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Pavlidis P, Maurer J, Apostolidou E, Kekes G, Kouvelas D. Memantine's action against aminoglycoside-induced ototoxicity. Eur Arch Otorhinolaryngol 2013; 271:1491-6. [PMID: 23917735 DOI: 10.1007/s00405-013-2647-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 07/20/2013] [Indexed: 11/30/2022]
Abstract
The objectives of this study were (1) to assess the protective role of NMDA antagonists against the ototoxic effects of aminoglycosides, (2) to provide any possible evidence between ototoxicity due to aminoglycosides and excitotoxicity. An animal experiment was conducted. Twenty-eight, 3-month-old female New Zealand rabbits, weighing 1,000-1,500 g, were studied prospectively for 28 days after intramuscular administration of amikacin (15 mg/kg/day divided into two equal doses) for 14 days. Twenty-one rabbits were categorized into three equal treatment groups and seven animals received no medication and served as the control group. The animals of A, B and C groups were injected, intramuscularly, with amikacin 15 mg/kg/day, divided into two equal doses every day for 14 days. Animals of group A received in parallel memantine (per os) and those of group B received p.o. the same volume of placebo solution. The rabbits of the third group (group C) received on the 15th day and every 2 days for the next 2 weeks, until the day 28, memantine of the same quantity as the members of group A. Differences in DPOAE amplitudes, and therefore in cochlear activity, between group A and group B were revealed. DPOAE amplitudes of group B were further reduced compared to the respective amplitudes in rabbits of group A. No improvement was observed in DPOAE measurements performed after the discontinuation of injections. The findings in group C should be examined separately. The measurements showed apparent reversal ototoxic effects in four of the animals. The development of aminoglycoside otoprotective strategies is a primary goal in ototoxicity research. The administration of NMDA antagonists has been shown to prevent, at least to some extent, toxic damage to hair cells in guinea pigs, treated with aminoglycoside antibiotics.
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Affiliation(s)
- Pavlos Pavlidis
- ENT Department, Katholisches Klinikum, Rudolf-Virchow-Str.7, 56073, Koblenz, Germany,
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Allitt BJ, Benjaminsen C, Morgan SJ, Paolini AG. Intralaminar stimulation of the inferior colliculus facilitates frequency-specific activation in the auditory cortex. J Neural Eng 2013; 10:046008. [DOI: 10.1088/1741-2560/10/4/046008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Roy-Leon JE, Lauzon WD, Toye B, Singhal N, Cameron DW. In vitro and in vivo activity of combination antimicrobial agents on Haemophilus ducreyi. J Antimicrob Chemother 2005; 56:552-8. [PMID: 16046468 DOI: 10.1093/jac/dki270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Development of single dose antibiotic treatments for chancroid has been followed by drug-resistant Haemophilus ducreyi in endemic areas. We examined the activity and interactions of antimicrobial agents and combinations against H. ducreyi. METHODS We evaluated the in vitro susceptibility of three virulent strains of H. ducreyi to ceftriaxone, azithromycin, rifabutin and streptomycin, and each two-drug combination by the agar dilution method. We then tested each two-antibiotic combination for activity by the chequerboard method. Lastly, we chose the antibiotic combination with the lowest fractional inhibitory concentration index (FICI) and tested combined sub-therapeutic doses, the highest doses which had no effect alone on lesion healing compared with controls, for in vivo interaction in the temperature-dependent rabbit model of H. ducreyi infection. RESULTS Each H. ducreyi strain was susceptible in vitro to each antibiotic and two-antibiotic combination, and combined ceftriaxone and streptomycin had the lowest FICI at 0.63. In five treated animals versus three untreated controls, combined sub-therapeutic doses of ceftriaxone (0.05 mg/kg) and streptomycin (10 mg/kg) reduced mean (SD) duration of culture positivity from 7.3 (1.1) to 2.6 (1.7) days (P<0.001), time to 50% reduction in lesion size from 9.7 (1.5) to 5.8 (0.8) days (P<0.005), and time to resolution of ulcer from 11.7 (2.3) to 6.6 (1.7) days (P<0.05). CONCLUSIONS Ceftriaxone and streptomycin have in vivo synergic interaction against H. ducreyi lesions in the temperature-dependent rabbit model of infection. Antibiotic combinations may be evaluated clinically as single-dose therapy for chancroid.
