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Li C, Chen L, Li Y, Li M, Zhang X, Cui L, Sun Y, Song X. Cortisol Sensitizes Cochlear Hair Cells to Gentamicin Ototoxicity Via Endogenous Apoptotic Pathway. Otol Neurotol 2024; 45:e49-e56. [PMID: 38085767 DOI: 10.1097/mao.0000000000004074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND The widespread use of aminoglycosides is a prevalent cause of sensorineural hearing loss. Patients receiving aminoglycosides usually have elevated levels of circulating stress hormones due to disease or physiological stress; however, whether the stress hormone cortisol impacts aminoglycoside-mediated injury of cochlear hair cells has not been fully investigated. METHODS House Ear Institute-Organ of Corti 1 (HEI-OC1) cells with or without cortisol pretreatment were exposed to gentamicin, we investigated the effect of cortisol pretreatment on gentamicin ototoxicity by assessing cell viability. Molecular pathogenesis was explored by detecting apoptosis and oxidative stress. Meanwhile, by inhibiting glucocorticoid receptors (GR) and mineralocorticoid receptors (MR), the potential roles of receptor types in cortisol-mediated sensitization were evaluated. RESULTS Cortisol concentrations below 75 μmol/l did not affect cell viability. However, pretreatment with 50 μmol/l cortisol for 24 hours sensitized hair cells to gentamicin-induced apoptosis. Further mechanistic studies revealed that cortisol significantly increased hair cell apoptosis and oxidative stress, and altered apoptosis-related protein expressions induced by gentamicin. In addition, blockade of either GR or MR attenuated cortisol-induced hair cell sensitization to gentamicin toxicity. CONCLUSION Cortisol pretreatment increased mammalian hair cell susceptibility to gentamicin toxicity. Sensitization was related to the activation of the intrinsic apoptotic pathway and excessive generation of reactive oxygen species. Cortisol may exacerbate aminoglycoside ototoxicity.
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Johns JD, Adadey SM, Hoa M. The role of the stria vascularis in neglected otologic disease. Hear Res 2023; 428:108682. [PMID: 36584545 PMCID: PMC9840708 DOI: 10.1016/j.heares.2022.108682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
The stria vascularis (SV) has been shown to play a critical role in the pathogenesis of many diseases associated with sensorineural hearing loss (SNHL), including age-related hearing loss (ARHL), noise-induced hearing loss (NIHL), hereditary hearing loss (HHL), and drug-induced hearing loss (DIHL), among others. There are a number of other disorders of hearing loss that may be relatively neglected due to being underrecognized, poorly understood, lacking robust diagnostic criteria or effective treatments. A few examples of these diseases include autoimmune inner ear disease (AIED) and/or autoinflammatory inner ear disease (AID), Meniere's disease (MD), sudden sensorineural hearing loss (SSNHL), and cytomegalovirus (CMV)-related hearing loss (CRHL). Although these diseases may often differ in etiology, there have been recent studies that support the involvement of the SV in the pathogenesis of many of these disorders. We strive to highlight a few prominent examples of these frequently neglected otologic diseases and illustrate the relevance of understanding SV composition, structure and function with regards to these disease processes. In this study, we review the physiology of the SV, lay out the importance of these neglected otologic diseases, highlight the current literature regarding the role of the SV in these disorders, and discuss the current strategies, both approved and investigational, for management of these disorders.
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Affiliation(s)
- J Dixon Johns
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University School of Medicine, Washington, DC, USA.
| | - Samuel M Adadey
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
| | - Michael Hoa
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University School of Medicine, Washington, DC, USA; Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
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Yao Y, Wang HX, Liu LW, Ding YL, Sheng JE, Deng XH, Liu B. Acute choroidal involvement in lupus nephritis: A case report and review of literature. World J Clin Cases 2022; 10:6520-6528. [PMID: 35979291 PMCID: PMC9294913 DOI: 10.12998/wjcc.v10.i19.6520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/19/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE), characterized by the production of autoantibodies and widespread deposition of immune complexes, predominantly affects women of childbearing age. More than one-third of SLE patients present ocular manifestations. Choroidal disease is currently not completely understood, and its precise differentiation from central serous chorioretinopathy is rarely achieved. To date, no more than 60 patients with choroidal involvement have been reported.
