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Ho JCS, Ma BBY, Chow JCH. Optimizing Hearing Outcomes in Nasopharyngeal Cancer Survivors in the Era of Modern Radiotherapy and Systemic Therapy. Cancers (Basel) 2024; 16:3237. [PMID: 39335208 PMCID: PMC11430699 DOI: 10.3390/cancers16183237] [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: 08/27/2024] [Revised: 09/16/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
Intensity-modulated radiation therapy (IMRT) improves disease control and reduces treatment-related toxicity in patients with localized nasopharyngeal carcinoma (NPC). However, due to the proximity of the auditory apparatus to the treatment volume and the frequent incorporation of cisplatin-based chemotherapy, treatment-related sensorineural hearing loss (SNHL) remains a common debilitating complication among NPC survivors. The reported crude incidence of SNHL following IMRT for NPC varies widely at 1-46% due to differences in auditory assessment methods and thresholds, follow-up durations, chemotherapy usage, and patient compositions. International guidelines and radiation dosimetric studies have recommended constraining the cochlear mean dose to less than 44-50 Gy, but the risk of SNHL remains high despite adherence to these constraints. Potential strategies to improve hearing outcomes in NPC survivors include cautious de-escalation of radiotherapy dose and volume, individualization of cochlear constraints, optimization of radiotherapy planning techniques, and the use of substitutes or alternative schedules for cisplatin-based chemotherapy. The addition of immune checkpoint inhibitors to chemoradiotherapy did not impact ototoxicity. Prospective studies that employ both objective and patient-reported auditory outcomes are warranted to test the long-term benefits of various approaches. This article aims to provide a comprehensive review of the incidence and radiation dose-toxicity relationship of SNHL in NPC survivors and to summarize potential strategies to optimize hearing outcomes in relation to nuances in radiotherapy planning and the selection of systemic therapy.
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Affiliation(s)
- Jason C S Ho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Brigette B Y Ma
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - James C H Chow
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
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2
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Gao Y, Wu F, He W, Cai Z, Pang J, Zheng Y. Reactive Oxygen Species-Related Disruptions to Cochlear Hair Cell and Stria Vascularis Consequently Leading to Radiation-Induced Sensorineural Hearing Loss. Antioxid Redox Signal 2024; 40:470-491. [PMID: 37476961 DOI: 10.1089/ars.2022.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Aims: Radiation-induced sensorineural hearing loss (RISNHL) is one of the major side effects of radiotherapy for head and neck cancers. At present, no effective clinical treatment or prevention is available for RISNHL. This study thus aimed to investigate the cochlear pathology so that the underlying mechanisms of RISNHL may be elucidated, consequently paving the way for potential protective strategies to be developed. Results: Functional and morphological impairment in the stria vascularis (SV) was observed after irradiation (IR), as indicated by endocochlear potential (EP) reduction, hyperpermeability, and SV atrophy. The expression of zonulae occludins-1 was found to have decreased after IR. The loss of outer hair cells (OHCs) occurred later than SV damage. The disruption to the SV and OHCs could be attributed to reactive oxygen species (ROS)-related damage. In addition, EP shifts and the loss of OHCs were reduced when ROS was reduced by N-acetylcysteine (NAC) in C57BL/6 mice, attenuating auditory threshold shifts. Innovation: The damage to the SV was found to occur before OHC loss. ROS-related damage accounted for SV damage and OHC loss. The incidences of SV damage and OHC loss were decreased through ROS modulation by NAC, subsequently preventing RISNHL, suggesting the possible role of NAC as a possible protective agent against RISNHL. Conclusion: The findings from this study suggest oxidative stress-induced early SV injury and late OHC loss to be the key factors leading to RISNHL. NAC prevents IR-induced OHC loss, and attenuates auditory brainstem response and EP shifts by regulating the level of oxidative stress. Antioxid. Redox Signal. 40, 470-491.
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Affiliation(s)
- Yiming Gao
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Fan Wu
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wuhui He
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ziyi Cai
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jiaqi Pang
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Shenshan Medical Center, Sun Yat-Sen Memorial Hospital, Shanwei, China
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3
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Tong J, Hu C, Wu Y, Liu Q, Sun D. Radiation-induced NF-κB activation is involved in cochlear damage in mice via promotion of a local inflammatory response. JOURNAL OF RADIATION RESEARCH 2023; 64:63-72. [PMID: 36253086 PMCID: PMC9855318 DOI: 10.1093/jrr/rrac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The radiation-induced inflammatory response is involved in radiation damage to the cochlea and causes sensorineural hearing loss (SNHL). NF-κB, as the master switch of the inflammatory response, regulates the expression of many inflammation-related genes and thus the inflammatory response. Therefore, in this study we used a mouse model to determine whether radiation-induced NF-κB activation is involved in damage to the cochlea and to investigate the underlying mechanism. Eventually, we found that NF-κB was activated after radiation of the cochleae and the activation reached a maximum at 2-6 h after radiation. And morphological analysis showed severe damage to the cochleae after radiation, but this damage was significantly ameliorated by JSH-23 (an inhibitor of NF-κB) pretreatment. Along with these morphological changes, the expression levels of proinflammatory molecules (including proinflammatory cytokines IL-6, TNF-α, COX-2 and inflammation-related proteins VCAM-1, MIP-1β) in the cochlear tissues were significantly increased after radiation, but were significantly decreased by JSH-23 pretreatment compared to radiation alone. Therefore, these results indicated that radiation-induced NF-κB activation was involved in damage to the cochleae and resultant SNHL via its promotion of the inflammatory response mediated by overexpression of some proinflammatory molecules in cochlear tissues, and inhibition of radiation-induced NF-κB was conducive to preventing such damage.