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Affiliation(s)
- Josée E Roy-Leon
- Faculty of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada
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Okuda T, Sugahara K, Takemoto T, Shimogori H, Yamashita H. Inhibition of caspases alleviates gentamicin-induced cochlear damage in guinea pigs. Auris Nasus Larynx 2005; 32:33-7. [PMID: 15882823 DOI: 10.1016/j.anl.2004.11.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2004] [Revised: 10/12/2004] [Accepted: 11/26/2004] [Indexed: 10/25/2022]
Abstract
The efficacy of caspase inhibitors for protecting the cochlea was evaluated in an in vivo study using guinea pigs, as the animal model system. Gentamicin (12 mg/ml) was delivered via an osmotic pump into the cochlear perilymphatic space of guinea pigs at 0.5 microl/h for 14 days. Additional animals were given either z-Val-Ala-Asp (Ome)-fluoromethyl ketone (z-VAD-FMK) or z-Leu-Glu-His-Asp-FMK (z-LEHD-FMK), a general caspase inhibitor and a caspase 9 inhibitor, respectively, in addition to gentamicin. The elevation in auditory brain stem response thresholds, at 4, 7, and 14 days following gentamicin administration, were decreased in animals that received both z-VAD-FMK and z-LEHD-FMK. Cochlear sensory hair cells survived in greater numbers in animals that received caspase inhibitors in addition to gentamicin, whereas sensory hair cells in animals that received gentamicin only were severely damaged. These results suggest that auditory cell death induced by gentamicin is closely related to the activation of caspases in vivo.
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Affiliation(s)
- Takeshi Okuda
- Department of Otolaryngology, Yamaguchi University School of Medicine, Minamikogushi 1-1-1, Ube, Yamaguchi, Japan
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Oei MLYM, Segenhout HM, Dijk F, Stokroos I, van der Want JJL, Albers FWJ. Functional and Anatomic Alterations in the Gentamicin-Damaged Vestibular System in the Guinea Pig. Otol Neurotol 2004; 25:57-64. [PMID: 14724494 DOI: 10.1097/00129492-200401000-00012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The purpose of this study was to investigate the expected functional and morphologic effect of gentamicin on the vestibular system simultaneously by measurement of vestibular evoked potentials and electron microscopic evaluation. BACKGROUND Vestibular short-latency evoked potentials to linear acceleration have been shown to be a useful parameter of vestibular function. In gentamicin-treated animals, the morphologic damage has been well documented, although this has seldom been quantified. METHODS Fifteen guinea pigs were divided into three equal groups. Two groups received different dosages of intramuscular gentamicin for 3 weeks; the third group was the control group. Vestibular short-latency evoked potentials to linear acceleration pulses were measured. After the last gentamicin dose, the utricles were prepared for scanning and transmission electron microscopy. On scanning electron microscopy photographs, the surface area damage ratio of the utricles, a simple method of quantifying gross morphologic damage, was calculated. RESULTS The vestibular short-latency evoked potential of gentamicin-treated guinea pigs showed a slow-developing, damaging, dose-response effect on the function of the vestibular system (p = 0.01). Scanning electron microscopy and transmission electron microscopy showed severe morphologic damage in the sensory hair cells of the utricle. The surface area damage ratio showed a dose-response relationship (p = 0.01). CONCLUSION Functional and anatomic alterations in the gentamicin-damaged vestibular system in the guinea pig are related.
