Ultrastructural changes in the outer hair cells of the guinea pig cochlea after exposure to quinine

Microtubule and auditory function - an underestimated connection

The organ of Corti, located in the cochlea within the inner ear is the receptor organ for hearing. It converts auditory signals into neuronal action potentials that are transmitted to the brain for further processing. The mature organ of Corti consists of a variety of highly differentiated sensory cells that fulfil unique tasks in the processing of auditory signals. The actin and microtubule cytoskeleton play essential function in hearing, however so far, more attention has been paid to the role of actin. Microtubules play important roles in maintaining cellular structure and intracellular transport in virtually all eukaryotic cells. Their functions are controlled by interactions with a large variety of microtubule-associated proteins (MAPs) and molecular motors. Current advances show that tubulin posttranslational modifications, as well as tubulin isotypes could play key roles in modulating microtubule properties and functions in cells. These mechanisms could have various effects on the stability and functions of microtubules in the highly specialised cells of the cochlea. Here, we review the current understanding of the role of microtubule-regulating mechanisms in the function of the cochlea and their implications for hearing, which highlights the importance of microtubules in the field of hearing research.

The Ototoxicity of Antimalarial Drugs-A State of the Art Review

This review summarizes current knowledge about the occurrence of hearing and balance disorders after antimalarial drugs treatment. It also examines the clinical applications of antimalarials, their mechanisms behind this ototoxicity and how it can be monitored. It includes studies with larger numbers of patients and those in which auditory function was assessed using audiological tests. Some antimalarials have been repurposed for other conditions like autoimmune disorders, rheumatic diseases, some viral diseases and cancers. While old antimalarial drugs, such as quinoline derivatives, are known to demonstrate ototoxicity, a number of new synthetic antimalarial agents particularly artemisinin derivatives, demonstrate unknown ototoxicity. Adverse audiovestibular effects vary depending on the medication itself, its dose and route of administration, as well as the drug combination, treated disease and individual predispositions of the patient. Dizziness was commonly reported, while vestibular symptoms, hearing loss and tinnitus were observed much less frequently, and most of these symptoms were reversible. As early identification of ototoxic hearing loss is critical to introducing possible alternative treatments with less ototoxic medications, therefore monitoring systems of those drugs ototoxic side effects are much needed.

Unique responses of auditory cortex networks in vitro to low concentrations of quinine

The anti-malarial drug quinine has several side effects including tinnitus. The aim of the study was to determine if cultured auditory networks growing on microelectrode arrays exhibited unique dynamic states when exposed to quinine. Eight auditory cortex networks (ACN), eight frontal cortex networks (FCN), and five inferior colliculus networks (ICN) were used in this study. Response of ACNs to quinine was biphasic, with an excitatory phase followed by inhibition. FCNs and ICNs revealed only inhibitory responses. The concentrations at which the spike rate was inhibited by 50% (IC50 mean +/- SE) were 42.5 +/- 3.9, 28.7 +/- 4.8 and 23.9 +/- 2.1 microM for ACNs, FCNs, and ICNs, respectively. Quinine increased the regularity and coordination of bursting in all three tissues. The increased burst pattern regularity of ICNs coupled with the excitatory responses seen only in ACNs between 1 and 10 microM show a unique susceptibility of auditory tissues to quinine that may be related to the underlying mechanism that triggers tinnitus-like activity.

Quinine-induced alterations of electrically evoked otoacoustic emissions and cochlear potentials in guinea pigs

Quinine is a well-known ototoxic drug which may affect portions of the auditory system with different biochemical effects, causing reversible hearing loss and tinnitus. Recent investigations indicate that quinine at high concentrations can act directly on cochlear outer hair cells to affect their motility and the mechanical response of the basilar membrane. This study aimed to investigate the effect of quinine on the electromotility of outer hair cells in vivo by means of measuring the electrically evoked otoacoustic emissions (EEOAEs), and the relationship between EEOAE and hearing sensitivity alterations in guinea pigs. Quinine was infused into the scala tympani with concentrations between 0.05 and 5 mM. An alternating current (35 microA RMS) swept from 400 Hz to 40 kHz was applied to the round window to evoke the EEOAE. The compound action potential (CAP), cochlear microphonic (CM) and summating potential (SP) were also measured. Results show that quinine affects the EEOAE in a dose-dependent manner and that its effects are reversible. Two aspects of the EEOAE were affected by quinine, depending on concentration: (1) the 'fine structure' only for concentrations below 0.1 mM and (2) the overall amplitude and the 'fine structure' for concentrations above 0.1 mM. At 5 mM the fine structure was completely absent and the mean amplitude of the EEOAE greatly decreased. Multiple component analysis shows the short delay component of the EEOAE is related to the mean value of the amplitude spectrum while the long delay component is related to the fine structure. The alterations of the EEOAE are roughly comparable to that of the cochlear potentials. A 'threshold concentration' for quinine's effects was found at 25 microM. CAP was significantly affected at 25 microM while EEOAE, CM and SP were not. Enhancement of the EEOAE amplitude was noticed in five out of 20 animals in the current study. The enhancement appears only related to the EEOAE mean level or short delay component. The results suggest that quinine can affect in vivo electromotility of outer hair cells at low concentration and therefore change the cochlear amplifier performance via an effect on electro-mechanical transduction. Its effects on the cochlear spiral ganglion neurons and/or their presynaptic process are also suggested, and these are speculated to be the primary sites for quinine's effects on the auditory system.

