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Herb M. NADPH Oxidase 3: Beyond the Inner Ear. Antioxidants (Basel) 2024; 13:219. [PMID: 38397817 PMCID: PMC10886416 DOI: 10.3390/antiox13020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Reactive oxygen species (ROS) were formerly known as mere byproducts of metabolism with damaging effects on cellular structures. The discovery and description of NADPH oxidases (Nox) as a whole enzyme family that only produce this harmful group of molecules was surprising. After intensive research, seven Nox isoforms were discovered, described and extensively studied. Among them, the NADPH oxidase 3 is the perhaps most underrated Nox isoform, since it was firstly discovered in the inner ear. This stigma of Nox3 as "being only expressed in the inner ear" was also used by me several times. Therefore, the question arose whether this sentence is still valid or even usable. To this end, this review solely focuses on Nox3 and summarizes its discovery, the structural components, the activating and regulating factors, the expression in cells, tissues and organs, as well as the beneficial and detrimental effects of Nox3-mediated ROS production on body functions. Furthermore, the involvement of Nox3-derived ROS in diseases progression and, accordingly, as a potential target for disease treatment, will be discussed.
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Affiliation(s)
- Marc Herb
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50935 Cologne, Germany;
- German Centre for Infection Research, Partner Site Bonn-Cologne, 50931 Cologne, Germany
- Cologne Cluster of Excellence on Cellular Stress Responses in Aging-Associated Diseases (CECAD), 50931 Cologne, Germany
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Rybak LP, Alberts I, Patel S, Al Aameri RFH, Ramkumar V. Effects of natural products on cisplatin ototoxicity and chemotherapeutic efficacy. Expert Opin Drug Metab Toxicol 2023; 19:635-652. [PMID: 37728555 DOI: 10.1080/17425255.2023.2260737] [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: 03/30/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Cisplatin is a very effective chemotherapeutic agent against a variety of solid tumors. Unfortunately, cisplatin causes permanent sensorineural hearing loss in at least two-thirds of patients treated. There are no FDA approved drugs to prevent this serious side effect. AREAS COVERED This paper reviews various natural products that ameliorate cisplatin ototoxicity. These compounds are strong antioxidants and anti-inflammatory agents. This review includes mostly preclinical studies but also discusses a few small clinical trials with natural products to minimize hearing loss from cisplatin chemotherapy in patients. The interactions of natural products with cisplatin in tumor-bearing animal models are highlighted. A number of natural products did not interfere with cisplatin anti-tumor efficacy and some agents actually potentiated cisplatin anti-tumor activity. EXPERT OPINION There are a number of natural products or their derivatives that show excellent protection against cisplatin ototoxicity in preclinical studies. There is a need to insure uniform standards for purity of drugs derived from natural sources and to ensure adequate pharmacokinetics and safety of these products. Natural products that protect against cisplatin ototoxicity and augment cisplatin's anti-tumor effects in multiple studies of tumor-bearing animals are most promising for advancement to clinical trials. The most promising natural products include honokiol, sulforaphane, and thymoquinone.
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Affiliation(s)
- Leonard P Rybak
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ian Alberts
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Shree Patel
- Department of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Raheem F H Al Aameri
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Vickram Ramkumar
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL, USA
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Ahmadi N, Saidov N, Gausterer JC, Kramer AM, Honeder C, Arnoldner C. Establishment of an optimized guinea pig model of cisplatin-induced ototoxicity. Front Vet Sci 2023; 10:1112857. [PMID: 37124562 PMCID: PMC10133486 DOI: 10.3389/fvets.2023.1112857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Cisplatin is among the most effective antineoplastic agents and has revolutionized the treatment of many cancer diseases. However, one of its serious side effects is a progressive and irreversible hearing loss, occurring in both adults and children. For the development of otoprotective therapies that prevent this side effect, cisplatin-induced hearing loss animal models are indispensable. Due to the high toxicity of cisplatin, the establishment of such animal models is a difficult and time-consuming task. Here we introduce the detailed protocol of a sophisticated guinea pig model with a sufficient and permanent hearing loss induced by cisplatin. This manuscript is intended to provide guidance in the development of future cisplatin guinea pig models which may reduce the mortality rate of the animals and help to gain more reproducible results. Methods Pigmented and unpigmented guineapigs were treated with an intravenous single application of 8 mg/kg cisplatin under general anesthesia. An extensive and long-term intensive care protocol consisting of scheduled application of fluids, antiemetics, analgesics, glucose and supportive feeding among others, was used to ensure wellbeing of the animals. Hearing tests were performed prior to and 5 days after cisplatin application. Animals were then euthanized. Results The ABR audiometry 5 days after cisplatin application revealed a hearing threshold ranging from 70 dB to 90 dB in the frequencies from 1 kHz to 32 kHz respectively.All animals presented a good health condition despite the treatment with cisplatin. Discussion The introduced care protocol in this manuscript is intended to serve as a guidance for the establishment of a stable guinea pig model for short- and long-term investigation regarding the inner ear and its protection in the frame work of cisplatin-induced damage.
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Affiliation(s)
- Navid Ahmadi
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Nodir Saidov
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Julia Clara Gausterer
- Division of Pharmaceutical Technology and Biopharmaceutics, Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | | | - Clemens Honeder
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
- *Correspondence: Christoph Arnoldner
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Evaluating the Efficacy of Intratympanic Dexamethasone in Protecting Against Irreversible Hearing Loss in Patients on Cisplatin-Based Cancer Treatment: A Randomized Controlled Phase IIIB Clinical Trial. Ear Hear 2021; 43:676-684. [PMID: 34483247 DOI: 10.1097/aud.0000000000001119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the efficacy of long-term high-dose intratympanic dexamethasone in protecting the hearing capacity of cancer patients undergoing cisplatin-based ototoxic treatment. DESIGN A randomized controlled phase IIIB clinical trial to evaluate the efficacy of dexamethasone in protecting against hearing loss in patients undergoing cisplatin treatment. The subjects participating in the clinical trial were patients with a neoplastic disease whose treatment protocol included cisplatin. The average dose of cisplatin was 444.87 mg (SD 235.2 mg). Treatment consisted of intratympanically administering dexamethasone via a passive diffusion device called Microwick (8 mg/24 h dose) from the start of treatment with cisplatin to 3 weeks after the last cycle. Patients were administered the medication to one ear, and the contralateral ear was used as the control. The treated ears were randomly chosen using a computer system (randomization). The hearing threshold was evaluated using pure tone audiometry before each cisplatin cycle. RESULTS Thirty-four patients were recruited over a 2-year period at a reference tertiary hospital, of whom 11 were excluded. Forty-six ears were analyzed (23 treated and 23 control ears). When treatment was completed, the audiometric analysis showed a higher hearing threshold in the study group than in the control group. Differences were statistically significant at frequencies of 500, 1000, and 6000 Hz: 4.9 dB (1.1 to 8.7), 5.5 dB (0.8 to 10.3), and 16 dB (3.2 to 28.7), respectively, (p < 0.05, 95% confidence interval), but were not clinically significant according to the ASHA hearing loss criteria. Both 8.69% infection complications during treatment and 34.8% permanent perforation at 6 mo were detected after device removal. CONCLUSIONS Long-term high-dose intratympanic dexamethasone treatment did not prevent cisplatin-induced hearing loss.
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Stanford JK, Bosworth NA, Morgan DS, Chen T, Spankovich C. A clinically derived guinea pig dosing model of cisplatin ototoxicity. Hear Res 2021; 404:108202. [PMID: 33621791 DOI: 10.1016/j.heares.2021.108202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/20/2021] [Accepted: 02/02/2021] [Indexed: 01/10/2023]
Abstract
The guinea pig is a commonly-used animal model in hearing research, as their audible frequency range is similar to that of humans, and they possess comparatively large cochleae among rodents. Numerous studies have investigated the ototoxic effects of cisplatin in guinea pigs, but these have been mostly limited to single high-dose bolus injections of cisplatin. This method of drug administration is not consistent with human treatment schedules, and therefore lacks translational value to clinical applications. We tested several different cisplatin dosing schedules in guinea pigs based on common research based and clinical regimens, measuring the resulting hearing loss and morbidity (weight loss). We propose a dosing paradigm of once-weekly 4 mg/kg cisplatin injections for three weeks to best mimic clinical treatment schedules. This method resulted in a configuration of hearing loss similar to what is observed in humans along with minimal changes in weight.
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Affiliation(s)
- James K Stanford
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Nicholas A Bosworth
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA; School of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Drew S Morgan
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA; School of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Tianwen Chen
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Christopher Spankovich
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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Mansour M, Abo El Ezz TA, Fattoh FN, AbouelFadl DM, Gad HA. Delineating the usage of dexamethasone-loaded cubosomes as a therapeutic armamentarium for hearing loss versus its protective effect: In-vitro and in-vivo animal study. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yan M, Li Y, Zeng H, Zhao X, Wu H, Qian W, Guo X. The effect of rat nerve growth factor combined with vitamin B on peripheral neuropathy in multiple myeloma patients. ACTA ACUST UNITED AC 2020; 25:264-269. [PMID: 32567522 DOI: 10.1080/16078454.2020.1784615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Peripheral neuropathy can induce marked disability and negative effects on quality of life and is the most common therapy-related complication in multiple myeloma patients treated with bortezomib. Currently, there is no useful method to prevent or treat it. So, it is necessary to study the clinical efficacy of rat nerve growth factor combined with vitamin B for the treatment of peripheral neuropathy in multiple myeloma patients. Methods: Sixty multiple myeloma patients who developed peripheral neuropathy after bortezomib-based chemotherapy in Jiaxing First Hospital from October 2015 to May 2018 were randomly divided into treatment and control groups. Changes in serum NGF level and electromyograms before and after treatment were analyzed, and the effects were evaluated via a FACT/GOG-Ntx questionnaire score. Results: After treatment, the NGF level in the treatment group (13.2 ± 3.73 pg/ml) was higher than that in the control group (9.22 ± 2.93 pg/ml, P < 0.05). Improvements in the electromyograms were more pronounced in treatment group than those in the control group, with statistical significance. The FACT/GOG-Ntx questionnaire scores, both in the treatment group and the control group, were decreased (4.00 ± 1.58 vs. 5.20 ± 2.33; P < 0.05), and the alleviation of the symptoms in the treatment group were more obvious. Conclusion: Rat nerve growth factor combined with vitamin B is a safe and effective method for treating peripheral neuropathy in multiple myeloma patients.