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Affiliation(s)
- Jiaojiao Tong
- Cancer Center, the Second Hospital of Shandong University, Jinan, Shandong Province 250033, China
| | - Chunhui Hu
- Cancer Center, the Second Hospital of Shandong University, Jinan, Shandong Province 250033, China
| | - Yuqian Wu
- Cancer Center, the Second Hospital of Shandong University, Jinan, Shandong Province 250033, China
| | - Qin Liu
- Cancer Center, the Second Hospital of Shandong University, Jinan, Shandong Province 250033, China
| | - Dianshui Sun
- Corresponding author. Cancer Center, the Second Hospital of Shandong University, No.247 Beiyuan Road, Jinan, Shandong Province, 250033, China. Tel: +86 13583111990;
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Ren H, Hu B, Jiang G. Advancements in prevention and intervention of sensorineural hearing loss. Ther Adv Chronic Dis 2022; 13:20406223221104987. [PMID: 35782345 PMCID: PMC9243368 DOI: 10.1177/20406223221104987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
The inner ear is a complex and difficult organ to study, and sensorineural hearing loss (SNHL) is a multifactorial sensorineural disorder with characteristics of impaired speech discrimination, recognition, sound detection, and localization. Till now, SNHL is recognized as an incurable disease because the potential mechanisms underlying SNHL have not been elucidated. The risk of developing SNHL is no longer viewed as primarily due to environmental factors. Instead, SNHL seems to result from a complicated interplay of genetic and environmental factors affecting numerous fundamental cellular processes. The complexity of SNHL is presented as an inability to make an early diagnosis at the earliest stages of the disease and difficulties in the management of symptoms during the process. To date, there are no treatments that slow the neurodegenerative process. In this article, we review the recent advances about SHNL and discuss the complexities and challenges of prevention and intervention of SNHL.
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Affiliation(s)
- Hongmiao Ren
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, P.R. China
| | - Bing Hu
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Guangli Jiang
- Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Liu Z, Luo Y, Guo R, Yang B, Shi L, Sun J, Guo W, Gong S, Jiang X, Liu K. Head and Neck Radiotherapy Causes Significant Disruptions of Cochlear Ribbon Synapses and Consequent Sensorineural Hearing Loss. Radiother Oncol 2022; 173:207-214. [DOI: 10.1016/j.radonc.2022.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
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Mechanism and Protection of Radiotherapy Induced Sensorineural Hearing Loss for Head and Neck Cancer. BIOMED RESEARCH INTERNATIONAL 2022; 2021:3548706. [PMID: 34970625 PMCID: PMC8714384 DOI: 10.1155/2021/3548706] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/18/2021] [Accepted: 12/08/2021] [Indexed: 12/15/2022]
Abstract
Purpose Radiotherapy-induced sensorineural hearing loss (RISNHL) is a common adverse effect in patients with head and neck cancer. Given that there are few studies on the pathogenesis of RISNHL at present, we summarized the possible pathogenesis of RISNHL and possible protective measures found at present by referring to relevant literatures. Methods We performed a comprehensive literature search in the PubMed database, using keywords “sensorineural hearing loss,” “radiotherapy,” and “cancer,” among others. The literature was examined for the possible mechanism and preventive measures of sensorineural hearing loss induced by radiotherapy. Results We found that the incidence of RISNHL was closely related to the damage directly caused by ionizing radiation and the radiation-induced bystander effect. It also depends on the dose of radiation and the timing of chemotherapy. Studies confirmed that RISNHL is mainly involved in post-RT inflammatory response and changes in reactive oxygen species, mitogen-activated protein kinase, and p53 signaling pathways, leading to specific manners of cell death. We expect to reduce the incidence of hearing loss through advanced radiotherapy techniques, dose limitation of organs at risk, application of cell signaling inhibitors, use of antioxidants, induction of cochlear hair cell regeneration, and cochlear implantation. Conclusion RISNHL is associated with radiation damage to DNA, oxidative stress, and inflammation of cochlear cells, stria vascularis endothelial cells, vascular endothelial cells, spiral ganglion neurons, and other supporting cells. At present, the occurrence mechanism of RISNHL has not been clearly illustrated, and further studies are needed to better understand the underlying mechanism, which is crucial to promote the formulation of better strategies and prevent the occurrence of RISNHL.