CASE SUMMARY A 37-year-old Chinese woman experienced decreased visual acuity bilaterally, accompanied by increasing periorbital swelling and severe conjunctival chemosis. Decreased breath sounds in both bases were detected via auscultation, as well as pitting edema in both ankles. SLE and lupus nephritis were diagnosed based on serositis, renal disorder, leukopenia and positive anti-Smith and anti-nuclear antibodies. Lupus choroidopathy was diagnosed based on ocular presentation and imaging. The patient was treated with systemic corticosteroids, spironolactone, hydroxychloroquine (HCQ), mycophenolate mofetil (MMF), and intravenous immunoglobulin. After 4 wk of hospitalization, the patient was discharged. Indocyanine green angiography showed no leakage from choroidal vessels, and ocular coherence tomography detected low amounts of subretinal fluid right before discharge. The patient was prescribed oral methylprednisolone, HCQ, and MMF. Two months after the first visit, ophthalmological examination revealed a visual acuity of 20/20 bilaterally, and SLE disease activity was well controlled; her symptoms disappeared completely.
CONCLUSION Here we presented a case of lupus choroidopathy, successfully treated with systemic corticosteroids, and discussed previously reported cases, focusing on differential diagnosis with a central serous chorioretinopathy.
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Affiliation(s)
- Yuan Yao
- Department of Rheumatology Immunology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Hai-Xia Wang
- Department of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Li-Wei Liu
- Department of Rheumatology Immunology, The People Hospital of Nanpi Country, Cangzhou 061000, Hebei Province, China
| | - Yue-Ling Ding
- Department of Hematology, The People Hospital of Dingzhou Country, Baoding 071000, Hebei Province, China
| | - Jiao-E Sheng
- Department of Rheumatology Immunology, Minda Hospital of Hubei Minzu University, Enshi 445000, Hubei Province, China
| | - Xiao-Hu Deng
- Department of Rheumatology Immunology, Chinese PLA General Hospital, Beijing 100000, China
| | - Bin Liu
- Department of Rheumatology Immunology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
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Nelson L, Johns JD, Gu S, Hoa M. Utilizing Single Cell RNA-Sequencing to Implicate Cell Types and Therapeutic Targets for SSNHL in the Adult Cochlea. Otol Neurotol 2021; 42:e1410-e1421. [PMID: 34510123 PMCID: PMC8595752 DOI: 10.1097/mao.0000000000003356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify genes implicated in sudden sensorineural hearing loss (SSNHL) and localize their expression in the cochlea to further explore potential pathogenic mechanisms and therapeutic targets. STUDY DESIGN Systematic literature review and bioinformatics analysis. DATA SOURCES The following sources were searched from inception through July 2, 2020: PubMed-NCBI, MEDLINE, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, OpenGrey, GreyNet, GreyLiterature Report, and European Union Clinical Trials Registry. PubMed-NCBI and MEDLINE were additionally searched for human temporal bone histopathologic studies related to SSNHL. METHODS Literature review of candidate SSNHL genes was conducted according to PRISMA guidelines. Existing temporal bone studies from SSNHL patients were analyzed to identify the most commonly affected inner ear structures. Previously published single-cell and single-nucleus RNA-Seq datasets of the adult mouse stria vascularis, as well as postnatal day 7 and 15 mouse cochlear hair cells and supporting cells, were utilized for localization of the SSNHL-related genes curated through literature review. CONCLUSIONS We report 92 unique single nucleotide polymorphisms (SNPs) in 76 different genes that have been investigated in relation to SSNHL in the literature. We demonstrate that a subset of these genes are expressed by cell types in the adult mouse stria vascularis and organ of Corti, consistent with findings from temporal bone studies in human subjects with SSNHL. We highlight several potential genetic targets relevant to current and possible future SSNHL treatments.
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Affiliation(s)
- Lacey Nelson
- Georgetown University School of Medicine, Washington, D.C
| | - J. Dixon Johns
- Department of Otolaryngology–Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
| | - Shoujun Gu
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, Bethesda, MD
| | - Michael Hoa
- Department of Otolaryngology–Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, Bethesda, MD
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Oral steroid treatment for hearing improvement in Ménière's disease and endolymphatic hydrops. Otol Neurotol 2013; 33:1685-91. [PMID: 23047260 DOI: 10.1097/mao.0b013e31826dba83] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effect of oral steroid treatment on hearing in unilateral Ménière's disease and endolymphatic hydrops patients. STUDY DESIGN Retrospective chart review. SETTING Tertiary referral center. PATIENTS All patients presenting during the 2010 calendar year with confirmed unilateral Ménière's disease or endolymphatic hydrops. Those with a first visit and second visit audiogram (n = 58) were included in the analysis of oral steroid treatment effect. INTERVENTION Steroid treatment for hearing loss. MAIN OUTCOME MEASURE Change in hearing, as defined by change in affected ear threshold values or speech discrimination score from pretreatment visit to posttreatment visit. RESULTS Hearing (threshold, speech discrimination score) in patients' affected ear did not significantly change from first visit to second visit after treatment with steroids relative to patients who did not receive steroid treatment. CONCLUSION The results of this and other studies would indicate that a Ménière's disease or endolymphatic hydrops patient is unlikely to experience an improvement in hearing from a short course of oral steroid. Clinically observed temporary improvement did not sustain over several months. Further work to elucidate the mechanisms underlying hearing loss in hydrops, perhaps focusing on the dendrite damage noted in animal models of hydrops, is warranted.
