Books > Medicine > Clinical & internal medicine > Otorhinolaryngology (ENT) > Audiology & otology
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Inflammatory Mechanisms in Mediating Hearing Loss (Hardcover, 1st ed. 2018)
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Inflammatory Mechanisms in Mediating Hearing Loss (Hardcover, 1st ed. 2018)
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Common forms of preventable hearing loss are drug and noise-induced
hearing loss which are believed to be produced by a similar
mechanism. The generation of reactive oxygen species appears to be
a common mechanism mediating hearing loss produced by these
different sources. As such, a number of laboratories have focused
their research towards identifying the sources of ROS production in
the cochlea following administration of chemotherapeutic agents or
noise exposure. This led to the identification of ROS generating
enzymes, such as xanthine oxidases, nitric oxide synthase, and
NADPH oxidases which are activated and/or induced during the
development of hearing loss. A consequence of these findings was
the implementation of antioxidants in preclinical studies for the
treatment of hearing loss. These antioxidants have provided
different levels of protection in animal and human studies, but
none of these have been approved by the US Food and Drug
Administration for the treatment of hearing loss. More recently, it
was shown that noise-induced hearing loss was associated with
recruitment of inflammatory cells and mediators in the cochlea.
This finding would suggest that noise could produce injury to the
cochlea which stimulates local and/or circulating inflammatory
cells. A similar finding was observed in the cochlea following
administration of the anticancer drug, cisplatin. In addition, our
laboratory and others have provided a plausible mechanism by which
noise or chemotherapeutic agents could stimulate the inflammatory
response. Surprisingly, this mechanism involves ROS activation of
transcription factors linked to inflammatory processes in the
cochlea. These studies have led to the use of anti-inflammatory
agents for the treatment of hearing loss. Preliminary studies
targeting inflammatory cytokines appear especially promising in
preclinical studies. A primary goal of this project is to describe
our current understanding of the oxidant hypothesis of noise and
drug-induced hearing loss and show how this relates to cochlear
inflammation. Several different aspects of the cochlear
inflammatory process will be discussed in detail, ranging from the
sources of inflammatory cells, chemokines, inflammatory cytokines,
and cochlea resident immune cells. Molecular pathways leading to
activation of the local inflammatory process will be highlighted
and treatment options will be discussed. The relevance of certain
clinically used anti-inflammatory interventions, such as
trans-typmanic steroids will also be discussed. Furthermore, we
will examine recent patents focusing on the use of
anti-inflammatory agents for the treatment of drug and
noise-induced hearing loss.
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