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Gentilin E, Cani A, Simoni E, Chicca M, Di Paolo ML, Martini A, Astolfi L. Hydrogen peroxide toxicity on auditory cells: An in vitro study. Chem Biol Interact 2021; 345:109575. [PMID: 34228970 DOI: 10.1016/j.cbi.2021.109575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/04/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
In recent decades, interest has increased in the role of reactive oxygen species (ROS) in health and disease. The ROS are key causative factors in several hearing loss pathologies including ototoxicity, noise trauma, cochlear ageing and ischemic injury. In order to investigate ROS effects on inner ear cells and counteract them, we developed an in vitro model of oxidative stress by exposing the inner ear cell line OC-k3 to hydrogen peroxide (H2O2) at concentrations able to affect in vivo cellular components but allowing cell survival. The treatment with high concentrations (20 and 30 μM) resulted in reduction of cell viability, activation of apoptosis/necrosis and alteration of morphology, cell cycle progression and antioxidant defences. The ROS effects in inner ear cells are difficult to assess in vivo. Organocultures may provide preservation of tissue architecture but involve ethical issues and can be used only for a limited time. An in vitro model that could be commercially available and easy to handle is necessary to investigate inner ear oxidative stress and the ways to counteract it. The OC-k3 line is a suitable in vitro model to study ROS effects on inner ear cells because the observed cell alterations and damages were similar to those reported in studies investigating ROS effects of ototoxic drugs, noise trauma and cochlear ageing.
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Affiliation(s)
- Erica Gentilin
- Bioacoustics Research Laboratory, Department of Neurosciences, University of Padua, Padua, Italy.
| | - Alice Cani
- Department of Woman and Children's Health, University of Padua, Padua, Italy.
| | - Edi Simoni
- Bioacoustics Research Laboratory, Department of Neurosciences, University of Padua, Padua, Italy.
| | - Milvia Chicca
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.
| | | | - Alessandro Martini
- Bioacoustics Research Laboratory, Department of Neurosciences, University of Padua, Padua, Italy; Interdepartmental Research Centre "I-APPROVE - International Auditory Processing Project in Venice", University of Padua, Santi Giovanni e Paolo Hospital, ULSS3 Serenissima, Venice, Italy.
| | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neurosciences, University of Padua, Padua, Italy; Interdepartmental Research Centre "I-APPROVE - International Auditory Processing Project in Venice", University of Padua, Santi Giovanni e Paolo Hospital, ULSS3 Serenissima, Venice, Italy.
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8
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MicroRNA-222 alleviates radiation-induced apoptosis by targeting BCL2L11 in cochlea hair cells. Biosci Rep 2021; 41:228576. [PMID: 33942856 PMCID: PMC8182987 DOI: 10.1042/bsr20201397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/27/2020] [Accepted: 01/08/2021] [Indexed: 11/28/2022] Open
Abstract
Radiation-induced hair cell injury is detrimental for human health but the underlying mechanism is not clear. MicroRNAs (miRNAs) have critical roles in various types of cellular biological processes. The present study investigated the role of miR-222 in the regulation of ionizing radiation (IR)-induced cell injury in auditory cells and its underlying mechanism. Real-time PCR was performed to identify the expression profile of miR-222 in the cochlea hair cell line HEI-OC1 after IR exposure. miRNA mimics or inhibitor-mediated up- or down-regulation of indicated miRNA was applied to characterize the biological effects of miR-222 using MTT, apoptosis and DNA damage assay. Bioinformatics analyses and luciferase reporter assays were applied to identify an miRNA target gene. Our study confirmed that IR treatment significantly suppressed miR-222 levels in a dose-dependent manner. Up-regulation of miR-222 enhances cell viability and alleviated IR-induced apoptosis and DNA damage in HEI-OC1 cells. In addition, BCL-2-like protein 11 (BCL2L11) was validated as a direct target of miR-222. Overexpression of BCL2L11 abolished the protective effects of miR-222 in IR-treated HEI-OC1 cells. Moreover, miR-222 alleviated IR-induced apoptosis and DNA damage by directly targeting BCL2L11. The present study demonstrates that miR-222 exhibits protective effects against irradiation-induced cell injury by directly targeting BCL2L11 in cochlear cells.