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Grewal AS, Nedzelski JM, Chen JM, Lin VYW. Dexamethasone uptake in the murine organ of Corti with transtympanic versus systemic administration. J Otolaryngol Head Neck Surg 2013; 42:19. [PMID: 23663237 PMCID: PMC3651220 DOI: 10.1186/1916-0216-42-19] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 01/06/2013] [Indexed: 12/20/2022] Open
Abstract
Objective To investigate glucocorticoid uptake in auditory hair cells following transtympanic versus systemic administration of dexamethasone. Study design Controlled experimental study. Setting Translational science experimental laboratory. Methods Swiss-Webster mice were injected with dexamethasone via transtympanic or systemic administration. At 1, 6, or 12 hours post-injection the temporal bones were harvested. After cryosectioning, immunohistochemical staining was performed using an antibody for dexamethasone. Results Dexamethasone labelling was greatest at 1 hour. Inner hair cells demonstrated much higher steroid uptake than outer hair cells. Both transtympanic injection and high-dose systemic administration resulted in strong dexamethasone labelling of hair cells, and a decreasing basal-to-apical gradient of hair cell fluorescence intensity was observed. Systemically delivered dexamethasone was rapidly eliminated from the inner ear, demonstrating mild labelling after 6 hours and none after 12 hours. In contrast, the mice receiving transtympanic injection had persistent moderate intensity fluorescence at 6 and 12 hours post-injection. Conclusion There is similar uptake of dexamethasone by auditory hair cells after transtympanic and high-dose systemic delivery. Novel findings include the presence of a decreasing basal-apical gradient of steroid uptake, and demonstration of greater affinity of inner hair cells for dexamethasone compared to outer hair cells. In this animal model transtympanic injection resulted in prolonged steroid uptake. These findings help further our understanding of the pharmacokinetics of steroids in the cochlea, with a focus on auditory hair cells.
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Affiliation(s)
- Amandeep S Grewal
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Suite M1-102, Toronto, ON M4N 3M5, Canada.
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The role of glucocorticoid receptors in dexamethasone-induced apoptosis of neuroprogenitor cells in the hippocampus of rat pups. Mediators Inflamm 2013; 2013:628094. [PMID: 23401645 PMCID: PMC3557631 DOI: 10.1155/2013/628094] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 12/17/2012] [Indexed: 12/25/2022] Open
Abstract
Background. Dexamethasone (Dex) has been used to reduce inflammation in preterm infants with assistive ventilation and to prevent chronic lung diseases. However, Dex treatment results in adverse effects on the brain. Since the hippocampus contains a high density of glucocorticoid receptors (GCRs), we hypothesized that Dex affects neurogenesis in the hippocampus through inflammatory mediators. Methods. Albino Wistar rat pups first received a single dose of Dex (0.5 mg/kg) on postnatal day 1 (P1) and were sacrificed on P2, P3, P5, and P7. One group of Dex-treated pups (Dex-treated D1D2) was given mifepristone (RU486, a GCR antagonist) on P1 and sacrificed on P2. Hippocampi were isolated for western blot analysis, TUNEL, cleaved-caspase 3 staining for cell counts, and morphological assessment. Control pups received normal saline (NS). Results. Dex reduced the developmental gain in body weight, but had no effect on brain weight. In the Dex-treated D1D2 group, apoptotic cells increased in number based on TUNEL and cleaved-caspase 3 staining. Most of the apoptotic cells expressed the neural progenitor cell marker nestin. Dex-induced apoptosis in P1 pups was markedly reduced (60%) by pretreatment with RU486, indicating the involvement of GCRs. Conclusion. Early administration of Dex results in apoptosis of neural progenitor cells in the hippocampus and this is mediated through GCRs.