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Affiliation(s)
- Minchao Yan
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
| | - Yuan Li
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
| | - Hui Zeng
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
| | - Xiaoyan Zhao
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
| | - Haibing Wu
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
| | - Wenbin Qian
- Malignant Lymphoma Diagnosis and Therapy Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.,Institute of Hematology, Zhejiang University, Hangzhou, People's Republic of China
| | - Xiaojun Guo
- Department of Hematology, First Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China
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Kökten N, Eğilmez OK, Erinç M, Doğan Ekici AI, Şerifler S, Yeşilada E, Kalcıoğlu MT. The Protective Effect of Nigella sativa Oil against Experimentally Induced Cisplatin Ototoxicity: An Animal Study. J Int Adv Otol 2020; 16:346-352. [PMID: 33136014 DOI: 10.5152/iao.2020.7761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The objective of this study was to investigate the potential protective effect of Nigella sativa oil (NSO) against cis-diamminedichloroplatinum or cisplatin (CDDP)-induced ototoxicity. MATERIALS AND METHODS Twenty-four Wistar albino rats were randomly and equally divided into four groups. Groups 1 and 2 were given a total of 15 mg/kg CDDP intraperitoneally, which was divided equally into three doses on days 1, 3, and 5. Group 2 was treated via gavage feeding with 15 ml NSO that was divided into five doses on days 1, 3, 5, 7, and 9. Groups 3 and 4 received only 15 ml of NSO and 15 ml of 0.9% saline solution, respectively, which were orally administered and divided into five doses on days 1, 3, 5, 7, and 9. Baseline high-frequency (8, 12, 16, and 32 kHz) auditory brainstem response (ABR) measurements were collected in all the groups before the medical administrations and were repeated on the 14th day before sacrifice. Afterward, a histopathological evaluation of the cochlea was performed. RESULTS There was a significant difference in the histopathological changes between group 1 and the other groups (p<0.01). Changes in the spiral ganglion cells, the stria vascularis, and the external ciliated cells were significantly different between groups 1 and 2 (p=0.019, 0.039, and 0.045, respectively). The ABR results revealed significant differences in the 16 and 32 kHz measurements between groups 1 and 2 (p=0.013 and p<0.01, respectively). CONCLUSION According to the results, NSO may have a protective effect on cochlear function against the disruptive effects of CDDP in rats.
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Affiliation(s)
- Numan Kökten
- Department of Otorhinolaryngology Head and Neck Surgery, İstanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Oğuz Kadir Eğilmez
- Department of Otorhinolaryngology Head and Neck Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Murat Erinç
- Department of Audiology, Istanbul Medeniyet University, İstanbul, Turkey
| | - A Işın Doğan Ekici
- Department of Pathology, Yeditepe University School of Medicine, İstanbul, Turkey
| | - Serkan Şerifler
- Department of Otorhinolaryngology Head and Neck Surgery, İstanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Erdem Yeşilada
- Department of Pharmacognosy, Yeditepe University School of Pharmacy, İstanbul, Turkey
| | - Mahmut Tayyar Kalcıoğlu
- Department of Otorhinolaryngology Head and Neck Surgery, İstanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
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Mukherjea D, Dhukhwa A, Sapra A, Bhandari P, Woolford K, Franke J, Ramkumar V, Rybak L. Strategies to reduce the risk of platinum containing antineoplastic drug-induced ototoxicity. Expert Opin Drug Metab Toxicol 2020; 16:965-982. [PMID: 32757852 DOI: 10.1080/17425255.2020.1806235] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Cisplatin is a highly effective chemotherapeutic agent against a variety of solid tumors in adults and in children. Unfortunately, a large percentage of patients suffer permanent sensorineural hearing loss. Up to 60% of children and at least 50% of adults suffer this complication that seriously compromises their quality of life. Hearing loss is due to damage to the sensory cells in the inner ear. The mechanisms of cochlear damage are still being investigated. However, it appears that inner ear damage is triggered by reactive oxygen species (ROS) formation and inflammation 34. AREAS COVERED We discuss a number of potential therapeutic targets that can be addressed to provide hearing protection. These strategies include enhancing the endogenous antioxidant pathways, heat shock proteins, G protein coupled receptors and counteracting ROS and reactive nitrogen species, and blocking pathways that produce inflammation, including TRPV1 and STAT1 36. EXPERT OPINION Numerous potential protective agents show promise in animal models by systemic or local administration. However, clinical trials have not shown much efficacy to date with the exception of sodium thiosulfate. There is an urgent need to discover safe and effective protective agents that do not interfere with the efficacy of cisplatin against tumors yet preserve hearing 151.
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Affiliation(s)
| | - Asmita Dhukhwa
- Springfield Combined Laboratory Facility, Novear Therapeutics LLC ., Springfield, IL, USA
| | - Amit Sapra
- Department of Internal Medicine, SIU School of Medicine , Springfield, IL, USA
| | - Priyanka Bhandari
- Department of Internal Medicine, SIU School of Medicine , Springfield, IL, USA
| | - Katlyn Woolford
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
| | - Jacob Franke
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
| | - Vickram Ramkumar
- Department of Pharmacology, SIU School of Medicine , Springfield, IL, USA
| | - Leonard Rybak
- Department of Otolaryngology, SIU School of Medicine , Springfield, IL, USA
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Clinical trials evaluating transtympanic otoprotectants for cisplatin-induced ototoxicity: what do we know so far? Eur Arch Otorhinolaryngol 2020; 277:2413-2422. [PMID: 32358651 DOI: 10.1007/s00405-020-06003-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cisplatin (CDDP) chemotherapy can cause serious side effects including irreversible and progressive hearing loss. Studies have aimed to assess potential protective strategies; however, systemic treatments have presented variable results, and potential interactions with CDDP have limited clinical trials. METHODS A review of the literature was performed in order to evaluate clinical trials that have studied a transtympanic approach as an otoprotectant strategy. RESULTS Six clinical trials were included. While a transtympanic approach can limit side effects and avoid interactions with CDDP, recurrent issues have been expressed including which otoprotectant to test, time delays between CDDP treatment and transtympanic injections, side effects such as pain and dizziness, concentrations, and number of injections. Clinical trials have used sodium thiosulfate, N-acetylcysteine and dexamethasone. CONCLUSIONS While a transtympanic approach seems like an attractive strategy, further research is needed to clarify which is the optimal otoprotectant, its dosage, and the number of injections.
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Maschio M, Zarabla A, Maialetti A, Marchesi F, Giannarelli D, Gumenyuk S, Pisani F, Renzi D, Galiè E, Mengarelli A. The Effect of Docosahexaenoic Acid and α-Lipoic Acid as Prevention of Bortezomib-Related Neurotoxicity in Patients With Multiple Myeloma. Integr Cancer Ther 2019; 18:1534735419888584. [PMID: 31868025 PMCID: PMC6928538 DOI: 10.1177/1534735419888584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background and Aims: In cancer patients, a common complication during chemotherapy is chemotherapy-induced peripheral neuropathy (CIPN). For this reason, we decided to conduct a phase II prospective study on 33 patients with multiple myeloma at first diagnosis, to evaluate whether a nutraceutical compound given for 6 months during bortezomib (BTZ) treatment succeeded in preventing the onset of neurotoxicity. Methods: Neurological evaluation, electroneurography, and functional and quality of life (QoL) scales were performed at baseline and after 6 months. We administered a tablet containing docosahexaenoic acid 400 mg, α-lipoic acid 600 mg, vitamin C 60 mg, and vitamin E 10 mg bid for 6 months. Results: Concerning the 25 patients who completed the study, at 6-month follow-up, 10 patients had no neurotoxicity (NCI-CTCAE [National Cancer Institute-Common Terminology Criteria for Adverse Events] = 0), while 13 progressed to NCI-CTCAE grade 1, 1 had NCI-CTCAE grade 1 with pain, and 1 experienced a NCI-CTCAE grade 2. Painful symptoms were reported only in 2 patients, and we observed stability on functional and QoL scales in all patients. None of the 25 patients stopped chemotherapy due to neurotoxicity. Conclusions: Our data seem to indicate that the co-administration of a neuroprotective agent during BTZ treatment can prevent the appearance/worsening of symptoms related to CIPN, avoiding the interruption of BTZ and maintaining valuable functional autonomy to allow normal daily activities. We believe that prevention remains the mainstay to preserve QoL in this particular patient population, and that future studies with a larger patient population are needed.
