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Hui Z, Pan X, Li Y, Zhang C, Zuo X, Tang J, Wang Y, Qiu N, Zheng S, Ye X, Hu R, Song D, Fang W, Yang J, Yan G. Dynamic carboxymethyl chitosan prodrug hydrogel precisely mediates robust therapy on wound infection. Int J Biol Macromol 2024; 260:129529. [PMID: 38237819 DOI: 10.1016/j.ijbiomac.2024.129529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/28/2023] [Accepted: 01/13/2024] [Indexed: 02/28/2024]
Abstract
Dynamic antibacterial polysaccharide prodrug hydrogels are in great demand for treatment of wound infection owing to their unique advantages such as excellent biocompatibility, superior antimicrobial property as well as favorable wound healing capacity. Herein, this work highlights the successful development of a dynamic carboxymethyl chitosan (CMC) prodrug hydrogel, which is facilely constructed through Schiffer base reaction between antibacterial components (amikacin and CMC) and crosslinker (dialdehyde PEG). Moderate dynamic imine linkages endow the hydrogel with excellent injectable and self-healing capability as well as targeted on-demand drug release in slightly alkaline condition at infected wound. All ingredients and their strong intermolecular interactions endow the hydrogel with favorable swelling and moisture retention capability. Moreover, the covalent and non-covalent interactions also endow the hydrogel with superior adhesion and mechanical property. These attractive characteristics enable hydrogel to effectively kill pathogens, promote wound healing and reduce side effects of amikacin. Thereby, such a dynamic CMC prodrug hydrogel may open a new avenue for a robust therapy on wound infection, greatly advancing their use in clinics.
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Affiliation(s)
- Zhenzhen Hui
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China; Anhui Province Quartz Sand Purification and Photovoltaic Glass Engineering Research Center, Fengyang, Anhui 233100, China
| | - Xinyuan Pan
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Ying Li
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Chensong Zhang
- Department of Oncology Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, China
| | - Xuzhong Zuo
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Jing Tang
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Yanping Wang
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Nannan Qiu
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Shengbiao Zheng
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Xiangju Ye
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Ruizhang Hu
- College of Chemistry and Materials Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Dongpo Song
- School of Materials Science and Engineering, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu 212003, China
| | - Wei Fang
- School of Life Science, Anhui University, Hefei, Anhui 230601, China.
| | - Jie Yang
- School of Materials Science and Engineering, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu 212003, China.
| | - Guoqing Yan
- School of Life Science, Anhui University, Hefei, Anhui 230601, China.
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Reynard P, Thai-Van H. Drug-induced hearing loss: Listening to the latest advances. Therapie 2024; 79:283-295. [PMID: 37957052 DOI: 10.1016/j.therap.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023]
Abstract
Sensorineural hearing loss (SNHL) is the most common type of hearing loss. Causes include degenerative changes in the sensory hair cells, their synapses and/or the cochlear nerve. As human inner ear hair cells have no capacity for regeneration, their destruction is irreversible and leads to permanent hearing loss. SNHL can be genetically inherited or acquired through ageing, exposure to noise or ototoxic drugs. Ototoxicity generally refers to damage to the structures and functions of the inner ear following exposure to specific drugs. Ototoxicity can be multifactorial, causing damage to cochlear hair cells or cells with homeostatic functions that modulate cochlear hair cell function. Clinical strategies to limit ototoxicity include identifying patients at risk, monitoring drug concentrations, performing serial hearing assessments and switching to less ototoxic therapy. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the PubMed® database. The search terms "ototoxicity", "hearing loss" and "drugs" were combined. We included studies published between September 2013 and June 2023, and focused on medicines and drugs used in hospitals. The review highlighted a number of articles reporting the main drug classes potentially involved: namely, immunosuppressants, antimalarials, vaccines, antibiotics, antineoplastic agents, diuretics, nonsteroidal anti-inflammatory drugs and analgesics. The presumed ototoxic mechanisms were described, together with the therapeutic and preventive options developed over the last ten years.