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9
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Chen T, Luo Y, Li Q, Yang C, Yuan Y, Peng J, Ban M, Liang Y, Zhang W. Melatonin reduces radiation damage in inner ear. JOURNAL OF RADIATION RESEARCH 2021; 62:217-225. [PMID: 33454767 PMCID: PMC7948882 DOI: 10.1093/jrr/rraa137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/25/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to use a murine model to determine if melatonin can protect the inner ear from radiation-induced damage. A total of 81 4-week-old Balb/c mice were randomly divided into five groups: control group; 50 mg/kg melatonin group; 5 mg/kg melatonin+radiotherapy group; 50 mg/kg melatonin+radiotherapy group; radiotherapy group. The radiotherapy groups received 16 Gy irradiation and melatonin was administered by intraperitoneal injection 30 min before radiotherapy. On days 3 and 7 after irradiation the function of outer hair cells was determined by auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAEs) testing, pathological changes of inner ear cells were observed by light microscopy, and the expression of prestin mRNA was determined. ABR thresholds were increased and wave I latencies were extended after radiotherapy; however, the increases were lower in the groups that received melatonin (P < 0.05). DPOAEs showed radiotherapy-induced hearing loss at 8-12 kHz, and hearing loss was greater on day 7 than day 3. However, hearing loss was less in the melatonin groups (P < 0.05). Histopathological examination showed irradiation resulted in breaks and distortion of the cochlear basement membrane, disruption of the stria vascularis, and swelling of outer hair cells. Melatonin reduced these changes. Radiotherapy upregulated prestin mRNA expression. Radiotherapy-induced upregulation of prestin was decreased in the melatonin groups (P < 0.05), and the decrease was greater in the 50 mg/kg melatonin group (P < 0.05). Melatonin protects against radiation-induced cochlear damage by reducing damage to outer hair cells.
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MESH Headings
- Animals
- Auditory Threshold/drug effects
- Auditory Threshold/radiation effects
- Ear, Inner/pathology
- Ear, Inner/physiopathology
- Ear, Inner/radiation effects
- Evoked Potentials, Auditory, Brain Stem/drug effects
- Gene Expression Regulation/drug effects
- Gene Expression Regulation/radiation effects
- Melatonin/pharmacology
- Melatonin/therapeutic use
- Mice, Inbred BALB C
- Molecular Motor Proteins/genetics
- Molecular Motor Proteins/metabolism
- Otoacoustic Emissions, Spontaneous/drug effects
- Otoacoustic Emissions, Spontaneous/radiation effects
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Radiation Injuries/drug therapy
- Radiation Injuries/genetics
- Radiation Injuries/physiopathology
- Signal-To-Noise Ratio
- Mice
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Affiliation(s)
- Ting Chen
- Department of Otolaryngology, GuangDong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Yuling Luo
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qi Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yixin Yuan
- Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinhao Peng
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Molu Ban
- Department of Otorhinolaryngology-Head and Neck Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Yong Liang
- Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Jiang A, Sun W, Zhao F, Wu Z, Shang D, Yu Q, Wang S, Zhu J, Yang F, Yuan S. Dosimetric evaluation of four whole brain radiation therapy approaches with hippocampus and inner ear avoidance and simultaneous integrated boost for limited brain metastases. Radiat Oncol 2019; 14:46. [PMID: 30876444 PMCID: PMC6419811 DOI: 10.1186/s13014-019-1255-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/07/2019] [Indexed: 01/31/2023] Open
Abstract
AIMS To perform a dosimetric evaluation of four different simultaneous integrated boost whole brain radiotherapy modalities with hippocampus and inner ear avoidance in the treatment of limited brain metastases. METHODS Computed tomography/magnetic resonance imaging data of 10 patients with limited (1-5) brain metastases were used to replan step-and-shoot intensity-modulated radiotherapy (sIMRT), dynamic intensity-modulated radiation therapy (dIMRT), volumetric-modulated arc therapy (VMAT), and helical tomotherapy (Tomo). The prescribed doses of 40-50 Gy in 10 fractions and 30 Gy in 10 fractions were simultaneously delivered to the metastatic lesions and the whole-brain volume, respectively. The hippocampal dose met the RTOG 0933 criteria for hippocampal avoidance (Dmax ≤17 Gy, D100% ≤10 Gy). The inner ear dose was restrained to Dmean ≤15 Gy. Target coverage (TC), homogeneity index (HI), conformity index (CI), maximum dose (Dmax), minimum dose (Dmin) and dose to organs at risk (OARs) were compared. RESULTS All plans met the indicated dose restrictions. The mean percentage of planning target volume of metastases (PTVmets) coverage ranged from 97.1 to 99.4%. For planning target volume of brain (PTVbrain), Tomo provided the lowest average D2% (37.5 ± 2.8 Gy), the highest average D98% (25.2 ± 2.0 Gy), and the best TC (92.6% ± 2.1%) and CI (0.79 ± 0.06). The two fixed gantry IMRT modalities (step and shot, dynamic) provided similar PTVbrain dose homogeneity (both 0.76). Significant differences across the four approaches were observed for the maximum and minimum doses to the hippocampus and the maximum doses to the eyes, lens and optic nerves. CONCLUSION All four radiotherapy modalities produced acceptable treatment plans with good avoidance of the hippocampus and inner ear. Tomo obtained satisfactory PTVbrain coverage and the best homogeneity index. TRIAL REGISTRATION Clinicaltrials.gov, NCT03414944 . Registered 29 January 2018.
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Affiliation(s)
- Aijun Jiang
- Shandong University, Jinan, 250117, Shandong, China.,Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Weipeng Sun
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Fen Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Zhenxuan Wu
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Dongping Shang
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Qingxi Yu
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Suzhen Wang
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Jian Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Fengchang Yang
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Shuanghu Yuan
- Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China.