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MESH Headings
- Animals
- Anti-Bacterial Agents/toxicity
- Dose-Response Relationship, Drug
- Evoked Potentials, Auditory, Brain Stem/drug effects
- Female
- Gentamicins/toxicity
- Guinea Pigs
- Hair Cells, Vestibular/drug effects
- Hair Cells, Vestibular/ultrastructure
- Microscopy, Electron
- Microscopy, Electron, Scanning
- Time Factors
- Vestibule, Labyrinth/drug effects
- Vestibule, Labyrinth/physiology
- Vestibule, Labyrinth/ultrastructure
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Affiliation(s)
- Markus L Y M Oei
- Department of Otorhinolaryngology, University Hospital Groningen, Groningen, The Netherlands.
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Imamura SI, Adams JC. Changes in cytochemistry of sensory and nonsensory cells in gentamicin-treated cochleas. J Assoc Res Otolaryngol 2003; 4:196-218. [PMID: 12943373 PMCID: PMC3202711 DOI: 10.1007/s10162-002-2037-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Effects of a single local dose of gentamicin upon sensory and nonsensory cells throughout the cochlea were assessed by changes in immunostaining patterns for a broad array of functionally important proteins. Cytochemical changes in hair cells, spiral ganglion cells, and cells of the stria vascularis, spiral ligament, and spiral limbus were found beginning 4 days post administration. The extent of changes in immunostaining varied with survival time and with cell type and was not always commensurate with the degree to which individual cell types accumulated gentamicin. Outer hair cells, types I and II fibrocytes of the spiral ligament, and fibrocytes in the spiral limbus showed marked decreases in immunostaining for a number of constituents. In contrast, inner hair cells, type III fibrocytes and root cells of the spiral ligament, cells of the stria vascularis, and interdental cells in the spiral limbus showed less dramatic decreases, and in some cases they showed increases in immunostaining. Results indicate that, in addition to damaging sensory cells, local application of gentamicin results in widespread and disparate disruptions of a variety of cochlear cell types. Only in the case of ganglion cells was it apparent that the changes in nonsensory cells were secondary to loss or damage of hair cells. These results indicate that malfunction of the ear following gentamicin treatment is widespread and far more complex than simple loss of sensory elements. The results have implications for efforts directed toward detecting, preventing, and treating toxic effects of aminoglycosides upon the inner ear.
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Affiliation(s)
- Shun-ichi Imamura
- Department of Otolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Joe C. Adams
- Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Imamura SI, Adams JC. Distribution of gentamicin in the guinea pig inner ear after local or systemic application. J Assoc Res Otolaryngol 2003; 4:176-95. [PMID: 12943372 PMCID: PMC3202710 DOI: 10.1007/s10162-002-2036-8] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Uptake and retention of gentamicin by cells in the guinea pig inner ear after a single peritoneal injection or local application on the round window were investigated using immunocytochemistry to localize the drug. The cells that accumulated the drug under the two conditions were the same, but staining for the drug was more intense and was often accompanied by widespread cochlear degeneration following local application. Soon after drug administration by either route, there was diffuse staining for the drug throughout all tissue within the labyrinth, including bone. At later times when distinct cell staining became evident, virtually all cell types were found to be positive, with several cell types staining more darkly for the drug than hair cells, indicating that hair cells were not the most avid in accumulating gentamicin. The infracuticular portion of auditory and vestibular hair cells as well as type III fibrocytes of the spiral ligament were positively stained in almost all cases and these sites were found to be positive for as long as six months post administration. In animals with loss of the organ of Corti, there was unusually intense staining for gentamicin in root cells of the spiral ligament, in marginal cells of the stria vascularis, and in cells of the spiral limbus. Dark staining of surviving cells in cases with overt tissue destruction suggests that variability in the extent of damage caused by the drug was determined more by the degree of its local uptake than by differences in animals' capacities to metabolize the drug systemically. The present results show that gentamicin may damage or destroy all cochlear cells following a single round window application. The findings broaden the scope of our knowledge of cochlear gentamicin uptake and damage and have implications for treatment of patients with vestibular disorders by infusion of aminoglycosides into the middle ear, as well as implications for prospects of rehabilitating patients that have been deafened by aminoglycosides.
