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Lewkowicz M, Jones M, Kovacevic B, Ionescu CM, Wagle SR, Foster T, Mikov M, Mooranian A, Al-Salami H. Potentials and limitations of pharmaceutical and pharmacological applications of bile acids in hearing loss treatment. Ther Deliv 2023; 13:477-488. [PMID: 36803017 DOI: 10.4155/tde-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Hearing loss is a worldwide epidemic, with approximately 1.5 billion people currently struggling with hearing-related conditions. Currently, the most wildly used and effective treatments for hearing loss are primarily focus on the use of hearing aids and cochlear implants. However, these have many limitations, highlighting the importance of developing a pharmacological solution that may be used to overcome barriers associated with such devices. Due to the challenges of delivering therapeutic agents to the inner ear, bile acids are being explored as potential drug excipients and permeation enhancers. This review, therefore, aims to explore the pathophysiology of hearing loss, the challenges in treatment and the manners in which bile acids could potentially aid in overcoming these challenges.
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Affiliation(s)
- Michael Lewkowicz
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Melissa Jones
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Bozica Kovacevic
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Corina Mihaela Ionescu
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Susbin Raj Wagle
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Thomas Foster
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Momir Mikov
- Department of Pharmacology, Toxicology & Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, 21101, Serbia
| | - Armin Mooranian
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
| | - Hani Al-Salami
- The Biotechnology & Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia
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Postema RJ, Kingma CM, Wit HP, Albers FW, Van Der Laan BF. Intratympanic gentamicin therapy for control of vertigo in unilateral Menire's disease: a prospective, double-blind, randomized, placebo-controlled trial. Acta Otolaryngol 2008; 128:876-80. [PMID: 18607963 DOI: 10.1080/00016480701762458] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONCLUSIONS Intratympanic application of gentamicin is a relatively safe and efficient treatment for the reduction of complaints of vertigo attacks associated with Menière's disease. The treatment also reduces the severity of the perceived aural fullness. OBJECTIVE To investigate the effectiveness of intratympanic gentamicin treatment in patients with unilateral Menière's disease. SUBJECTS AND METHODS In a prospective, double-blind, randomized, placebo-controlled clinical trial subjects scored vertigo complaints, aural fullness and tinnitus, before, during and up to 1 year after treatment. Hearing loss was monitored with pure tone audiometry. RESULTS Gentamicin treatment resulted in a significant reduction of the score for vertigo complaints and the score for perceived aural fullness. A small increase in hearing loss (average 8 dB) was measured in the gentamicin group.
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Wit HP, Warmerdam TJ, Albers FW. Measurement of the mechanical compliance of the endolymphatic compartments in the guinea pig. Hear Res 2000; 145:82-90. [PMID: 10867280 DOI: 10.1016/s0378-5955(00)00078-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
During injection of artificial endolymph into scala media of the guinea pig, fluid pressure was simultaneously measured in endolymph and perilymph with micropipettes. Pressure differences in the order of 10 Pa could reproducibly be measured upon injection of 2-4 microl of artificial endolymph with a rate of 50 nl/s. Injection of larger volumes damaged the endolymphatic system. From the results, values were derived for the compliances of the membranes surrounding scala media and the vestibular part of the endolymphatic system. The shape of the pressure-time curve during and between repetitive injections of fluid could well be described with a two-component model for the endolymphatic system, consisting of two compartments with compliant walls, connected through a flow resistance. With this model, a larger compliance was found for the second compartment (vestibular part of endolymphatic system) than for the first compartment, into which fluid was injected (scala media).
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Affiliation(s)
- H P Wit
- Department of Otorhinolaryngology, University Hospital Groningen, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands.
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Abstract
Primary open angle glaucoma is a common eye disease characterized by loss of the axons of the retinal ganglion cells leading to progressive loss of vision. The site of damage to the axons is at the level of the lamina cribrosa in the optic nerve head. The mechanism of axonal loss is unknown but elevated intraocular pressure and age are the most common factors associated with the disease. Previous studies in human glaucoma and in experimental glaucoma in monkeys have established a relationship between chronic elevation of intraocular pressure and remodeling of the optic nerve head tissues known clinically as cupping of the optic disc. This review focuses on the astrocytes, the major cell type in the optic nerve head. Astrocytes participate actively in the remodeling of neural tissues during development and in disease. In glaucomatous optic neuropathy, astrocytes play a major role in the remodeling of the extracellular matrix of the optic nerve head, synthesize growth factors and other cellular mediators that may affect directly, or indirectly, the axons of the retinal ganglion cells. Due to the architecture of the lamina cribrosa, formed by the cells and the fibroelastic extracellular matrix, astrocytes may respond to changes in intraocular pressure in glaucoma, leading to some of the detrimental events that underlie axonal loss and retinal ganglion cell degeneration.