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11
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Ye B, Wang Q, Hu H, Shen Y, Fan C, Chen P, Ma Y, Wu H, Xiang M. Restoring autophagic flux attenuates cochlear spiral ganglion neuron degeneration by promoting TFEB nuclear translocation via inhibiting MTOR. Autophagy 2019; 15:998-1016. [PMID: 30706760 PMCID: PMC6526833 DOI: 10.1080/15548627.2019.1569926] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Macroautophagy/autophagy dysfunction is associated with many neurodegenerative diseases. TFEB (transcription factor EB), an important molecule that regulates lysosomal and autophagy function, is regarded as a potential target for treating some neurodegenerative diseases. However, the relationship between autophagy dysfunction and spiral ganglion neuron (SGN) degeneration and the role of TFEB in SGN degeneration has not yet been established. Here, we showed that in degenerated SGNs, induced by sensory epithelial cell loss in the cochlea of mice following kanamycin and furosemide administration, the lipofuscin area and oxidative stress level were increased, the nuclear-to-cytoplasmic TFEB ratio was decreased, and the late stage of autophagic flux was impaired. After autophagy dysfunction was partially ameliorated with an MTOR inhibitor, which promoted TFEB translocation into the nucleus from the cytoplasm, we found that the lysosomal deficits were significantly relieved, the oxidative stress level was reduced, and the density of surviving SGNs and auditory nerve fibers was increased. The results in the present study reveal that autophagy dysfunction is an important component of SGN degeneration, and TFEB may be a potential target for attenuating SGN degeneration following sensory epithelial cell loss in the cochlea of mice. Abbreviations: 3-NT: 3-nitrotyrosine; 4-HNE: 4-hydroxynonenal; 8-OHdG: 8-hydroxy-2ʹ-deoxyguanosine; ABR: auditory brainstem response; APP: amyloid beta (A4) precursor protein; CLEAR: coordinated lysosomal expression and regulation; CTSB: cathespin B; CTSD: cathespin D; SAMR1: senescence-accelerated mouse/resistance 1; SAMP8: senescence-accelerated mouse/prone 8; MAPK1/ERK2: mitogen-activated protein kinase 1; MTOR: mechanistic target of rapamycin kinase; SGN: spiral ganglion neuron; SQSTM1/p62: sequestosome 1; TEM: transmission electron microscope; TFEB: transcription factor EB
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Affiliation(s)
- Bin Ye
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Quan Wang
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Haixia Hu
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Yilin Shen
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Cui Fan
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Penghui Chen
- b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Yan Ma
- b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Hao Wu
- b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
| | - Mingliang Xiang
- a Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,c Ear Institute , Shanghai Jiao tong University School of Medicine , Shanghai , China
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12
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Ye B, Fan C, Shen Y, Wang Q, Hu H, Xiang M. The Antioxidative Role of Autophagy in Hearing Loss. Front Neurosci 2019; 12:1010. [PMID: 30686976 PMCID: PMC6333736 DOI: 10.3389/fnins.2018.01010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 12/17/2018] [Indexed: 01/01/2023] Open
Abstract
Autophagy, a highly conserved cellular mechanism, plays an essential role in the development and pathology of many central and peripheral nervous system diseases. The auditory system, especially hair cells (HCs) and spiral ganglion neurons (SGNs) in the inner ear, are postmitotic cells, which are extremely reliant on cellular homeostasis and energy supply. Therefore, autophagy may be involved in contributing to and facilitating the normal function of inner ear cells. Recently, studies on hearing loss induced by ototoxic drugs, noise exposure and other factors have revealed that autophagy could serve in an antioxidative capacity and could possess the potential to treat sensorineural hearing loss (SNHL). Therefore, here we review previous studies concerning autophagy and SNHL to gain insight into the role of autophagic mechanisms in inner ear disorders.
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Affiliation(s)
- Bin Ye
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Cui Fan
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yilin Shen
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Quan Wang
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Haixia Hu
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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13
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Chung LK, Ung N, Sheppard JP, Nguyen T, Lagman C, Choy W, Tenn S, Pouratian N, Lee P, Kaprealian T, Selch M, De Salles A, Gopen Q, Yang I. Impact of Cochlear Dose on Hearing Preservation following Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy for the Treatment of Vestibular Schwannoma. J Neurol Surg B Skull Base 2017; 79:335-342. [PMID: 30009113 DOI: 10.1055/s-0037-1607968] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022] Open
Abstract
Objective The objective of this study was to examine the effect of cochlear dose on hearing preservation in stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) for vestibular schwannoma (VS). Design This is a retrospective case-control study. Setting This study was completed at the Ronald Reagan UCLA Medical Center, a university-affiliated tertiary care center. Participants Patients who underwent SRS (marginal dose of 12 Gy) or fSRT (marginal dose of 50.4 Gy) procedures for VS were included in the study. Main Outcome Measures The main outcome measure was hearing preservation. Audiometric data, when available, were used to determine the level of hearing according to the Gardner Robertson scale. Results A total of 38 patients (14 SRS and 24 fSRT) were analyzed. SRS patients with decreased hearing received a significantly higher minimum cochlear dose (7.41 vs. 4.24 Gy, p = 0.02) as compared with those with stable hearing. In fSRT patients, there were no significant differences in cochlear dose for patients with decreased hearing as compared with those with stable hearing. For SRS patients, who received a minimum cochlear dose above 6 Gy, there was a significant risk of decreased hearing preservation (odds ratio: 32, p = 0.02). Conclusion Higher minimum cochlear dose was predictive of decreased hearing preservation following SRS. Though the study is low powered, the radiation dose to the cochlea should be a parameter that is considered when planning SRS or fSRT therapies for patients with VS.