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Abstract
PURPOSE OF REVIEW To describe ion and water homeostatic mechanisms in the inner ear, how they are compromised in hearing disorders, and what treatments are employed to restore auditory function. RECENT FINDINGS The ion and water transport functions in the inner ear help maintain the proper endolymph K concentration required for hair cell function. Gene defects and idiopathic alterations in these transport functions cause hearing loss, but often the underlying cause is unknown. Current therapies largely involve glucocorticoid treatment, although the mechanisms of restoration are often undeterminable. Recent studies of these ion homeostatic functions in the ear are characterizing their cellular and molecular control. It is anticipated that future management of these hearing disorders will be more targeted to the cellular processes involved and improve the likelihood of hearing recovery. SUMMARY A better understanding of the ion homeostatic processes in the ear will permit more effective management of their associated hearing disorders. Sufficient insight into many homeostatic hearing disorders has now been attained to usher in a new era of better therapies and improved clinical outcomes.
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Affiliation(s)
- Dennis R Trune
- Oregon Hearing Research Center, Department of Otolaryngology Head Neck Surgery, Oregon Health & Science University, Portland, Oregon 97239-3098, USA.
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Medical management of common peripheral vestibular diseases. Curr Opin Otolaryngol Head Neck Surg 2010; 18:407-12. [DOI: 10.1097/moo.0b013e32833e587a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Current Opinion in Otolaryngology & Head and Neck Surgery. Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:466-74. [PMID: 20827086 DOI: 10.1097/moo.0b013e32833f3865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Trune DR, Kempton JB. Low dose combination steroids control autoimmune mouse hearing loss. J Neuroimmunol 2010; 229:140-5. [PMID: 20800906 DOI: 10.1016/j.jneuroim.2010.07.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 07/27/2010] [Indexed: 11/25/2022]
Abstract
The severe side effects of glucocorticoids prevent long term management of hearing loss. Alternative steroid treatments that minimize or eliminate these effects would significantly benefit therapeutic control of hearing disorders. A steroid treatment study of autoimmune mouse hearing loss was conducted to determine the efficacy of combining aldosterone and prednisolone at low doses. An assessment also was made of low dose fludrocortisone, a synthetic mineralocorticoid that also has a slight glucocorticoid effect. MRL/MpJ-Fas(lpr) mice were tested for baseline ABR thresholds at 3 months of age and then treated with aldosterone (3.0 μg/kg) or prednisolone (1.0 mg/kg) to determine the lowest effective dose of each. Other mice were given the two steroids in combination at doses of Pred 0.5 mg+Aldo 1.5 μg; Pred 1.0 mg+Aldo 3.0 μg; or Pred 1.5 mg+Aldo 5.0 μg. Mice were retested with ABR at 1 and 2 months to determine the efficacy of the different steroid treatments in controlling hearing loss. Another series of mice were given the synthetic mineralocorticoid fludrocortisone at low (2.8 μg/kg) or high (10 μg/kg) doses and retested at monthly intervals for 3 months. Autoimmune mouse hearing loss developed in untreated controls. This threshold elevation was not prevented by prednisolone at 1 mg/kg or by aldosterone at 3 μg/kg when each was given alone. However, the two steroids combined at these doses effectively controlled hearing loss. The fludrocortisone treatments also were effective at low doses in preventing or reversing the autoimmune mouse hearing loss. This efficacy of combined steroids at low doses suggests the potential for reducing the side effects of glucocorticoids in the therapeutic control of hearing disorders.
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Affiliation(s)
- Dennis R Trune
- Oregon Hearing Research Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR 97239-3098, USA.
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Hamid MA, Trune DR, Dutia MB. Advances in Auditory and Vestibular Medicine. AUDIOLOGICAL MEDICINE 2009; 7:180-188. [PMID: 20711412 PMCID: PMC2920488 DOI: 10.3109/02841860903364076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Auditory and Vestibular medicine is becoming more accepted as a specialty of its own, Medical NeurOtology. Recent advances in the field have been instrumental in the understanding of the scientific foundations, pathophysiology, clinical approach and management of patients with hearing and vestibular disorders. This paper will review these advances.
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Affiliation(s)
- Mohamed A Hamid
- Professor of Audiology and Otolaryngology, Founder and Medical Director, The Cleveland Hearing and Balance Center, 29001 Cedar Rd, #203, Lyndhurst, Oh, 44124, USA, 01(216) 684-9970,
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