The effect of quinine on outer hair cell shape, compliance and force

Quinine intoxication causes a well-described syndrome that includes tinnitus, sensorineural hearing loss and vertigo. The pathophysiology of quinine's effects on hearing is unknown, but may include a peripheral component. The cochlear outer hair cell is known to be motile and to contribute force to amplify the vibration pattern of the organ of Corti. The outer hair cell is also a target of diseases involving tinnitus and sensorineural hearing loss, including salicylate intoxication. These effects may be mediated through changes either in motile force or in mechanical properties. Quinine's effects on outer hair cell motility and mechanical properties have therefore been examined in vitro. Quinine at 5.0 mM substantially decreased active force generation in isolated guinea pig cochlear outer hair cells. Isolated cells also elongated and dilated in diameter when exposed to 5.0 mM quinine. No consistent changes in mechanical properties were observed. 1.0 mM quinine was ineffective in either force reduction or elongation. Trifluoperazine, a calmodulin inhibitor, and ML-9, a blocker of myosin light chain kinases, were ineffective in blocking quinine-induced force reduction or elongation. Deferoxamine, a hydroxyl free radical scavenger, also failed to block either the force decrease or the elongation.

Effects of quinine on the excitability and voltage-dependent currents of isolated spiral ganglion neurons in culture

This work examined how quinine, a drug that induces both hearing loss and tinnitus, interfered with the excitability of spiral ganglion (SG) neurons in cultures. The membrane potential changes and the modification of the action-potential waveform induced by quinine were studied in SG neurons under current clamp. The effects of the drug on voltage-dependent currents in SG neurons were also investigated by the voltage-clamp method. Quinine did not appreciably affect either resting membrane potentials or input resistance at rest. However, action potentials fired by SG neurons were significantly broadened by the presence of quinine. With higher concentrations of quinine (>20 microM), the amplitude of action potentials was also reduced. Voltage-clamp results demonstrated that quinine primarily blocked the whole cell potassium currents (IK) in a voltage-dependent manner. Up to 100 microM of quinine did not appreciably block IK evoked by a test pulse to -35 mV. In contrast, IK was significantly reduced with more positive test pulses, e.g., the concentration needed to obtain 50% inhibition (IC50) was 8 microM for a test pulse to 65 mV. At higher concentrations (>20 microM), quinine also reduced the size of sodium currents (INa) in a use-dependent manner, while leaving calcium currents (ICa) relatively unaffected. Compared with the potency of quinine's effects on other targets in the inner ear, the relatively low IC50 and the voltage-dependent nature of quinine inhibition on IK suggested that its modulation of the waveform and threshold of action potentials of SG neurons probably was primarily responsible for its ototoxic effects. From the point of view of how neural signaling process is affected by the drug, quinine-induced tinnitus may be explained by its broadening of action potentials while the drug's inhibition on INa may result in hearing loss by making the conversion from excitatory postsynaptic potentials to the generation of action potentials more difficult.

Ototoxic reactions of quinine in healthy persons and patients with Plasmodium falciparum infection

Audiometric changes following quinine administration were studied in healthy Caucasian subjects and patients suffering from falciparum malaria disease. Quinine-dihydrochloride was administered intravenously as a single dose of 300 mg to 12 healthy subjects and as multiple doses of 600 mg in 4 h every 8 h in 10 Plasmodium falciparum malaria patients. The hearing function was monitored by conventional and high frequency audiometry. In nine healthy subjects hearing loss was documented at 2-4 h after infusion of Quinine-dihydrochloride at a mean maximal plasma quinine concentration of only 2 mg/l. In one healthy subject a persistent loss occurred of 20 dB at 14 kHz in one ear. In all malaria patients severe hearing losses and adverse effects related to ototoxicity were documented, but all the audiograms had returned to normal after 1 week and side effects disappeared. This study has shown that ototoxicity induced by quinine is almost completely reversible in healthy volunteers and in malaria patients.