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Affiliation(s)
- Lawrance K Chung
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Nolan Ung
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - John P Sheppard
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Thien Nguyen
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Carlito Lagman
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Winward Choy
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Stephen Tenn
- Department of Radiation Oncology, University of California, California, United States
| | - Nader Pouratian
- Department of Neurosurgery, University of California, Los Angeles, California, United States.,Department of Radiation Oncology, University of California, California, United States
| | - Percy Lee
- Department of Radiation Oncology, University of California, California, United States
| | - Tania Kaprealian
- Department of Neurosurgery, University of California, Los Angeles, California, United States.,Department of Radiation Oncology, University of California, California, United States.,UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, United States
| | - Michael Selch
- Department of Radiation Oncology, University of California, California, United States
| | - Antonio De Salles
- Department of Neurosurgery, University of California, Los Angeles, California, United States
| | - Quinton Gopen
- Department of Head and Neck Surgery, University of California, Los Angeles, California, United States
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, California, United States.,Department of Radiation Oncology, University of California, California, United States.,UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, United States.,Department of Head and Neck Surgery, University of California, Los Angeles, California, United States.,Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, California, United States.,Los Angeles Biomedical Research Institute, Torrance, California, United States
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14
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Guthrie OW. Functional consequences of inducible genetic elements from the p53 SOS response in a mammalian organ system. Exp Cell Res 2017; 359:50-61. [DOI: 10.1016/j.yexcr.2017.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/02/2017] [Accepted: 08/05/2017] [Indexed: 10/19/2022]
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15
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Effects of Intratympanic Dexamethasone on High-Dose Radiation Ototoxicity In Vivo. Otol Neurotol 2017; 38:180-186. [DOI: 10.1097/mao.0000000000001289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Effects of Chemoradiation on Hearing in Patients with Head and Neck Malignancies: Experience at a Tertiary Referral Care Hospital. Indian J Otolaryngol Head Neck Surg 2016; 68:456-461. [PMID: 27833872 DOI: 10.1007/s12070-016-0985-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 05/02/2016] [Indexed: 10/21/2022] Open
Abstract
Hearing loss as a side effect in patients with head and neck malignancies with chemoradiation is frequently ignored. Its effects on auditory functions are less studied and there are studies done on animals which are less reliable. The present study was undertaken to identify the type of hearing loss and also to quantify the degree of hearing loss in these patients. A prospective, descriptive study was undertaken in histologically proven head and neck cancer patients treated with cobalt 60 teletherapy who received a dose of 60-66 Grays (Gy) over a period of 6-7 weeks with concurrent Cisplatin 30 mg/m2 once weekly for 6 weeks. The study included 40 patients (80 ears) undergoing chemoradiation. A baseline pure tone audiometry and impedance audiometry was performed in all the cases prior to the therapy and the same was repeated immediately after the completion of treatment, at 8 and 16 weeks. The changes in pure tone level thresholds and impedance from baseline were correlated with the dose of radiation and chemotherapy. Sensori neural hearing loss (SNHL) and conductive hearing loss was observed in 82.5 and 17.5 % respectively. At the end of 16 weeks, SNHL was found in 27.5, 72.5 and 82.5 % at 2, 4 and 8 kHz respectively. In addition, Eustachian tube dysfunction and Otitis media with effusion was observed in 10 and 7.5 % of patients respectively which lead to conductive hearing loss. Further, it was noted that SNHL in patients with high risk site malignancy (81.8 %) was alarmingly higher compared with low risk site malignancy (18.1 %). The hearing loss at 62, 64 and 66 Gy in comparison to 60 Gy was statistically significant. Hearing loss, specially SNHL was the predominant finding in our study with >80 % of patients showing the inner ear damage due to irradiation of head and neck malignancies. Although, all the frequencies like 2, 4 and 8 kHz were significantly affected, SNHL was more marked in the latter two frequencies. Nearly, 90 % of the patients who had SNHL belonged to high risk site category of head and neck malignancies. Increasing the radiation dosage was directly proportional to the degree of hearing loss with the dose more than 60 Gy causing significant injury to the middle and inner ear.