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Affiliation(s)
- Marta Maschio
- Center for Tumor-related epilepsy, UOSD Neurology, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Alessia Zarabla
- Center for Tumor-related epilepsy, UOSD Neurology, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Andrea Maialetti
- Center for Tumor-related epilepsy, UOSD Neurology, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Diana Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Svitlana Gumenyuk
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Francesco Pisani
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Daniela Renzi
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Edvina Galiè
- UOSD Neurology, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
| | - Andrea Mengarelli
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute IRCCS-IFO - Via Elio Chianesi 53, Rome, Italy
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Deshpande R, Raina P, Shinde K, Mansara P, Karandikar M, Kaul-Ghanekar R. Flax seed oil reduced tumor growth, modulated immune responses and decreased HPV E6 and E7 oncoprotein expression in a murine model of ectopic cervical cancer. Prostaglandins Other Lipid Mediat 2019; 143:106332. [DOI: 10.1016/j.prostaglandins.2019.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/29/2019] [Accepted: 04/04/2019] [Indexed: 12/18/2022]
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Rybak LP, Dhukhwa A, Mukherjea D, Ramkumar V. Local Drug Delivery for Prevention of Hearing Loss. Front Cell Neurosci 2019; 13:300. [PMID: 31338024 PMCID: PMC6629775 DOI: 10.3389/fncel.2019.00300] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
Systemic delivery of therapeutics for targeting the cochlea to prevent or treat hearing loss is challenging. Systemic drugs have to cross the blood-labyrinth barrier (BLB). BLB can significantly prevent effective penetration of drugs in appropriate concentrations to protect against hearing loss caused by inflammation, ototoxic drugs, or acoustic trauma. This obstacle may be obviated by local administration of protective agents. This route can deliver higher concentration of drug compared to systemic application and preclude systemic side effects. Protective agents have been administered by intra-tympanic injection in numerous preclinical studies. Drugs such as steroids, etanercept, D and L-methionine, pifithrin-alpha, adenosine agonists, melatonin, kenpaullone (a cyclin-dependent kinase 2 (CDK2) inhibitor) have been reported to show efficacy against cisplatin ototoxicity in animal models. Several siRNAs have been shown to ameliorate cisplatin ototoxicity when administered by intra-tympanic injection. The application of corticosteroids and a number of other drugs with adjuvants appears to enhance efficacy. Administration of siRNAs to knock down AMPK kinase, liver kinase B1 (LKB1) or G9a in the cochlea have been found to ameliorate noise-induced hearing loss. The local administration of these compounds appears to be effective in protecting the cochlea against damage from cisplatin or noise trauma. Furthermore the intra-tympanic route yields maximum protection in the basal turn of the cochlea which is most vulnerable to cisplatin ototoxicity and noise trauma. There appears to be very little transfer of these agents to the systemic circulation. This would avoid potential side effects including interference with anti-tumor efficacy of cisplatin. Nanotechnology offers strategies to effectively deliver protective agents to the cochlea. This review summarizes the pharmacology of local drug delivery by intra-tympanic injection to prevent hearing loss caused by cisplatin and noise exposure in animals. Future refinements in local protective agents provide exciting prospects for amelioration of hearing loss resulting from cisplatin or noise exposure.
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Affiliation(s)
- Leonard P Rybak
- Department of Otolaryngology, School of Medicine, Southern Illinois University, Springfield, IL, United States.,Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Asmita Dhukhwa
- Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Debashree Mukherjea
- Department of Otolaryngology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Vickram Ramkumar
- Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
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Drögemöller BI, Wright GE, Lo C, Le T, Brooks B, Bhavsar AP, Rassekh SR, Ross CJ, Carleton BC. Pharmacogenomics of Cisplatin‐Induced Ototoxicity: Successes, Shortcomings, and Future Avenues of Research. Clin Pharmacol Ther 2019; 106:350-359. [DOI: 10.1002/cpt.1483] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/12/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Britt I. Drögemöller
- Faculty of Pharmaceutical SciencesUniversity of British Columbia Vancouver British Columbia Canada
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
| | - Galen E.B. Wright
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
- Division of Translational TherapeuticsDepartment of PediatricsUniversity of British Columbia Vancouver British Columbia Canada
| | - Cody Lo
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
- Faculty of MedicineUniversity of British Columbia Vancouver British Columbia Canada
| | - Tan Le
- Faculty of Pharmaceutical SciencesUniversity of British Columbia Vancouver British Columbia Canada
| | - Beth Brooks
- Audiology and Speech Pathology DepartmentBC Children's Hospital Vancouver British Columbia Canada
| | - Amit P. Bhavsar
- Department of Medical Microbiology and ImmunologyFaculty of Medicine and DentistryUniversity of Alberta Edmonton Alberta Canada
| | - Shahrad R. Rassekh
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
- Division of Translational TherapeuticsDepartment of PediatricsUniversity of British Columbia Vancouver British Columbia Canada
| | - Colin J.D. Ross
- Faculty of Pharmaceutical SciencesUniversity of British Columbia Vancouver British Columbia Canada
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
| | - Bruce C. Carleton
- BC Children's Hospital Research Institute Vancouver British Columbia Canada
- Division of Translational TherapeuticsDepartment of PediatricsUniversity of British Columbia Vancouver British Columbia Canada
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Maschio M, Zarabla A, Maialetti A, Marchesi F, Giannarelli D, Gumenyuk S, Pisani F, Renzi D, Galiè E, Mengarelli A. Prevention of Bortezomib-Related Peripheral Neuropathy With Docosahexaenoic Acid and α-Lipoic Acid in Patients With Multiple Myeloma: Preliminary Data. Integr Cancer Ther 2018; 17:1115-1124. [PMID: 30295079 PMCID: PMC6247541 DOI: 10.1177/1534735418803758] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background and Aims: Peripheral neuropathy is a common complication of chemotherapy that can induce marked disability that negatively affects the quality of life in patients with multiple myeloma (MM). The aim of this study was to prevent the onset or the worsening of peripheral neuropathy in MM patients treated with bortezomib (BTZ), using a new nutritional neuroprotective compound. We report preliminary results of 18 out of 33 patients who completed the study. Methods: We administered a tablet of Neuronorm to patients, containing docosahexaenoic acid 400 mg, α-lipoic acid 600 mg, vitamin C 60 mg, and vitamin E 10 mg bid for the whole follow-up period. Neurological visit assessment, electroneurography, and evaluation scales were performed at baseline and after 6 months. Results: At 6 months, 8 patients had no chemotherapy-induced peripheral neuropathy, while 10 patients experienced chemotherapy-induced peripheral neuropathy of grade 1 according to the Common Terminology Criteria for Adverse Events, one of them with pain. Seventeen patients did not report painful symptoms; no limitation of functional autonomy and stability in quality of life domains explored was observed. Conclusions: Our results seem to indicate that early introduction of a neuroprotective agent in our patients with MM treated with BTZ could prevent the onset or the worsening of neuropathic pain, avoiding the interruption of the therapy with BTZ, and maintaining a good functional autonomy to allow normal daily activities. Despite the limitations due to the fact that this is a preliminary study, in a small population, with short follow-up, our data seem to indicate that the nutraceutical may have some potential to be considered for a future trial.
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Affiliation(s)
- Marta Maschio
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessia Zarabla
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Maialetti
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Marchesi
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Svitlana Gumenyuk
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Pisani
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniela Renzi
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Edvina Galiè
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Mengarelli
- 1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Hazlitt RA, Min J, Zuo J. Progress in the Development of Preventative Drugs for Cisplatin-Induced Hearing Loss. J Med Chem 2018; 61:5512-5524. [PMID: 29361217 PMCID: PMC6043375 DOI: 10.1021/acs.jmedchem.7b01653] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
![]()
Cisplatin
is a highly effective treatment for malignant cancers
and has become a cornerstone in chemotherapeutic regimens. Unfortunately,
its use in the clinic is often coupled with a high incidence of severe
hearing loss. Over the past few decades, enormous effort has been
put forth to find protective agents that selectively protect against
the ototoxic side effects of cisplatin and do not interfere with its
antitumoral activity. Many therapies have been successful in preclinical
work, but only a few have shown any protection in the clinic, and
none have been approved by the FDA. This review summarizes the clinical
and preclinical studies of the most effective small-molecule candidates
currently in clinical trials, while also detailing their molecular
mechanisms of action, to gain insight for future drug development
in the field.
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17
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Gevrek F, Erdemir F. Investigation of the effects of curcumin, vitamin E and their combination in cisplatin-induced testicular apoptosis using immunohistochemical technique. Turk J Urol 2018; 44:16-23. [PMID: 29484222 PMCID: PMC5821277 DOI: 10.5152/tud.2017.95752] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/08/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Cisplatin is an effective antineoplastic agent used in cancer therapy. However, the use of cisplatin is restricted due to its toxic side effects. Alleviation of its side effects which restricts cisplatin use is highly important. We aimed to investigate the effects of curcumin, vitamin E and their combination in cisplatin induced testicular apoptosis. MATERIAL AND METHODS Thirty-five Wistar albino male adult rats, weighing 300-350 g were divided randomly into five groups including seven rats in each as control, cisplatin, curcumin, vitamin E, and curcumin + vitamin E. On the posttest 5th day, rats were sacrificed, and their testes were removed. 4-5 μm sections from formalin fixed paraffin embedded testis tissues were stained both hematoxylin-eosin to analyze histologically and immunohistochemically to determine the expression of the apoptotic pathway proteins (Bax, Cas-3, Bcl-2). RESULTS Increased histological damage with cisplatin administration was reduced in treatment, especially in combination therapy. Cas-3 and Bax protein immunostaining intensities H-scores were significantly increased but Bcl-2 was slightly decreased in the cisplatin group compared to the control. In all treatment groups Bax, Cas-3 decreased compared to cisplatin group however Bcl-2 decreased in the curcumin and vitamin E groups. Bax/Bcl-2 was the highest in the cisplatin, and decreased in all treatment groups in favor of control. CONCLUSION Cas-3 expression increased by cisplatin administration suggests that cisplatin causes apoptosis of germ cells. According to the present findings, cisplatin mainly caused testicular apoptosis through the Cas-3 and Bax apoptotic protein pathways. Cisplatin-induced testicular apoptosis can be prevented by administration of curcumin, vitamin E, and combination therapy.