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Affiliation(s)
- Shun-ichi Imamura
- Department of Otolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Joe C. Adams
- Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Akaho E, Maekawa T, Uchinashi M, Kanamori R. A study of streptomycin blood level information of patients undergoing hemodialysis. Biopharm Drug Dispos 2002; 23:47-52. [PMID: 11932958 DOI: 10.1002/bdd.293] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Pharmacokinetic feature of streptomycin (SM) was investigated before and during hemodialysis (HD) in four patients with renal failure undergoing HD. SM concentrations were assayed by using TDX SM KIT (DAINABOT). Patients received 10 mg/kg of SM by intramuscular injection before HD. Pharmacokinetic parameters of SM intramuscular injection before HD were k(a)=2.38+/-0.53 h(-1); k(e)=0.0130+/-0.0025 h(-1); V(d)=0.313+/-0.026l/kg and t(1/2)=55.6+/-10.4 h. The maximum concentration (C(max)) of SM was observed at about 2 h after the SM administration and the mean serum concentration of SM was 30.4 microg/ml; even 4 h after the SM injection, the concentration still remained in a range over 30 microg/ml. The data suggest that a possible toxicity might have appeared in the patients. During the hemodialysis an average t(1/2) value was 3.32 h. This value is close to the value of a healthy person. The k(e) value of patient A during the hemodialysis became 24 times as large as that observed before the hemodialysis. On the average it was 17 times as large as that observed before the hemodialysis. Thus, it was found that the values of pharmacokinetics parameters such as k(e) and t(1/2) during the hemodialysis were similar to those of a healthy person, although there are some variations.
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Affiliation(s)
- Eiichi Akaho
- School of Pharmacy and High Technology Research Center, Kobe Gakuin University, 518 Arise Ikawadani-cho, Nishi-ku, Kobe 651-2180, Japan
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Harvey SC, Li X, Skolnick P, Kirst HA. The antibacterial and NMDA receptor activating properties of aminoglycosides are dissociable. Eur J Pharmacol 2000; 387:1-7. [PMID: 10633153 DOI: 10.1016/s0014-2999(99)00798-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The use of aminoglycoside antibiotics is limited by side effects, the most critical of which are vestibular and cochlear toxicity. Recent evidence indicates that these effects result from an excitotoxic process mediated, at least in part, through a polyamine-like activation of NMDA receptors. This study investigated whether these positive modulatory effects of aminoglycosides at NMDA receptors are dissociable from their antibacterial properties. A group of structurally related apramycin derivatives was evaluated for the ability to enhance [3H]dizocilpine binding to rat brain membranes, and for the ability to augment agonist responses on recombinant (NR1A/2B) NMDA receptors expressed in Xenopus oocytes. Based on the antibacterial potencies of these derivatives against Staphylococcus aureus and Escherichia coli, it is concluded that there is no correlation between the ability of an aminoglycoside to produce a positive modulation of NMDA receptors and minimum inhibitory antibacterial concentrations. These findings indicate that it may be possible to develop an aminoglycoside antibiotic with reduced potential for ototoxicity.
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Affiliation(s)
- S C Harvey
- Lilly Research Laboratories, Neuroscience Discovery, Eli Lilly and Company Corporate Center, Bldg. 48, Drop Code 0510, Indianapolis, IN, USA.
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In Vitro Ototoxicity of aminoglycosides and platin derivatives. A semi-automatic assay for sensory hair cell damage in explanted rat organ of corti. Toxicol In Vitro 1998; 12:705-14. [DOI: 10.1016/s0887-2333(98)00048-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/1998] [Indexed: 11/19/2022]
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