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17
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Abstract
HYPOTHESIS Dexamethasone (DXM) protects against radiation-induced loss of auditory hair cells (HCs) in rat organ of Corti (OC) explants by reducing levels of oxidative stress and apoptosis. BACKGROUND Radiation-induced sensorineural hearing loss (HL) is progressive, dose-dependent, and irreversible. Currently, there are no preventative therapeutic modalities for radiation-induced HL. DXM is a synthetic steroid that can potentially target many of the pathways involved in radiation-induced ototoxicity. METHODS Whole OC explants were dissected from 3-day-old rat cochleae exposed to specific dosages of single-fraction radiation (0, 2, 5, 10, or 20 Gy), were either untreated or treated with DXM (75, 150, 300 μg/mL), and then cultured for 48 or 96 hours. Confocal microscopy for oxidative stress (CellRox, 48 h) and apoptosis (TUNEL assay, 96 h) and fluorescent microscopy for viable HC counts (fluorescein isothiocyanate-phalloidin, 96 h) were performed. Analysis of variance and Tukey post hoc testing were used for statistical analysis. RESULTS Radiation exposure initiated dose-dependent losses of inner and outer HCs, predominantly in the basal turns of the OC explants. DXM protected against radiation-induced HC losses in a dose-dependent manner. DXM significantly reduced levels of oxidative stress and apoptosis in radiation-injured OC explants (p < 0.001). CONCLUSIONS Radiation-initiated HC losses were dose-dependent in OC explants. DXM treatment protected explant HCs against radiation-initiated losses by decreasing the levels of oxidative stress and apoptosis. DXM may potentially be a therapeutic modality for preventing radiation-induced HL; further in vivo studies are necessary.
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18
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Kamran MZ, Ranjan A, Kaur N, Sur S, Tandon V. Radioprotective Agents: Strategies and Translational Advances. Med Res Rev 2016; 36:461-93. [PMID: 26807693 DOI: 10.1002/med.21386] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/15/2015] [Accepted: 01/01/2016] [Indexed: 01/08/2023]
Abstract
Radioprotectors are agents required to protect biological system exposed to radiation, either naturally or through radiation leakage, and they protect normal cells from radiation injury in cancer patients undergoing radiotherapy. It is imperative to study radioprotectors and their mechanism of action comprehensively, looking at their potential therapeutic applications. This review intimately chronicles the rich intellectual, pharmacological story of natural and synthetic radioprotectors. A continuous effort is going on by researchers to develop clinically promising radioprotective agents. In this article, for the first time we have discussed the impact of radioprotectors on different signaling pathways in cells, which will create a basis for scientific community working in this area to develop novel molecules with better therapeutic efficacy. The bright future of exceptionally noncytotoxic derivatives of bisbenzimidazoles is also described as radiomodulators. Amifostine, an effective radioprotectant, has been approved by the FDA for limited clinical use. However, due to its adverse side effects, it is not routinely used clinically. Recently, CBLB502 and several analog of a peptide are under clinical trial and showed high success against radiotherapy in cancer. This article reviews the different types of radioprotective agents with emphasis on the strategies for the development of novel radioprotectors for drug development. In addition, direction for future strategies relevant to the development of radioprotectors is also addressed.
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Affiliation(s)
- Mohammad Zahid Kamran
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Atul Ranjan
- Kansas University of Medical Center, Kansas City, KS, 66160
| | - Navrinder Kaur
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, 110007, India
| | - Souvik Sur
- Department of Chemistry, University of Delhi, Delhi, 110007, India
| | - Vibha Tandon
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067, India.,Department of Chemistry, University of Delhi, Delhi, 110007, India
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19
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Wang J, Chen YY, Tai A, Chen XL, Huang SM, Yang C, Bao Y, Li NW, Deng XW, Zhao C, Chen M, Li XA. Sensorineural Hearing Loss after Combined Intensity Modulated Radiation Therapy and Cisplatin-Based Chemotherapy for Nasopharyngeal Carcinoma. Transl Oncol 2015; 8:456-62. [PMID: 26692526 PMCID: PMC4700287 DOI: 10.1016/j.tranon.2015.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/19/2015] [Accepted: 10/19/2015] [Indexed: 12/04/2022] Open
Abstract
PURPOSE The incidence of sensorineural hearing loss (SNHL) after treatment with combination of intensity-modulated radiation therapy (IMRT) and cisplatin-based chemotherapy in nasopharyngeal carcinoma (NPC) patients was evaluated, and relationships of SNHL with host factors, treatment-related factors, and radiation dosimetric parameters were investigated. METHODS Fifty-one NPC patients treated with IMRT from 2004 to 2009 were analyzed. All patients received neoadjuvant, concurrent, or adjuvant use of cisplatin. Pure tone audiometry was performed during the follow-up period with a median time of 60months, ranging from 28 to 84months. Correlation of SNHL at low frequencies (pure tone average, 0.5-2kHz) with a series of factors was analyzed. RESULTS Among 102 ears, 12.7% had low-frequency SNHL and 42.2% had high-frequency (4kHz) SNHL. The incidence of low-frequency SNHL was greater in patients with age>40, with T-stage 4, or who received cumulative cisplatin dose (CCD)>200mg/m(2) (P=.034, .011, and .003, respectively) and in ears with secretory otitis media (SOM) (P=.002). Several dosimetric parameters were found to be correlated with SNHL. Univariate analysis showed that the minimum radiation dose to 0.1ml highest dose volume (D0.1ml) of the cochlea was the best radiation-related predictive parameter. Multivariate analysis indicated that CCD, SOM, and D0.1ml of cochlea (P=.035, .012, and .022, respectively) were the factors associated with SNHL. CONCLUSION For NPC patients treated with IMRT and chemotherapy, the incidence of treatment-related SNHL was associated with CCD, D0.1ml of cochlea, and SOM.