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Affiliation(s)
- Fikret Gevrek
- Department of Histology and Embryology, Gaziosmanpasa University, Tokat, Turkey
| | - Fikret Erdemir
- Department of Urology, Gaziosmanpasa University, Tokat, Turkey
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18
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Martín-Saldaña S, Palao-Suay R, Aguilar MR, García-Fernández L, Arévalo H, Trinidad A, Ramírez-Camacho R, San Román J. pH-sensitive polymeric nanoparticles with antioxidant and anti-inflammatory properties against cisplatin-induced hearing loss. J Control Release 2017; 270:53-64. [PMID: 29197586 DOI: 10.1016/j.jconrel.2017.11.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 11/28/2022]
Abstract
Polymeric nanoparticles (NPs) based on smart synthetic amphiphilic copolymers are used to transport and controlled release dexamethasone in the inner ear to protect against the ototoxic effect of cisplatin. The NPs were based on a mixture of two pseudo-block polymer drugs obtained by free radical polymerization: poly(VI-co-HEI) and poly(VP-co-MVE) or poly(VP-co-MTOS), being VI 1-vinylimidazole, VP N-vinylpyrrolidone, and HEI, MVE and MTOS the methacrylic derivatives of ibuprofen, α-tocopherol and α-tocopheryl succinate, respectively. The NPs were obtained by nanoprecipitation with appropriate hydrodynamic properties, and isoelectric points that matched the pH of inflamed tissue. The NPs were tested both in vitro (using HEI-OC1 cells) and in vivo (using a murine model) with good results. Although the concentration of dexamethasone administered in the NPs is around two orders of magnitude lower that the conventional treatment for intratympanic administration, the NPs protected from the cytotoxic effect of cisplatin when the combination of the appropriate properties in terms of size, zeta potential, encapsulation efficiency and isoelectric point were achieved. To the best of our knowledge this is the first time that pH sensitive NPs are used to protect from cisplatin-induced hearing loss by intratympanic administration.
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Affiliation(s)
- Sergio Martín-Saldaña
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain; Ear Research Group, Hospital UniversitarioPuerta de Hierro Majadahonda, Health Research Institute Puerta de Hierro, Madrid, Spain
| | - Raquel Palao-Suay
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain
| | - María Rosa Aguilar
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain.
| | - Luis García-Fernández
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain
| | - Humberto Arévalo
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Almudena Trinidad
- Ear Research Group, Hospital UniversitarioPuerta de Hierro Majadahonda, Health Research Institute Puerta de Hierro, Madrid, Spain
| | - Rafael Ramírez-Camacho
- Ear Research Group, Hospital UniversitarioPuerta de Hierro Majadahonda, Health Research Institute Puerta de Hierro, Madrid, Spain
| | - Julio San Román
- Grupo de Biomateriales, Departamento de Nanomateriales Poliméricos y Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, ICTP-CSIC, C/Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain
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Kalinec GM, Lomberk G, Urrutia RA, Kalinec F. Resolution of Cochlear Inflammation: Novel Target for Preventing or Ameliorating Drug-, Noise- and Age-related Hearing Loss. Front Cell Neurosci 2017; 11:192. [PMID: 28736517 PMCID: PMC5500902 DOI: 10.3389/fncel.2017.00192] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 06/20/2017] [Indexed: 12/11/2022] Open
Abstract
A significant number of studies support the idea that inflammatory responses are intimately associated with drug-, noise- and age-related hearing loss (DRHL, NRHL and ARHL). Consequently, several clinical strategies aimed at reducing auditory dysfunction by preventing inflammation are currently under intense scrutiny. Inflammation, however, is a normal adaptive response aimed at restoring tissue functionality and homeostasis after infection, tissue injury and even stress under sterile conditions, and suppressing it could have unintended negative consequences. Therefore, an appropriate approach to prevent or ameliorate DRHL, NRHL and ARHL should involve improving the resolution of the inflammatory process in the cochlea rather than inhibiting this phenomenon. The resolution of inflammation is not a passive response but rather an active, highly controlled and coordinated process. Inflammation by itself produces specialized pro-resolving mediators with critical functions, including essential fatty acid derivatives (lipoxins, resolvins, protectins and maresins), proteins and peptides such as annexin A1 and galectins, purines (adenosine), gaseous mediators (NO, H2S and CO), as well as neuromodulators like acetylcholine and netrin-1. In this review article, we describe recent advances in the understanding of the resolution phase of inflammation and highlight therapeutic strategies that might be useful in preventing inflammation-induced cochlear damage. In particular, we emphasize beneficial approaches that have been tested in pre-clinical models of inflammatory responses induced by recognized ototoxic drugs such as cisplatin and aminoglycoside antibiotics. Since these studies suggest that improving the resolution process could be useful for the prevention of inflammation-associated diseases in humans, we discuss the potential application of similar strategies to prevent or mitigate DRHL, NRHL and ARHL.
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Affiliation(s)
- Gilda M Kalinec
- Laboratory of Auditory Cell Biology, Department of Head and Neck Surgery, David Geffen School of Medicine, University of CaliforniaLos Angeles, Los Angeles, CA, United States
| | - Gwen Lomberk
- Epigenetics and Chromatin Dynamics Laboratory, Translational Epigenomic Program, Center for Individualized Medicine (CIM) Mayo ClinicRochester, MN, United States
| | - Raul A Urrutia
- Epigenetics and Chromatin Dynamics Laboratory, Translational Epigenomic Program, Center for Individualized Medicine (CIM) Mayo ClinicRochester, MN, United States
| | - Federico Kalinec
- Laboratory of Auditory Cell Biology, Department of Head and Neck Surgery, David Geffen School of Medicine, University of CaliforniaLos Angeles, Los Angeles, CA, United States
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Martín-Saldaña S, Palao-Suay R, Aguilar MR, Ramírez-Camacho R, San Román J. Polymeric nanoparticles loaded with dexamethasone or α-tocopheryl succinate to prevent cisplatin-induced ototoxicity. Acta Biomater 2017; 53:199-210. [PMID: 28213099 DOI: 10.1016/j.actbio.2017.02.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/23/2017] [Accepted: 02/11/2017] [Indexed: 12/20/2022]
Abstract
The aim of this work is the development of highly protective agents to be administered locally within the middle ear to avoid cisplatin-induced ototoxicity, which affects to 100% of the clinical patients at ultra-high concentrations (16mg/kg). The protective agents are based on polymeric nanoparticles loaded with dexamethasone or α-tocopheryl succinate as anti-inflammarory and anti-apoptotic molecules. Dexamethasone and α-tocopheryl succinate are poorly soluble in water and present severe side effects when systemic administered during long periods of time. Their incorporation in the hydrophobic core of nanoparticles with the appropriate hydrodynamic properties provides the desired effects in vitro (lower cisplatin-induced toxicity, decreasing of caspase 3/7 activity, and lower IL-1β release) and in vivo (reducing the hearing loss at the local level). The local administration of the nanoparticles by bullostomy provides an adequate dose of drug without systemic interference with the chemotherapeutic effect of cisplatin. STATEMENT OF SIGNIFICANCE 100% of the cancer patients receiving ultra-high doses of CDDP (16mg/kg) suffer severe hearing loss, being a limiting factor in antineoplastic treatments. In this paper we describe the application of polymeric nanoparticles loaded with dexamethasone or α-tocopheryl succinate to palliate the cisplatin ototoxicity derived from chemotherapy treatment. These new nanoparticles, that encapsulate, transport, and deliver dexamethasone or α-tocopheryl succinate in the middle ear, are able to partially prevent ototoxicity derived from high doses of CDDP. This is an interdisciplinary study in which in vitro and in vivo experiments are described and extensively discussed. The importance of the results opens an excellent opportunity to the translation to the clinic.
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Affiliation(s)
- Sergio Martín-Saldaña
- Department of Otorhinolaryngology, Puerta de Hierro Majadahonda University Hospital, C/ Manuel de Falla, 1, 28222 Majadahonda, Spain; Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology, CSIC, C/ Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Raquel Palao-Suay
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology, CSIC, C/ Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain
| | - María Rosa Aguilar
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology, CSIC, C/ Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain.
| | - Rafael Ramírez-Camacho
- Department of Otorhinolaryngology, Puerta de Hierro Majadahonda University Hospital, C/ Manuel de Falla, 1, 28222 Majadahonda, Spain; Universidad Autónoma de Madrid, Cantoblanco Campus University, 28049 Madrid, Spain
| | - Julio San Román
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology, CSIC, C/ Juan de la Cierva, 3, 28006 Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain
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Lee JH, Oh SH, Kim TH, Go YY, Song JJ. Anti-apoptotic effect of dexamethasone in an ototoxicity model. Biomater Res 2017; 21:4. [PMID: 28405467 PMCID: PMC5383979 DOI: 10.1186/s40824-017-0090-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/30/2017] [Indexed: 12/20/2022] Open
Abstract
Background Dexamethasone (DEX) is used for the treatment of various inner ear diseases. However, the molecular mechanism of DEX on gentamicin induced hair cell damage is not known. Therefore, this study investigated the protective effect of DEX on gentamicin (GM)-induced ototoxicity and the effect of GM on the expression of apoptosis related genes. Methods The protective effects of DEX were measured by phalloidin staining of explant cultures of organ of Corti from postnatal day 2–3 mice with GM-induced hair cell loss. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining was used to detect apoptosis and immunofluorescence was done to analyze the effect of DEX on the expression of apoptosis related genes. Results Cochlear explant cultures of postnatal day-4-old mice were exposed to 0, 1, 5, 10, 30, 50, and 100 μg/ml DEX and GM during culture. DEX protected from GM-induced hair cell loss in the inner ear of postnatal day 4 mice. To understand the molecular mechanisms by which DEX pre-treatment decreased hair cell loss, the testes of cochlear explant cultures of postnatal day 4 mice were examined for changes in expression of cochlear apoptosis mediators. The pro-apoptotic protein Bax was significantly down-regulated and numbers of apoptotic hair cells were decreased. Conclusions DEX has a protective effect on GM-induced hair cell loss in neonatal cochlea cultures and the protective mechanism may involve inhibition of the mitochondrial apoptosis pathway. The combination with scaffold technique can improve delivery of DEX into the inner ear to protect GM-induced ototoxicity.