The induction of counter-interactions in tumor cells as a basis for the development of a therapy

A tumor cell in a stringent situation is under the influence of two, opposite vectorial 'forces'. Resulting from the stringent situation, one of these 'forces' acts as an inhibitor of the synthesis process, whilst the perpetuation of the genetic induction of synthesis processes in the nucleus causes the second 'force' to act in the opposite manner. The influence of these 'forces' results in the formation of a counter interaction which leads to a 'breaking away' or decoupling of interdependent functions which are tuned to each other. This could be characterized as an apospasis and leads to irreversible cell-damage. If there is no decoupling, then there is a differentiation, or loss of the self-renewing capacity. Due to the fact that the counter interaction is inducible in tumor cells with proliferation activities as well as in tumor cells without proliferation activities, cells in both the growth and non-growth fraction can be attacked.

Direct effects of reactive oxygen species on cochlear outer hair cell shape in vitro

Reactive oxygen species (ROS) have been implicated in the ototoxicity of various agents. This study examines the effects of superoxide anion (O2), hydroxyl radical (OH.) and hydrogen peroxide (H2O2), on isolated cochlear outer hair cell (OHC) morphology. OHCs were superfused with artificial perilymph (AP) or AP containing a specific ROS scavenger, and then with AP, ROS system or scavenger plus ROS system for 90 min. The generation of ROS as well as the scavenging properties of other agents were confirmed by specific biochemical assays. Control cells decreased 4.8% in mean length, and showed no obvious membrane damage. Generation of O2. or OH. resulted in high rates (85.7 and 42.9%, respectively) of bleb formation at the synaptic pole, and decreased (O2., 15.2%; OH., 17.3%) mean cell length. Length change and bleb formation rate were H2O2 concentration-dependent. 20 mM H2O2 led to 33.3% decreased mean cell length, and only 20% bleb formation; 0.1 mM H2O2 led to 83.3% bleb formation, with no length decrease. Superoxide dismutase, deferoxamine and catalase protected against O2., OH. and H2O2 effects, respectively. Bleb formation and diminished cell length likely represent differential lipid peroxidative outcomes at supra- and infranuclear membranes, and are consistent with effects of certain ototoxicants.

Effects of quinine on the mechanical frequency response of the cupula in the fish lateral line

Quinine induces changes in the motion of the cupula in the lateral line canal of the African knife-fish in response to sinusoidal water movements. Two different phases in the action of quinine on the cupular frequency response can be discerned. In the first phase the best frequency, i.e., the frequency at which the cupular vibratory displacement is maximal in response to constant-amplitude sinusoidal canal fluid displacement, shifts toward higher frequencies. During this phase, lasting about 70-100 min, the best frequency increases by a factor between 1.3 and 1.5. In the second phase, during roughly the following 90 min, the best frequency decreases gradually to a value 0.3-0.5 times that observed before the application of quinine.

Structural variability of the sub-surface cisternae in intact, isolated outer hair cells shown by fluorescent labelling of intracellular membranes and freeze-fracture

The intracellular membrane systems in intact, isolated outer hair cells were visualised using the fluorescent membrane probe 3,3'-dihexyloxacarbocyanine iodide (DiOC6) and by freeze-fracture, and f-actin distribution was examined with rhodamine-phalloidin. DiOC6 stained the sub-surface cisternal membranes in the lateral wall and revealed a membrane system running in the centre of the cell from the nucleus to the sub-cuticular region. In optical sections of the lateral wall of fluorescently labelled cells, obtained by scanning laser confocal microscopy, the sub-surface membrane appeared as a fenestrated sheet or a fine network of tubules. Freeze-fracture replicas of rapidly-frozen, unfixed outer hair cells also showed the sub-surface membrane as a fenestrated sheet in some cells or as a network of tubules in others. These combined studies indicate that the interruptions within the cisternal membranes as seen in normal thin sections of outer hair cells are not fixation artefacts but may reflect the dynamic and plastic properties of this membrane system. Double staining of cells with rhodamine-phalloidin and DiOC6 showed substantial co-localisation of intracellular membranes and f-actin. The results suggest there may be a continuous, dynamic endoplasmic reticulum system, forming a core in the centre of the cell, broadening in the subcuticular region and extending down the lateral wall, that may have a role in the turnover and distribution of cytoskeletal assemblies within the outer hair cell.