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Affiliation(s)
- Jin Wang
- Departments of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Yuan-Yuan Chen
- Departments of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - An Tai
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Xue-Lin Chen
- Department of Nasopharyngeal Carcinoma, Cancer Center, Sun Yat-sen University Guangzhou, People's Republic of China
| | - Shao-Ming Huang
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Cungen Yang
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Yong Bao
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ning-Wei Li
- Department of Nasopharyngeal Carcinoma, Cancer Center, Sun Yat-sen University Guangzhou, People's Republic of China
| | - Xiao-Wu Deng
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Chong Zhao
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Ming Chen
- Departments of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - X Allen Li
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI.
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20
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Chen J, Zhao Y, Zhou X, Tan L, Ou Z, Yu Y, Wang Y. Methylprednisolone use during radiotherapy extenuates hearing loss in patients with nasopharyngeal carcinoma. Laryngoscope 2015; 126:100-3. [PMID: 26309227 DOI: 10.1002/lary.25527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate the hearing protective effects of methylprednisolone use during radiotherapy in patients with nasopharyngeal carcinoma. STUDY DESIGN Prospective, controlled clinical study. METHODS Fifty-three patients with nasopharyngeal carcinoma (106 ears). Twenty-five patients (50 ears) received radiotherapy with intravenous methylprednisolone for 14 days, and another 28 patients (56 ears) received radiotherapy alone. Pure tone audiometry, distortion product otoacoustic emission (DPOAE), and auditory brainstem responses (ABR) results were reviewed before and 1 year after radiotherapy. RESULT One year after radiotherapy, the air-and-bone conduction pure tone hearing thresholds increased, and the DPOAE levels decreased in the control group. There was no difference in the ABR wave I, III, and V latencies and the I to V interwave latencies before and 1 year after radiotherapy. The pure tone air conduction thresholds decreased, and the DPOAE levels increased in the treatment group compared with the control group. CONCLUSION Early sensorineural hearing loss after radiotherapy primarily affected the outer hair cells. The use of methylprednisolone during radiotherapy can extenuate early sensorineural hearing loss caused by irradiation.
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Affiliation(s)
- Junming Chen
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Yuanxin Zhao
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | | | - Lingmei Tan
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Zeying Ou
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Youjun Yu
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Yuejian Wang
- Department of Otolaryngology, The First People's Hospital of Foshan, Foshan, People's Republic of China
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21
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Tan PX, Du SS, Ren C, Yao QW, Zheng R, Li R, Yuan YW. MicroRNA-207 enhances radiation-induced apoptosis by directly targeting Akt3 in cochlea hair cells. Cell Death Dis 2014; 5:e1433. [PMID: 25275594 PMCID: PMC4649514 DOI: 10.1038/cddis.2014.407] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/06/2014] [Accepted: 08/20/2014] [Indexed: 02/01/2023]
Abstract
MicroRNAs (miRNAs) have important roles in various types of cellular biological processes. Our study aimed to determine whether miRNAs function in the regulation of ionizing radiation (IR)-induced cell death in auditory cells and to determine how they affect the cellular response to IR. Microarray and qRT-PCR were performed to identify and confirm the differential expression of miRNAs in the cochlea hair cell line HEI-OC1 and in vivo after IR. Upregulation or downregulation of miRNAs using miRNA mimics or inhibitor were detected to characterize the biological effects of the indicated miRNAs. Bioinformatic analyses, luciferase reporter assays and mRNA knockdown were performed to identify a miRNA target gene. We determined that miR-207 was significantly upregulated after IR. MiR-207 enhances IR-induced apoptosis and DNA damage in HEI-OC1 cells. Furthermore, Akt3 was confirmed to be a direct target of miR-207. Downregulation of Akt3 mimics the effects of miR-207. MiR-207 enhances IR-induced apoptosis by directly targeting Akt3 and anti-miR-207 may have a potential role in protecting cochlea hair cells from IR.
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Affiliation(s)
- P-x Tan
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - S-s Du
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - C Ren
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Q-w Yao
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - R Zheng
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - R Li
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Y-w Yuan
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
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