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Affiliation(s)
- Jin Ho Lee
- Department of Advanced Materials, Hannam University, Daejeon, Korea
| | - Se Heang Oh
- Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan, Korea
| | - Tae Ho Kim
- Department of Advanced Materials, Hannam University, Daejeon, Korea
| | - Yoon Young Go
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
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Soyalıç H, Gevrek F, Koç S, Avcu M, Metin M, Aladağ İ. Intraperitoneal curcumin and vitamin E combination for the treatment of cisplatin-induced ototoxicity in rats. Int J Pediatr Otorhinolaryngol 2016; 89:173-8. [PMID: 27619052 DOI: 10.1016/j.ijporl.2016.08.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/19/2016] [Accepted: 08/20/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cisplatin ototoxicity is characterized by irreversible, progressive, bilateral sensorineural hearing loss at high frequencies, accompanied by tinnitus. The aim of this study is to demonstrate the protective action of curcumin alone or in combination with vitamin E against cisplatin-induced ototoxicity in animal models. MATERIAL AND METHODS The study included 42 rats. Experimental animals were randomized into 6 groups. In the first group, intra-peritoneal cisplatin was administered alone. In the second group, intra-peritoneal cisplatin and curcumin were administered together. In the third group, intra-peritoneal cisplatin and vitamin E were administered together. In the fourth group, intra-peritoneal cisplatin was administered together with curcumin in combination with vitamin E. In the fifth group, intra-peritoneal curcumin was administered alone. The sixth group was sacrificed directly without administration of any drugs. A distortion product otoacoustic emission (DPOAE) test was applied to both ears of all experimental animals. Curcumin was administered 1 h before cisplatin treatment continued for three successive days. Vitamin E was administered only as a single dose 30 min prior to cisplatin. All animals were sacrificed following DPOAE testing on the 5th day of cisplatin administration. Histopathological findings included a TUNEL (TdT-mediated deoxyuridine triphosphate nick end-labeling) assay, and the percentage of apoptotic cells was calculated. DPOAE values and the percentage of apoptotic cells were compared before and after treatment and between experimental groups. RESULTS In Group 1, DPOAE values were significantly decreased at all frequencies (3000 Hz, 4000 Hz and 6000 Hz; P < 0.05). In Groups 2, 3, 4 and 5 there was no significant difference between the pre- and post-treatment DPOAE results (p > 0.05). Apoptotic index values were lower in all treatment groups compared to the cisplatin group, however the difference was only statistically significant in group 3 (p = 0.009). CONCLUSION In rats, cisplatin ototoxicity can be prevented with curcumin or curcumin-vitamin E combination.
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Affiliation(s)
- Harun Soyalıç
- Ahi Evran University Training and Research Hospital, Department of Otorhinolaryngology, Kırşehir, Turkey.
| | - Fikret Gevrek
- Gaziosmanpaşa University, Department of Histology and Embryology, Tokat, Turkey
| | - Sema Koç
- Antalya Training and Research Hospital, Department of Otorhinolaryngology, Antalya, Turkey
| | - Mustafa Avcu
- Ahi Evran University Training and Research Hospital, Department of Otorhinolaryngology, Kırşehir, Turkey
| | - Mehmet Metin
- Ahi Evran University Training and Research Hospital, Department of Otorhinolaryngology, Kırşehir, Turkey
| | - İbrahim Aladağ
- Katip Çelebi University, Atatürk Training and Research Hospital, Department of Otorhinolaryngology, İzmir, Turkey
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Dexamethasone Protects Against Apoptotic Cell Death of Cisplatin-exposed Auditory Hair Cells In Vitro. Otol Neurotol 2016; 36:1566-71. [PMID: 26375980 DOI: 10.1097/mao.0000000000000849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
HYPOTHESIS Dexamethasone (DXM) protects against cisplatin-induced auditory hair cell (HC) loss in rat organ of Corti (OC) explants in vitro by reducing levels of oxidative stress and NADPH-Oxidase-3 (NOX-3). BACKGROUND Intratympanic DXM has demonstrated protective effects against cisplatin-induced hearing loss in a few animal studies and one clinical trial. However, levels of protection with intratympanic DXM vary significantly between studies, which may not be a result of the intrinsic properties of DXM but rather reflect the diffusion of DXM into the cochlea. The molecular mechanisms and degree of DXM protection against cisplatin ototoxicity are currently unknown. METHODS OC explants from 3-day-old rats were cultured with no treatment or various concentrations of cisplatin (2, 5, or 10 μM) and DXM (75, 150, or 300 μg/mL) in vitro. HC viability and TUNEL assay were performed after 72 hours in vitro and levels of oxidative stress and NOX-3 were evaluated with confocal microscopy after 48 hours in vitro. Analysis of variance with Tukey's post hoc testing was performed. RESULTS Cisplatin initiated dose-dependent losses of outer HCs (OHCs) in the basal turns of exposed explants (p < 0.001). DXM protected against cisplatin (2 μM)-induced OHC loss in a dose-dependent manner with complete protection at 300 μg/mL of DXM (p < 0.001). DXM (150 μg/mL) significantly reduced levels of oxidative stress, NOX-3, and apoptosis in the basal turn of explants exposed to cisplatin (2 μM). CONCLUSIONS DXM protects against cisplatin-induced loss of OHCs in the basal turn of rat OC explants as demonstrated by reductions in oxidative stress and NOX-3 production and decreased levels of apoptotic cell death.
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Comparison of the protective effects of intratympanic dexamethasone and methylprednisolone against cisplatin-induced ototoxicity. The Journal of Laryngology & Otology 2016; 130:225-34. [PMID: 26830667 DOI: 10.1017/s0022215115003473] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to compare the efficacies of intratympanic dexamethasone and methylprednisolone in preventing in cisplatin-induced ototoxicity in rats. METHODS Experimental groups of rats (n = 8 each) received intratympanic isotonic saline, intraperitoneal cisplatin and intratympanic isotonic saline, intraperitoneal cisplatin and intratympanic dexamethasone, or intraperitoneal cisplatin and intratympanic methylprednisolone. Distortion product otoacoustic emission thresholds were compared on days 0 and 10 in all rats, and correlations between drug effects and changes in cochlear histology were evaluated. RESULTS Distortion product otoacoustic emission thresholds were comparable in groups III and IV (p > 0.05). Significant protection against cisplatin-induced ototoxicity was seen in groups III and IV compared with group II (p < 0.05). Dexamethasone and, to a lesser extent, methylprednisolone protected against cellular apoptosis in cisplatin-induced ototoxicity. CONCLUSION Dexamethasone (and possibly methylprednisolone) may be clinically useful as an intratympanic chemopreventive agent to treat cisplatin ototoxicity. Future clinical studies should investigate the use of dexamethasone for this purpose in adult patients.
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Fernandez R, Harrop-Jones A, Wang X, Dellamary L, LeBel C, Piu F. The Sustained-Exposure Dexamethasone Formulation OTO-104 Offers Effective Protection against Cisplatin-Induced Hearing Loss. Audiol Neurootol 2016; 21:22-9. [DOI: 10.1159/000441833] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/19/2015] [Indexed: 11/19/2022] Open
Abstract
The otoprotective effects of OTO-104 were investigated following both acute and chronic administration of cisplatin. The acute administration of cisplatin to guinea pigs resulted in profound hearing loss (70-80 dB SPL) across all frequencies tested. A single intratympanic injection of 6% OTO-104, but not of lower doses, almost completely protected against cisplatin ototoxicity. In contrast, a dexamethasone solution administered under the same experimental conditions offered no otoprotection. OTO-104 was also very effective in protecting against the progressive hearing loss observed with the chronic administration of cisplatin (3 injections at a weekly interval). The otoprotection was found to be dependent upon the activation of dexamethasone-dependent classical nuclear receptor pathways.
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Chtourou Y, Aouey B, Aroui S, Kebieche M, Fetoui H. Anti-apoptotic and anti-inflammatory effects of naringin on cisplatin-induced renal injury in the rat. Chem Biol Interact 2016; 243:1-9. [DOI: 10.1016/j.cbi.2015.11.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/30/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
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Callejo A, Sedó-Cabezón L, Juan ID, Llorens J. Cisplatin-Induced Ototoxicity: Effects, Mechanisms and Protection Strategies. TOXICS 2015; 3:268-293. [PMID: 29051464 PMCID: PMC5606684 DOI: 10.3390/toxics3030268] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 12/11/2022]
Abstract
Cisplatin is a highly effective chemotherapeutic agent that is widely used to treat solid organ malignancies. However, serious side effects have been associated with its use, such as bilateral, progressive, irreversible, dose-dependent neurosensory hearing loss. Current evidence indicates that cisplatin triggers the production of reactive oxygen species in target tissues in the inner ear. A variety of agents that protect against cisplatin-induced ototoxicity have been successfully tested in cell culture and animal models. However, many of them interfere with the therapeutic effect of cisplatin, and therefore are not suitable for systemic administration in clinical practice. Consequently, local administration strategies, namely intratympanic administration, have been developed to achieve otoprotection, without reducing the antitumoral effect of cisplatin. While a considerable amount of pre-clinical information is available, clinical data on treatments to prevent cisplatin ototoxicity are only just beginning to appear. This review summarizes clinical and experimental studies of cisplatin ototoxicity, and focuses on understanding its toxicity mechanisms, clinical repercussions and prevention strategies.