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Affiliation(s)
- Pierre Reynard
- Service d'audiologie & explorations oto-neurologiques, hospices civils de Lyon, hôpital Edouard-Herriot & hôpital Femme Mère-Enfant, 69000 Lyon, France; Institut Pasteur, Institut de l'Audition, Center for Research and Innovation in Human Audiology, 75000 Paris, France; Université Claude Bernard Lyon 1, 69622 Villeurbanne, France
| | - Hung Thai-Van
- Service d'audiologie & explorations oto-neurologiques, hospices civils de Lyon, hôpital Edouard-Herriot & hôpital Femme Mère-Enfant, 69000 Lyon, France; Institut Pasteur, Institut de l'Audition, Center for Research and Innovation in Human Audiology, 75000 Paris, France; Université Claude Bernard Lyon 1, 69622 Villeurbanne, France.
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Sparg T, Petersen L, Mayers P, Rogers C. South African adolescents' lived experiences of acquired hearing loss following multidrug-resistant tuberculosis treatment. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1336346. [PMID: 38469378 PMCID: PMC10925655 DOI: 10.3389/fresc.2024.1336346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/10/2024] [Indexed: 03/13/2024]
Abstract
Objective The impact of acquiring hearing loss might be exacerbated during adolescence, as this normal transition from childhood to adulthood is characterised by identity construction and social intensity. This study aimed to describe the lived experiences of South African adolescents with acquired hearing loss following aminoglycoside treatment for multidrug resistant tuberculosis. Design The study adopted a descriptive phenomenological design and in-depth, semi-structured interviews were conducted in English, isiZulu and Afrikaans. The data was managed and analysed according to a modified version of Hycner's framework. Study sample Six participants aged 16-24 years with bilateral, mild to profound hearing loss acquired from aminoglycoside treatment were recruited from two South African provinces. Results Three themes emerged which created a triple burden for participants. They endured socio-economic hardship encompassing limited economic and emotional support. Participants battled the consequences of life-threatening MDR-TB including illness, hospitalisation, stigma, and other challenges. Finally, participants were left with life-changing hearing loss. Conclusion The findings indicate the necessity of holistic management of adolescents with aminoglycoside-related acquired hearing loss and serves as motivation to improve ototoxic monitoring practices and patient uptake of monitoring services and calls for the cessation, or at least cautious use, of aminoglycosides.
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Affiliation(s)
- Tarryn Sparg
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucretia Petersen
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pat Mayers
- Division of Nursing and Midwifery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Christine Rogers
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Prasad K, Borre ED, Dillard LK, Ayer A, Der C, Bainbridge KE, McMahon CM, Tucci DL, Wilson BS, Schmidler GDS, Saunders J. Priorities for hearing loss prevention and estimates of global cause-specific burdens of hearing loss: a systematic rapid review. Lancet Glob Health 2024; 12:e217-e225. [PMID: 38245112 DOI: 10.1016/s2214-109x(23)00514-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/16/2023] [Accepted: 10/26/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Hearing loss affects approximately 1·6 billion individuals worldwide. Many cases are preventable. We aimed to estimate the annual number of new hearing loss cases that could be attributed to meningitis, otitis media, congenital rubella syndrome, cytomegalovirus, and ototoxic medications, specifically aminoglycosides, platinum-based chemotherapeutics, and antimalarials. METHODS We used a targeted and a rapid systematic literature review to calculate yearly global incidences of each cause of hearing loss. We estimated the prevalence of hearing loss for each presumed cause. For each cause, we calculated the global number of yearly hearing loss cases associated with the exposure by multiplying the estimated exposed population by the prevalence of hearing loss associated with the exposure, accounting for mortality when warranted. FINDINGS An estimated 257·3 million people per year are exposed to these preventable causes of hearing loss, leading to an estimated 33·8 million new cases of hearing loss worldwide per year. Most hearing loss cases were among those with exposure to ototoxic medications (19·6 million [range 12·6 million-27·9 million] from short-course aminoglycoside therapy and 12·3 million from antimalarials). We estimated that 818 000 cases of hearing loss were caused by otitis media, 346 000 by meningitis, 114 000 by cytomegalovirus, and 59 000 by congenital rubella syndrome. INTERPRETATION The global burden of preventable hearing loss is large. Hearing loss that is attributable to disease sequelae or ototoxic medications contributes substantially to the global burden of hearing loss. Prevention of these conditions should be a global health priority. FUNDING The US National Institute on Deafness and Other Communication Disorders and the US National Institute on Aging.
