams alike.
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Affiliation(s)
- Tanisha L Hammill
- a Department of Defense Hearing , Center of Excellence , JBSA Lackland , TX , USA.,b Zcore Business Solutions, LLC , Round Rock , TX , USA
| | - Kathleen C Campbell
- c Department of Medical Microbiology, Immunology and Cell Biology, School of Medicine , Southern Illinois University , Springfield , IL , USA
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Ganesan P, Schmiedge J, Manchaiah V, Swapna S, Dhandayutham S, Kothandaraman PP. Ototoxicity: A Challenge in Diagnosis and Treatment. J Audiol Otol 2018; 22:59-68. [PMID: 29471610 PMCID: PMC5894487 DOI: 10.7874/jao.2017.00360] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/10/2018] [Accepted: 01/16/2018] [Indexed: 12/20/2022] Open
Abstract
Ototoxicity is the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. The panorama of drug-induced hearing loss has widened over last few decades. Although ototoxic medications play an imperative role in modern medicine, they have the capacity to cause harm and lead to significant morbidity. Evidence has shown early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. Although many ototoxicity monitoring protocols exist, their practicality is questionable due to several factors. Even though the existing protocols have proven to be effective, certain lacunae in practice have been encountered due to discrepancies among recommended protocols. Implementation of these protocols is mostly held back due to the incapacitated status of the patient. The choice of early ototoxicity identification techniques is still debatable due to variables such as high degree of sensitivity, specificity and reliability, less time consumption and less labour-intensive to the patient. Hence, the diagnosis and effective treatment of ototoxicity is challenging, even today. A stringent protocol with more practicality encompassing all elements aimed at profiling the effects of ototoxicity is greatly needed. This review describes an efficient application of ototoxicity monitoring and treatment protocol as an attempt to reduce the challenges in diagnosis and management of ototoxicity.
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Affiliation(s)
| | - Jason Schmiedge
- Expert Hearing Solutions, Wall Street Audiology Group Inc., Saskatoon, Canada
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
- Audiology India, Mysore, India
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Hazlitt RA, Min J, Zuo J. Progress in the Development of Preventative Drugs for Cisplatin-Induced Hearing Loss. J Med Chem 2018; 61:5512-5524. [PMID: 29361217 PMCID: PMC6043375 DOI: 10.1021/acs.jmedchem.7b01653] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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Cisplatin
is a highly effective treatment for malignant cancers
and has become a cornerstone in chemotherapeutic regimens. Unfortunately,
its use in the clinic is often coupled with a high incidence of severe
hearing loss. Over the past few decades, enormous effort has been
put forth to find protective agents that selectively protect against
the ototoxic side effects of cisplatin and do not interfere with its
antitumoral activity. Many therapies have been successful in preclinical
work, but only a few have shown any protection in the clinic, and
none have been approved by the FDA. This review summarizes the clinical
and preclinical studies of the most effective small-molecule candidates
currently in clinical trials, while also detailing their molecular
mechanisms of action, to gain insight for future drug development
in the field.
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Kuang X, Sun Y, Wang Z, Zhou S, Liu H. A mitochondrial targeting tetrapeptide Bendavia protects lateral line hair cells from gentamicin exposure. J Appl Toxicol 2017; 38:376-384. [PMID: 29105116 DOI: 10.1002/jat.3547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/29/2017] [Accepted: 09/10/2017] [Indexed: 12/18/2022]
Abstract
The hearing loss induced by aminoglycosides is caused by the permanent loss of mechanosensory hair cells of the inner ear. The aim of the present study is therefore to evaluate the protective effect of Bendavia, a novel antioxidant, on gentamicin-induced hair cell damage in zebrafish lateral lines. The results demonstrated the pretreatment of Bendavia exhibited dose-dependent protection against gentamicin in both acute and chronic exposure. We found that Bendavia at 150 μm conferred optimal protection from either acute or chronic exposure with ototoxin. Bendavia reduced uptake of fluorescent-tagged gentamicin via mechanoelectrical transduction channels, suggesting its protective effects may be partially due to decreasing ototoxic molecule uptake. The intracellular death pathways inhibition triggered by gentamicin might be also included as no blockage of gentamicin was observed. Our data suggest that Bendavia represents a novel otoprotective drug that might provide a therapeutic alternative for patients receiving aminoglycoside treatment.
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Affiliation(s)
- Xiao Kuang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
| | - Yanhui Sun
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
| | - Zhenjie Wang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
| | - Shuang Zhou
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
| | - Hongzhuo Liu
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
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Esen E, Özdoğan F, Gürgen SG, Özel HE, Başer S, Genç S, Selçuk A. Ginkgo biloba and Lycopene are Effective on Cisplatin Induced Ototoxicity? J Int Adv Otol 2017. [PMID: 28639555 DOI: 10.5152/iao.2017.3137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine the anti-ototoxic impact of Ginkgo biloba extract and lycopene on the model of cisplatin-induced ototoxicity in rats. MATERIALS AND METHODS Thirty-two Wistar albino rats were examined with the distortion product otoacoustic emission (DPOAE) test (MADSEN Capella2 ; GN Otometrics, ICS Medical, Chicago USA), and they were randomly divided into four groups. Group 1 (n=8) was defined as the healthy control group. Cisplatin was given intraperitoneally as single dose of 12 mg/kg to group 2 (n=8), group 3 (n=8), and group 4 (n=8). Group 2 was determined as ototoxic control group. G. biloba extract (100 mg/kg) was given to group 3, and 20 mg/kg lycopene was given to group 4 with orogastric feeding tube daily for 10 days. DPOAE test was repeated on day 10 on all the groups. Finally, histopathological examination was performed. The study has been lead in agreement with the principles by the Institutional Animal Care and Use Committee Review Board at Kocaeli University Medical Center (KOÜ HADYEK- 1/9-14). The animals were treated in accordance with protocols approved by this committee. RESULTS When DPOAE tests were compared, there was no significant difference in the four groups before the application (p > 0.05). At the end of day 10, in groups 2 to 4, statistically significant changes were observed (p < 0.05). According to the cisplatin group, a significant increase in the DP-grams on G. biloba and lycopene groups was observed (p < 00.5). Corti organ and spiral ganglion neurons of groups 1, 3, and 4 were observed to have weak expression. Strong reactions were determined in organum spirale and some spiral ganglions of the cisplatin group. The striae vascularis damage on group 2 was found to be more significant more compared with groups 3 and 4. CONCLUSION There is a protective effect of G. biloba and lycopene on cisplatin-dependent ototoxic rat model.
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Affiliation(s)
- Erkan Esen
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Fatih Özdoğan
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Seren Gülşen Gürgen
- Department of Histology and Embryology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Halil Erdem Özel
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Serdar Başer
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Selahattin Genç
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Adin Selçuk
- Clinic of Otolaryngology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
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