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Affiliation(s)
- M R Hernandez
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Zucca G, Botta L, Valli S, Giannoni B, Mira E, Perin P, Buizza A, Valli P. Effects of caloric stimuli on frog ampullar receptors. Hear Res 1999; 137:8-14. [PMID: 10545629 DOI: 10.1016/s0378-5955(99)00125-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The observation that caloric nystagmus can be evoked even in microgravity conditions argues against Barany's convective theory. To justify this result, gravity-independent mechanisms (mainly endolymphatic volume changes and direct action of the temperature on vestibular sensors) are believed to contribute to caloric-induced activation of vestibular receptors. To define the importance of both gravity-dependent and gravity-independent mechanisms, the posterior semicircular canal of the frog was thermally stimulated by a microthermistor positioned close to the sensory organ. The stimulus produced a gravity-dependent transcupular pressure difference that, depending on the position of the heater, could result in either excitation or inhibition of ampullar receptor sensory discharge. When the heater was positioned on the ampulla, or when the canal rested on the horizontal plane, no responses could be evoked by thermal stimuli. These results suggest that, in our experimental conditions (DeltaT up to 1.5 degrees C), neither a thermally induced expansion of the endolymph nor a direct action of the temperature on vestibular sensors play any major role.
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Affiliation(s)
- G Zucca
- Department of Physiological and Pharmacological Sciences, University of Pavia, Via Forlanini 6, I-27100, Pavia, Italy
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Wit HP, Thalen EO, Albers FW. Dynamics of inner ear pressure release, measured with a double-barreled micropipette in the guinea pig. Hear Res 1999; 132:131-9. [PMID: 10392555 DOI: 10.1016/s0378-5955(99)00048-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The inner ear fluid pressure was measured in scala media of the guinea pig through one barrel of a double-barreled micropipette after a sudden volume increase or decrease, caused by injection or withdrawal of artificial endolymph through the other barrel. During injection or withdrawal, the inner ear pressure changed in the order of 1-10 cm water, but it returned to its initial value within a few seconds. The time constant for the pressure recovery depended on the flow direction. It was on average 1.1 s after a short overpressure and 2.8 s after underpressure. The obtained results could be fitted with a simple physical model, when it was assumed that inner ear pressure recovery is a non-linear process, governed by a pressure-dependent flow resistance and/or membrane compliance.
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Affiliation(s)
- H P Wit
- Department of Otorhinolaryngology, University Hospital Groningen, The Netherlands.
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Zucca G, Botta L, Valli S, Giannoni B, Mira E, Perin P, Valli P. Caloric stimulation of ampullar receptors: a new method to produce mechanically-evoked responses in frog semicircular canals. J Neurosci Methods 1999; 88:141-51. [PMID: 10389660 DOI: 10.1016/s0165-0270(99)00021-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A microthermistor positioned close to the exposed posterior semicircular canal in isolated labyrinth preparations of the frog was used to stimulate the sensory organ. Our results indicated that, depending on the position of the heater, the induced endolymphatic convection currents may result in either excitatory or inhibitory cupular deflections and thus in a modulation of ampullar receptor resting activity. Other possible thermal-dependent mechanisms, such as a direct action of the stimulus on vestibular sensors or endolymphatic volume changes, had, in the present experimental conditions, a minor role. Caloric stimulation could therefore represent a novel method to stimulate the semicircular canals 'in situ'.
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Affiliation(s)
- G Zucca
- Institute of General Physiology, University of Pavia, Italy
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Zucca G, Maracci A, Milesi V, Trimarchi M, Mira E, Manfrin M, Quaglieri S, Valli P. Osmolar changes and neural activity in frog vestibular organs. Acta Otolaryngol 1995; 115:34-9. [PMID: 7762382 DOI: 10.3109/00016489509133343] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effects of hypotonic and hypertonic solutions (the normal value was 240 mOsm) on posterior canal resting and evoked discharge were studied in isolated labyrinth preparations. Hypotonic solutions (60-180 mOsm) were obtained by reducing the perilymphatic NaCl content. Hypertonic solutions (300-420 mOsm) were obtained by adding to normal perilymphatic solutions suitable amounts of NaCl, glucose, sucrose, glycerol, mannitol and urea. The results demonstrated that any kind of receptor activity was inhibited by hypotonic solutions. On the contrary, hypertonic solutions produced different effects on resting and evoked activity. The resting discharge was, with the exception of urea, constantly increased whereas the evoked responses were constantly decreased by all the hypertonic solutions tested. The possible effects of media with changed osmolarity in Meniere's patients is also discussed.
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Affiliation(s)
- G Zucca
- Institute of General Physiology, University of Pavia, Italy
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Suzuki M, Kitahara M, Kitano H. The influence of middle ear pressure changes on the primary vestibular neurons in guinea pigs. ACTA OTO-LARYNGOLOGICA. SUPPLEMENTUM 1994; 510:9-15. [PMID: 8128882 DOI: 10.3109/00016489409127294] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The responses of primary vestibular neurons and perilymphatic pressure changes to middle ear pressure stimuli in guinea pigs were investigated in order to clarify the direct effects of pressure stimulus on the vestibular apparatus. The vestibular response was related to the amount of middle ear pressure change applied at a rate of +/- 100 mmH2O/s. The neural response rates of vestibular units to positive pressure in the middle ear were significantly larger than those to negative pressure. The time course pattern of the perilymphatic pressure change resembled that of the response of the vestibular units, indicating that the vestibular response is elicited by middle ear pressure via the pressure transmitted in the inner ear.
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Affiliation(s)
- M Suzuki
- Department of Otolaryngology, Shiga University of Medical Science, Otsu, Japan
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