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Affiliation(s)
- Angela Callejo
- Unitat Funcional d'Otorrinolaringologia i Al·lèrgia, Institut Universtiari Quirón Dexeus, 08028 Barcelona, Catalonia, Spain.
| | - Lara Sedó-Cabezón
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Catalonia, Spain.
| | - Ivan Domènech Juan
- Unitat Funcional d'Otorrinolaringologia i Al·lèrgia, Institut Universtiari Quirón Dexeus, 08028 Barcelona, Catalonia, Spain.
- Servei d'Otorrinolaringologia, Hospital Universitario de Bellvitge, 08907 L'Hospitalet de Llobregat, Catalonia, Spain.
| | - Jordi Llorens
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Catalonia, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), 08907 L'Hospitalet de Llobregat, Catalonia, Spain.
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Dogan R, Merıc A, Gedık O, Tugrul S, Eren SB, Ozturan O. Does systemic steroid deficiency affect inner ear functions? Am J Otolaryngol 2015; 36:568-74. [PMID: 25599654 DOI: 10.1016/j.amjoto.2014.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/04/2014] [Accepted: 12/21/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE Today corticosteroids are employed for the treatment of various inner ear disorders. In this study we have investigated probable changes in hearing functions resulting from a deficiency of systemic steroid secretions. MATERIALS AND METHODS Twenty four healthy female rats were used in our study, allocated into three groups (medical adrenalectomy, medical adrenalectomy+dexamethasone, no treatment). Audiological evaluations were conducted at the beginning of the study and on days 7, 14 and 21. Blood samples were taken at the beginning and at the end of the study and blood corticosterone levels were determined. RESULTS While there were no significant differences between the basal, 7th, 14th and 21st day DPOAE values of group 1, their ABR threshold values showed significant increases. In group 2, there were no significant differences between the basal, 7th, 14th and 21st day DPOAE values. ABR thresholds of group 2 showed significant increases on days 7 and 14 as compared to their basal values, but there were no significant differences between the 21st day and basal ABR threshold values. There were no significant differences between the basal cortisol levels of the three groups. The mean cortisol level of group 1 on day 21 was found to be significantly lower than those of groups 2 and 3. CONCLUSION The results of the study demonstrated that there were no significant changes in DPOAE values with the cessation of cortisol secretion, while there was a progressive increase in ABR thresholds, which could be overcome with cortisone replacement.
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Affiliation(s)
- Remzi Dogan
- Department of Otorhinolaryngology, Bayrampasa State Hospital, Bayrampasa, Istanbul, Turkey.
| | - Ayşenur Merıc
- Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Ozge Gedık
- Faculty of Health Sciences, Department of Audiology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Selahattin Tugrul
- Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Sabri Baki Eren
- Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Orhan Ozturan
- Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
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Golchin L, Shabani M, Harandi S, Razavinasab M. Pistachio supplementation attenuates motor and cognition impairments induced by cisplatin or vincristine in rats. Adv Biomed Res 2015; 4:92. [PMID: 26015918 PMCID: PMC4434487 DOI: 10.4103/2277-9175.156656] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/25/2014] [Indexed: 11/30/2022] Open
Abstract
Background: A large number of natural products and dietary components have been evaluated as potential chemoprotective agents. In the present investigation we report the effects of treatment with the dietary antioxidant, pistachio, on cisplatin- or vincristine-induced neurotoxicity in male Wistar rats. Materials and Methods: Dietary pistachio (10%) was assessed for its neuroprotective effects through the alteration in performance of hippocampus- and cerebellum-related behaviors following chronic cisplatin (5 mg/kg) or vincristine (0.2 mg/kg) treatment in male rats. We also evaluated the effects of cisplatin, vincristine, and pistachio administration on nociception. Six behavioral tasks were used: open field, rotarod, grasping, Morris water maze (MWM), hot plate, and motor nerve conductive velocity (MNCV). Results: We showed that the exposure of adolescent rats to cisplatin or vincristine resulted in a significant decrease in explorative behaviors and memory retention. Pistachio consumption somewhat improved memory and motor abilities in cisplatin- or vincristine-treated rats, while pistachio alone did not show any significant changes in these abilities compared to saline. Cisplatin and vincristine increased the latency of response to nociception, and pistachio did not reverse this effect. Conclusion: We conclude that pistachio in the diet following anticancer drugs such as cisplatin and vincristine might have a protective effect against anticancer drug-induced disruptions in motor and cognitive function. However, further studies are needed to elucidate the exact mechanisms of this protective effect of pistachio.
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Affiliation(s)
- Leila Golchin
- Department of Neuroscience, Neuroscience Research Center, Neuropharamcology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Shabani
- Department of Neuroscience, Neuroscience Research Center, Neuropharamcology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Shaahin Harandi
- Department of Neuroscience, Neuroscience Research Center, Neuropharamcology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Moazamehosadat Razavinasab
- Department of Neuroscience, Neuroscience Research Center, Neuropharamcology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Naringin Abrogates Cisplatin-Induced Cognitive Deficits and Cholinergic Dysfunction Through the Down-Regulation of AChE Expression and iNOS Signaling Pathways in Hippocampus of Aged Rats. J Mol Neurosci 2015; 56:349-62. [DOI: 10.1007/s12031-015-0547-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/16/2015] [Indexed: 01/25/2023]
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Ma W, Hu J, Cheng Y, Wang J, Zhang X, Xu M. Ginkgolide B protects against cisplatin-induced ototoxicity: enhancement of Akt–Nrf2–HO-1 signaling and reduction of NADPH oxidase. Cancer Chemother Pharmacol 2015; 75:949-59. [DOI: 10.1007/s00280-015-2716-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/24/2015] [Indexed: 12/12/2022]
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Zhang QH, Gong C, Yang H, Wei H, Zhou WB, Qi C, Wang CH. Pharmacokinetics of cisplatin in the absence or presence of zengmian yiliu granules (a traditional Chinese medicine compound) in rats determined via ICP-MS: an investigation on drug-herb interactions. PHARMACEUTICAL BIOLOGY 2015; 53:159-166. [PMID: 25339463 DOI: 10.3109/13880209.2014.912241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CONTEXT Cisplatin is a highly effective chemotherapeutic agent against many tumors; however, it has potent adverse effects. Zengmian Yiliu granule (ZMYL), a traditional Chinese medicine (TCM) compound, has been clinically used against platinum (Pt)-induced toxicity and to enhance the efficacy of cisplatin. OBJECTIVE The study was conducted to investigate the likelihood of potential pharmacokinetics drug-herbs interaction (DHI) between cisplatin and ZMYL. MATERIALS AND METHODS An improved ICP-MS method combined with ultrafiltration and microwave-assisted digestion was performed to determine the total and free Pt concentrations in rat plasma after intraperitoneal administration of cisplatin (9 mg/kg) or a combined administration with ZMYL (1 g/kg) by gavage. RESULTS ZMYL produced a potential DHI on the pharmacokinetic parameters of cisplatin, calculated from the total Pt concentration. The clearance rate decreased from 110.52 to 66.12 mLh(-1 )kg(-1), the mean residence time extended from 63.1 to 164.54 h, the area under the plasma concentration-time curve increased from 86.58 to 152.93 µg h mL(-1), the elimination half-life extended from 48.38 to 126.4 h, and the elimination rate constant decreased from 0.017 to 0.006 h, in the ZMYL combination group (p < 0.05). In terms of free Pt concentration, the apparent volume of distribution and clearance rate was statistically different (p < 0.05). The Pt plasma protein binding ratios in the early dose stages were significantly boosted by the co-administration of ZMYL (p < 0.01). DISCUSSION AND CONCLUSION ZMYL is a potential complementary and alternative medicine for cisplatin chemotherapy. The therapeutic benefits of ZMYL-cisplatin chemotherapy derived from pharmacokinetic interaction needs further investigation.
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Affiliation(s)
- Qin-Hua Zhang
- Department of Gynaecology, Shanghai Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine , Shanghai , PR China
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Lemmo W. Potential interactions of prescription and over‐the‐counter medications having antioxidant capabilities with radiation and chemotherapy. Int J Cancer 2014; 137:2525-33. [DOI: 10.1002/ijc.29208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/01/2014] [Accepted: 08/12/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Walter Lemmo
- LEMMO Integrated Cancer Care Inc.Vancouver Canada
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Mukherjea D, Ghosh S, Bhatta P, Sheth S, Tupal S, Borse V, Brozoski T, Sheehan KE, Rybak LP, Ramkumar V. Early investigational drugs for hearing loss. Expert Opin Investig Drugs 2014; 24:201-17. [PMID: 25243609 DOI: 10.1517/13543784.2015.960076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Sensorineural hearing loss (HL) is becoming a global phenomenon at an alarming rate. Nearly 600 million people have been estimated to have significant HL in at least one ear. There are several different causes of sensorineural HL included in this review of new investigational drugs for HL. They are noise-induced, drug-induced, sudden sensorineural HL, presbycusis and HL due to cytomegalovirus infections. AREAS COVERED This review presents trends in research for new investigational drugs encompassing a variety of causes of HL. The studies presented here are the latest developments either in the research laboratories or in preclinical, Phase 0, Phase I or Phase II clinical trials for drugs targeting HL. EXPERT OPINION While it is important that prophylactic measures are developed, it is extremely crucial that rescue strategies for unexpected or unavoidable cochlear insult be established. To achieve this goal for the development of drugs for HL, innovative strategies and extensive testing are required for progress from the bench to bedside. However, although a great deal of research needs to be done to achieve the ultimate goal of protecting the ear against acquired sensorineural HL, we are likely to see exciting breakthroughs in the near future.
