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Garinis AC, Liao S, Cross CP, Galati J, Middaugh JL, Mace JC, Wood AM, McEvoy L, Moneta L, Lubianski T, Coopersmith N, Vigo N, Hart C, Riddle A, Ettinger O, Nold C, Durham H, MacArthur C, McEvoy C, Steyger PS. Effect of gentamicin and levels of ambient sound on hearing screening outcomes in the neonatal intensive care unit: A pilot study. Int J Pediatr Otorhinolaryngol 2017; 97:42-50. [PMID: 28483249 PMCID: PMC5439527 DOI: 10.1016/j.ijporl.2017.03.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/16/2017] [Accepted: 03/18/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Hearing loss rates in infants admitted to neonatal intensive care units (NICU) run at 2-15%, compared to 0.3% in full-term births. The etiology of this difference remains poorly understood. We examined whether the level of ambient sound and/or cumulative gentamicin (an aminoglycoside) exposure affect NICU hearing screening results, as either exposure can cause acquired, permanent hearing loss. We hypothesized that higher levels of ambient sound in the NICU, and/or gentamicin dosing, increase the risk of referral on the distortion product otoacoustic emission (DPOAE) assessments and/or automated auditory brainstem response (AABR) screens. METHODS This was a prospective pilot outcomes study of 82 infants (<37 weeks gestational age) admitted to the NICU at Oregon Health & Science University. An ER-200D sound pressure level dosimeter was used to collect daily sound exposure in the NICU for each neonate. Gentamicin dosing was also calculated for each infant, including the total daily dose based on body mass (mg/kg/day), as well as the total number of treatment days. DPOAE and AABR assessments were conducted prior to discharge to evaluate hearing status. Exclusion criteria included congenital infections associated with hearing loss, and congenital craniofacial or otologic abnormalities. RESULTS The mean level of ambient sound was 62.9 dBA (range 51.8-70.6 dBA), greatly exceeding American Academy of Pediatrics (AAP) recommendation of <45.0 dBA. More than 80% of subjects received gentamicin treatment. The referral rate for (i) AABRs, (frequency range: ∼1000-4000 Hz), was 5%; (ii) DPOAEs with a broad F2 frequency range (2063-10031 Hz) was 39%; (iii) DPOAEs with a low-frequency F2 range (<4172 Hz) was 29%, and (iv) DPOAEs with a high-frequency F2 range (>4172 Hz) was 44%. DPOAE referrals were significantly greater for infants receiving >2 days of gentamicin dosing compared to fewer doses (p = 0.004). The effect of sound exposure and gentamicin treatment on hearing could not be determined due to the low number of NICU infants without gentamicin exposure (for control comparisons). CONCLUSION All infants were exposed to higher levels of ambient sound that substantially exceed AAP guidelines. More referrals were generated by DPOAE assessments than with AABR screens, with significantly more DPOAE referrals with a high-frequency F2 range, consistent with sound- and/or gentamicin-induced cochlear dysfunction. Adding higher frequency DPOAE assessments to existing NICU hearing screening protocols could better identify infants at-risk for ototoxicity.
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Affiliation(s)
- Angela C. Garinis
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Selena Liao
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Campbell P. Cross
- School of Medicine, Oregon Health & Science University, Portland, Oregon,Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
| | - Johnathan Galati
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
| | - Jessica L. Middaugh
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Jess C. Mace
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Anna-Marie Wood
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
| | - Lindsey McEvoy
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
| | - Lauren Moneta
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Troy Lubianski
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon
| | - Noe Coopersmith
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon
| | - Nicholas Vigo
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Christopher Hart
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Artur Riddle
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Olivia Ettinger
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
| | - Casey Nold
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon
| | - Heather Durham
- Child Development and Research Center, Oregon Health & Science University, Portland, Oregon
| | - Carol MacArthur
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Cynthia McEvoy
- Department of Neonatology, Oregon Health & Science University, Portland, Oregon
| | - Peter S. Steyger
- Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon,Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon
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Van Hook K, Wang Z, Chen D, Nold C, Zhu Z, Anur P, Lee HJ, Yu Z, Sheppard B, Dai MS, Sears R, Spellman P, Lopez CD. ΔN-ASPP2, a novel isoform of the ASPP2 tumor suppressor, promotes cellular survival. Biochem Biophys Res Commun 2016; 482:1271-1277. [PMID: 27939881 DOI: 10.1016/j.bbrc.2016.12.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/05/2016] [Indexed: 12/15/2022]
Abstract
ASPP2 is a tumor suppressor that works, at least in part, through enhancing p53-dependent apoptosis. We now describe a new ASPP2 isoform, ΔN-ASPP2, generated from an internal transcription start site that encodes an N-terminally truncated protein missing a predicted 254 amino acids. ΔN-ASPP2 suppresses p53 target gene transactivation, promoter occupancy, and endogenous p53 target gene expression in response to DNA damage. Moreover, ΔN-ASPP2 promotes progression through the cell cycle, as well as resistance to genotoxic stress-induced growth inhibition and apoptosis. Additionally, we found that ΔN-ASPP2 expression is increased in human breast tumors as compared to adjacent normal breast tissue; in contrast, ASPP2 is suppressed in the majority of these breast tumors. Together, our results provide insight into how this new ASPP2 isoform may play a role in regulating the ASPP2-p53 axis.
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Affiliation(s)
- Kathryn Van Hook
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Zhiping Wang
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Dexi Chen
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Beijing Institute of Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China
| | - Casey Nold
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Zhiyi Zhu
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Pavana Anur
- Department of Molecular and Medical Genetics and the Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Hun-Joo Lee
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Zhiyong Yu
- Shandong Tumor Hospital and Institute, Jinan, 250117, China
| | - Brett Sheppard
- Department of Surgery and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Mu-Shui Dai
- Department of Molecular and Medical Genetics and the Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rosalie Sears
- Department of Molecular and Medical Genetics and the Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Paul Spellman
- Department of Molecular and Medical Genetics and the Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Charles D Lopez
- Department of Medicine, Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA.
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