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Affiliation(s)
- Debashree Mukherjea
- Southern Illinois University School of Medicine, Department of Surgery , P.O. Box 19629, Springfield, IL 62794-9629 , USA
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Erken HA, Koç ER, Yazıcı H, Yay A, Önder GÖ, Sarıcı SF. Selenium partially prevents cisplatin-induced neurotoxicity: a preliminary study. Neurotoxicology 2014; 42:71-5. [PMID: 24751598 DOI: 10.1016/j.neuro.2014.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 04/02/2014] [Accepted: 04/08/2014] [Indexed: 12/18/2022]
Abstract
Cisplatin is an anticancer drug and it has neurotoxic effects. On the other hand, the neuroprotective effect of selenium was observed in previous studies. However, the effect of selenium on cisplatin-induced neurotoxicity has not been studied yet. Therefore, we aimed to investigate whether selenium prevent cisplatin-induced neurotoxicity. Twenty-one male Wistar albino rats were divided into three groups: control (C), cisplatin (CS), cisplatin and selenium (CSE, n=7 in each group). Cisplatin (12 mg/kg/day, i.p.) was administered for 3 days to CS and CSE groups. Also, CSE group received via oral gavage 3 mg/kg/day (twice-a-day as 1.5 mg/kg) selenium 5 days before of cisplatin injection and continued for 11 consecutive days. The same volumes of saline were intraperitoneally and orally administered to C group at same time. At the end of experimental protocol, electrophysiological and histopathological examinations were performed. The nerve conduction velocity, amplitude of compound action potential and number of axon of CS group were significantly lower than the C group. However, the same parameters of CSE group were significantly higher than the CS group. Although, cisplatin has a peripheral neurotoxic effect in rats, this effect was partially prevented by selenium treatment. Thus, it appears that co-administration of selenium and cisplatin may be a useful approach to decrease severity of peripheral neurotoxicity.
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Affiliation(s)
- Haydar Ali Erken
- Balikesir University, Faculty of Medicine, Department of Physiology, Balikesir, Turkey.
| | - Emine Rabia Koç
- Balikesir University, Faculty of Medicine, Department of Neurology, Balikesir, Turkey
| | - Haşmet Yazıcı
- Balikesir University, Faculty of Medicine, Department of Ear Nose Throat, Balikesir, Turkey
| | - Arzu Yay
- Erciyes University, Faculty of Medicine, Department of Histology and Embryology, Kayseri, Turkey
| | - Gözde Özge Önder
- Erciyes University, Faculty of Medicine, Department of Histology and Embryology, Kayseri, Turkey
| | - Saim Furkan Sarıcı
- Hacettepe University, Faculty of Medicine, Department of Oncology, Ankara, Turkey
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Marshak T, Steiner M, Kaminer M, Levy L, Shupak A. Prevention of Cisplatin-Induced Hearing Loss by Intratympanic Dexamethasone. Otolaryngol Head Neck Surg 2014; 150:983-90. [DOI: 10.1177/0194599814524894] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/31/2014] [Indexed: 12/28/2022]
Abstract
Objective To examine the role of intratympanic Dexamethasone (ITD) in the prevention of Cisplatin-induced hearing loss. Study Design Prospective randomized controlled clinical trial. Setting Tertiary referral center. Subjects and Methods Twenty-six patients suffering from a neoplastic disease for which the treatment protocol included Cisplatin were recruited. Prior to each Cisplatin treatment session ITD was injected to the baseline randomly assigned ear while the other ear of the same patient served as the control. Audiometry and Distortion Product Otoacoustic Emissions (DPOAEs) test results of the baseline and follow-up examinations were compared within and between the study and control ears. Results The cumulative dose of Cisplatin was greater than 400 mg for the 15 subjects who completed the study. The pure tone threshold at 8000 Hz and pure tone average threshold at 4000 to 8000 Hz significantly increased in both the study ( P < .005, P < .03, respectively) and control ears ( P < .01, P < .005, respectively). Significant increase in the pure tone threshold for 6000 Hz was observed in the control ( P < .02) but not in the study group. Within the groups comparison also revealed significant decrease in the DPOAE average signal-to-noise ratio (SNR) for the f2 frequencies 7031 ( P < .04) and 8391 Hz ( P < .04) and SNR average for 4000 to 8000 Hz in the control ( P < .04) but not in the study ears. Conclusions ITD significantly attenuated hearing loss at 6000 Hz and decreased the outer hair dysfunction in the DPOAE f2 range of 4000 to 8000 Hz. ITD might have potential in the reduction of Cisplatin-induced hearing loss.
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Affiliation(s)
- Tal Marshak
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel
- Department of Otolaryngology Head and Neck Surgery, Carmel Medical Center, Haifa, Israel
| | | | | | - Levana Levy
- Department of Oncology Lin Medical Center, Haifa, Israel
| | - Avi Shupak
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel
- Department of Otolaryngology Head and Neck Surgery, Carmel Medical Center, Haifa, Israel
- The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel
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Hughes AL, Hussain N, Pafford R, Parham K. Dexamethasone otoprotection in a multidose cisplatin ototoxicity mouse model. Otolaryngol Head Neck Surg 2013; 150:115-20. [PMID: 24233060 DOI: 10.1177/0194599813511948] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop a murine model for multidose administration of cisplatin that produces significant hearing threshold elevations and to use this model to assess the protective properties of intratympanic (IT) dexamethasone against cisplatin ototoxicity. STUDY DESIGN Controlled repeated measures design. SETTING Translational research laboratory. SUBJECTS AND METHODS Intraperitoneal (IP) cisplatin, 2 or 3 mg/kg/day, was administered for a total of 5 or 10 days in young CBA/J mice. Pure-tone evoked auditory brainstem response (ABR) thresholds were performed on days 7, 14, 21, and 28 to evaluate hearing threshold shifts. After development of the optimal dosing regimen, 15 mice received IT dexamethasone (24 mg/ml) in one ear and IT saline in the contralateral ear. RESULTS Significant threshold elevations were obtained for the 2 and 3 mg/kg/day 10 day groups, but both had high mortality rates and were excluded as potential multidose murine models. The 3 mg/kg/day 5 day group had a lower mortality rate and significant ABR threshold elevations for all frequencies on days 7, 14, 21, and 28. Using this dosing model, no statistically significant difference between IT dexamethasone and saline treated ears was found. CONCLUSIONS Unlike previous single dose models, IT dexamethasone did not have an otoprotective effect in a multidose murine model of cisplatin ototoxicity.
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Affiliation(s)
- Amy Lawrason Hughes
- University of Connecticut Health Center, Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, Farmington, Connecticut, USA
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Schloss JM, Colosimo M, Airey C, Masci PP, Linnane AW, Vitetta L. Nutraceuticals and chemotherapy induced peripheral neuropathy (CIPN): a systematic review. Clin Nutr 2013; 32:888-93. [PMID: 23647723 DOI: 10.1016/j.clnu.2013.04.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/25/2013] [Accepted: 04/04/2013] [Indexed: 10/27/2022]
Abstract
Chemotherapy induced peripheral neuropathy [CIPN] is a common significant and debilitating side effect resulting from the administration of neurotoxic chemotherapeutic agents. These pharmaco-chemotherapeutics can include taxanes, vinca alkaloids and others. Moderate to severe CIPN significantly decreases the quality of life and physical abilities of cancer patients and current pharmacotherapy for CIPN e.g. Amifostine and antidepressants have had limited efficacy and may themselves induce adverse side effects. To determine the potential use of nutraceuticals i.e. vitamin E, acetyl-L-carnitine, glutamine, glutathione, vitamin B6, omega-3 fatty acids, magnesium, calcium, alpha lipoic acid and n-acetyl cysteine as adjuvants in cancer treatments a systematic literature review was conducted. Revised clinical studies comprised of randomized clinical trials that investigated the anti-CIPN effect of nutraceuticals as the adjuvant intervention in patients administered chemotherapy. Twenty-four studies were assessed on methodological quality and limitations identified. Studies were mixed in their recommendations for nutraceuticals. Currently no agent has shown solid beneficial evidence to be recommended for the treatment or prophylaxis of CIPN. The standard of care for CIPN includes dose reduction and/or discontinuation of chemotherapy treatment. The management of CIPN remains an important challenge and future studies are warranted before recommendations for the use of supplements can be made.
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Affiliation(s)
- Janet M Schloss
- The University of Queensland, School of Medicine, Centre for Integrative Clinical and Molecular Medicine, Level 5, TRI, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia
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Waissbluth S, Daniel SJ. Cisplatin-induced ototoxicity: transporters playing a role in cisplatin toxicity. Hear Res 2013; 299:37-45. [PMID: 23467171 DOI: 10.1016/j.heares.2013.02.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 01/16/2013] [Accepted: 02/07/2013] [Indexed: 12/13/2022]
Abstract
Cisplatin is a potent antineoplastic agent widely used for a variety of cancer types. Unfortunately, its use leads to dose limiting side effects such as ototoxicity. Up to 93% of patients receiving cisplatin chemotherapy will develop progressive and irreversible sensorineural hearing loss which leads to a decreased quality of life in cancer survivors. No treatment is currently available for cisplatin-induced ototoxicity. It appears that cisplatin causes apoptosis by binding DNA, activating the inflammatory cascade as well as generating oxidative stress in the cell. Various studies have aimed to assess the potential protective effects of compounds such as antioxidants, anti-inflammatories, caspase inhibitors, anti-apoptotic agents and calcium channel blockers against the toxicity caused by cisplatin in the inner ear with variable degrees of protection. Nevertheless, the pathophysiology of cisplatin-induced ototoxicity remains unclear. This review summarizes all of the known transporters that could play a role in cisplatin influx, leading to cisplatin-induced ototoxicity. The following were evaluated: copper transporters, organic cation transporters, the transient receptor potential channel family, calcium channels, multidrug resistance associated proteins, mechanotransduction channels and chloride channels.
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Affiliation(s)
- Sofia Waissbluth
- Department of Otolaryngology, The Montreal Children's Hospital, Quebec, Canada
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A combination of cilostazol and Ginkgo biloba extract protects against cisplatin-induced Cochleo-vestibular dysfunction by inhibiting the mitochondrial apoptotic and ERK pathways. Cell Death Dis 2013; 4:e509. [PMID: 23429295 PMCID: PMC3734837 DOI: 10.1038/cddis.2013.33] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cisplatin (cis-diammine-dichloroplatinum; CDDP) is an anticancer drug that induces significant hearing loss and balance dysfunction as side effects. Cilostazol (CS, 6-[4-(1-cyclohexyl-1H-tetrazol-5-yl) butoxy]-3, 4-dihydro-2-(1H)-quinolinone) has neuroprotective and antioxidant effects, whereas Ginkgo biloba extract (GbE) has preventive effects on CDDP-induced hearing loss in rats, and GbE enhances the antiatherogenic effect of CS by inhibiting the generation of reactive oxygen species (ROS). The purpose of this study was to investigate the effects of renexin (RXN), which contains GbE and CS, against CDDP-induced cochleo-vestibular dysfunction in rats and to elucidate the mechanism underlying the protective effects of RXN on auditory cells. Rats intraperitoneally injected with CDDP exhibited an increase in hearing threshold and vestibular dysfunction, which agreed with hair cell damage in the Organ of Corti and otoliths. However, these impairments were significantly prevented in a dose-dependent manner by pre- and co-treatment with RXN, and these preventive effects in RXN-treated rats were more prominent than those in GbE-treated rats. In a CDDP pharmacokinetic study, platinum concentration was very similar between CDDP-only treated and RXN+CDDP cotreated rats. RXN markedly attenuated CDDP-induced intracellular ROS and significantly reduced CDDP-activated expression of p-extracellular regulated kinase (ERK), BAX, cytochrome c, cleaved caspase-3 and cleaved poly (ADP-ribose) polymerase, but increased BCL-XL expression. These results show that RXN may have a synergistic effect by strongly protecting hearing and vestibular dysfunction induced by CDDP by inhibiting ROS production, mitochondrial pathways and the ERK pathway, without interfering with CDDP pharmacokinetics. Therefore, RXN could potentially be used to reduce CDDP-related hearing loss and dizziness.
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Shafik AG, Elkabarity RH, Thabet MT, Soliman NB, Kalleny NK. Effect of intratympanic dexamethasone administration on cisplatin-induced ototoxicity in adult guinea pigs. Auris Nasus Larynx 2013; 40:51-60. [DOI: 10.1016/j.anl.2012.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 05/15/2012] [Accepted: 05/23/2012] [Indexed: 12/13/2022]
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Abstract
A variety of drugs in veterinary use have side effects that can potentially damage the senses of hearing or balance in animals. A large body of literature exists on the incidence and mechanisms of ototoxicity in experimental animals and in humans, but little is documented in domestic dogs and cats. However, the generality of these adverse actions across species allows one to extrapolate and provide the veterinarian with insight into possible complications of chemotherapy.
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Walnut consumption protects rats against cisplatin-induced neurotoxicity. Neurotoxicology 2012; 33:1314-21. [DOI: 10.1016/j.neuro.2012.08.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 08/14/2012] [Accepted: 08/15/2012] [Indexed: 01/13/2023]
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Waissbluth S, Salehi P, He X, Daniel SJ. Systemic dexamethasone for the prevention of cisplatin-induced ototoxicity. Eur Arch Otorhinolaryngol 2012; 270:1597-605. [DOI: 10.1007/s00405-012-2150-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 07/25/2012] [Indexed: 12/20/2022]
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Brock PR, Knight KR, Freyer DR, Campbell KCM, Steyger PS, Blakley BW, Rassekh SR, Chang KW, Fligor BJ, Rajput K, Sullivan M, Neuwelt EA. Platinum-induced ototoxicity in children: a consensus review on mechanisms, predisposition, and protection, including a new International Society of Pediatric Oncology Boston ototoxicity scale. J Clin Oncol 2012; 30:2408-17. [PMID: 22547603 DOI: 10.1200/jco.2011.39.1110] [Citation(s) in RCA: 251] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The platinum chemotherapy agents cisplatin and carboplatin are widely used in the treatment of adult and pediatric cancers. Cisplatin causes hearing loss in at least 60% of pediatric patients. Reducing cisplatin and high-dose carboplatin ototoxicity without reducing efficacy is important. PATIENTS AND METHODS This review summarizes recommendations made at the 42nd Congress of the International Society of Pediatric Oncology (SIOP) in Boston, October 21-24, 2010, reflecting input from international basic scientists, pediatric oncologists, otolaryngologists, oncology nurses, audiologists, and neurosurgeons to develop and advance research and clinical trials for otoprotection. RESULTS Platinum initially impairs hearing in the high frequencies and progresses to lower frequencies with increasing cumulative dose. Genes involved in drug transport, metabolism, and DNA repair regulate platinum toxicities. Otoprotection can be achieved by acting on several these pathways and generally involves antioxidant thiol agents. Otoprotection is a strategy being explored to decrease hearing loss while maintaining dose intensity or allowing dose escalation, but it has the potential to interfere with tumoricidal effects. Route of administration and optimal timing relative to platinum therapy are critical issues. In addition, international standards for grading and comparing ototoxicity are essential to the success of prospective pediatric trials aimed at reducing platinum-induced hearing loss. CONCLUSION Collaborative prospective basic and clinical trial research is needed to reduce the incidence of irreversible platinum-induced hearing loss, and optimize cancer control. Wide use of the new internationally agreed-on SIOP Boston ototoxicity scale in current and future otoprotection trials should help facilitate this goal.
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Affiliation(s)
- Penelope R Brock
- Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom
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Shabani M, Larizadeh MH, Parsania S, Hajali V, Shojaei A. Evaluation of destructive effects of exposure to cisplatin during developmental stage: no profound evidence for sex differences in impaired motor and memory performance. Int J Neurosci 2012; 122:439-48. [PMID: 22416800 DOI: 10.3109/00207454.2012.673515] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We have elucidated the alteration in hippocampal and cerebellum function following chronic cisplatin treatment in male and female rats. Hippocampus and cerebellum related behavioral dysfunction in cisplatin-treated [intraperitoneally, 5 mg/(kg/week) for 5 weeks from 23-day-old] rats were analyzed using explorative, motor function, learning, and memory tasks (grasping, rotarod, open field, and Morris water maze tests). Exposure to cisplatin impaired the motor coordination in male and female rats. Exposure to cisplatin was reflected by a decrease in grasping time compared to vehicle-treated controls (saline) only in male rat while there were not any differences in female rats. When the rearing frequency, total distance moved and velocity of their recorded in open fieldtest, both males and females were dramatically affected by exposure to cisplatin. Compared to the saline, male and female rats trained 5 weeks after cisplatin injection showed significant memory deficits in the Morris water maze test. However, hippocampal and cerebellum functions of male and female rats were profoundly affected by exposure to cisplatin while no sex differences in the most variable were evident.
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Affiliation(s)
- Mohammad Shabani
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
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Mukherjea D, Rybak LP, Sheehan KE, Kaur T, Ramkumar V, Jajoo S, Sheth S. The design and screening of drugs to prevent acquired sensorineural hearing loss. Expert Opin Drug Discov 2011; 6:491-505. [PMID: 22646075 DOI: 10.1517/17460441.2011.562887] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Sensorineural hearing loss affects a high percentage of the population. Ototoxicity is a serious and pervasive problem in patients treated with cisplatin. Strategies to ameliorate ototoxicity without compromising on antitumor activity of treatments are urgently needed. Similar problems occur with aminoglycoside antibiotic therapy for infections. Noise-induced hearing loss affects a large number of people. The use of ear protection is not always possible or effective. The prevention of hearing loss with drug therapy would have a huge impact in reducing the number of people with hearing loss from these major causes. AREAS COVERED This review discusses significant research findings dealing with the use of protective agents against hearing loss caused by cisplatin, aminoglycoside antibiotics and noise trauma. The efficacy in animal studies and the application of these protective agents in clinical trials that are ongoing are presented. EXPERT OPINION The reader will gain new insights into current and projected future strategies to prevent sensorineural hearing loss from cisplatin chemotherapy, aminoglycoside antibiotic therapy and noise exposure. The future appears to offer numerous agents to prevent hearing loss caused by cisplatin, aminoglycoside antibiotics and noise. Novel delivery systems will provide ways to guide these protective agents to the desired target areas in the inner ear and circumvent problems with therapeutic interference of antitumor and antibiotics agents as well as minimize undesired side effects.
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Affiliation(s)
- Debashree Mukherjea
- Southern Illinois University, School of Medicine, Department of Surgery , P.O. Box 19653, Springfield, IL 62794-9653 , USA
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