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Affiliation(s)
- Kavita Prasad
- Tufts University School of Medicine, Boston, MA, USA
| | - Ethan D Borre
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren K Dillard
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Austin Ayer
- University of California San Diego, San Diego, CA, USA
| | - Carolina Der
- Facultad de Medicina Universidad del Desarrollo, Clínica Alemana de Santiago, Santiago, Chile
| | - Kathleen E Bainbridge
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | | | - Debara L Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Blake S Wilson
- Duke Global Health Institute, Duke University, Durham, NC, USA; Department of Electrical & Computer Engineering, Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA; Department of Surgery, Geisel School of Medicine, Dartmouth University, Lebanon, NH, USA
| | - Gillian D Sanders Schmidler
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA; Duke-Margolis Center for Health Policy, Durham, NC, USA
| | - James Saunders
- Duke-Margolis Center for Health Policy, Durham, NC, USA.
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Lee J, Fernandez K, Cunningham LL. Hear and Now: Ongoing Clinical Trials to Prevent Drug-Induced Hearing Loss. Annu Rev Pharmacol Toxicol 2024; 64:211-230. [PMID: 37562496 DOI: 10.1146/annurev-pharmtox-033123-114106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Each year over half a million people experience permanent hearing loss caused by treatment with therapeutic drugs with ototoxic side effects. There is a major unmet clinical need for therapies that protect against this hearing loss without reducing the therapeutic efficacy of these lifesaving drugs. At least 17 clinical trials evaluating 10 therapeutics are currently underway for therapies aimed at preventing aminoglycoside- and/or cisplatin-induced ototoxicity. This review describes the preclinical and clinical development of each of these approaches, provides updates on the status of ongoing trials, and highlights the importance of appropriate outcome measures in trial design and the value of reporting criteria in the dissemination of results.
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Affiliation(s)
- John Lee
- Laboratory of Hearing Biology and Therapeutics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA;
| | - Katharine Fernandez
- Laboratory of Hearing Biology and Therapeutics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA;
| | - Lisa L Cunningham
- Laboratory of Hearing Biology and Therapeutics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA;
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Zhu K, Wang T, Li S, Liu Z, Zhan Y, Zhang Q. NcRNA: key and potential in hearing loss. Front Neurosci 2024; 17:1333131. [PMID: 38298898 PMCID: PMC10827912 DOI: 10.3389/fnins.2023.1333131] [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: 11/04/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024] Open
Abstract
Hearing loss has an extremely high prevalence worldwide and brings incredible economic and social burdens. Mechanisms such as epigenetics are profoundly involved in the initiation and progression of hearing loss and potentially yield definite strategies for hearing loss treatment. Non-coding genes occupy 97% of the human genome, and their transcripts, non-coding RNAs (ncRNAs), are widely participated in regulating various physiological and pathological situations. NcRNAs, mainly including micro-RNAs (miRNAs), long-stranded non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), are involved in the regulation of cell metabolism and cell death by modulating gene expression and protein-protein interactions, thus impacting the occurrence and prognosis of hearing loss. This review provides a detailed overview of ncRNAs, especially miRNAs and lncRNAs, in the pathogenesis of hearing loss. We also discuss the shortcomings and issues that need to be addressed in the study of hearing loss ncRNAs in the hope of providing viable therapeutic strategies for the precise treatment of hearing loss.
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Affiliation(s)
- Keyu Zhu
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Sicheng Li
- Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zeming Liu
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhan
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Zhang
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Han L, Wang Z, Wang D, Gao Z, Hu S, Shi D, Shu Y. Mechanisms and otoprotective strategies of programmed cell death on aminoglycoside-induced ototoxicity. Front Cell Dev Biol 2024; 11:1305433. [PMID: 38259515 PMCID: PMC10800616 DOI: 10.3389/fcell.2023.1305433] [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: 10/01/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Aminoglycosides are commonly used for the treatment of life-threatening bacterial infections, however, aminoglycosides may cause irreversible hearing loss with a long-term clinical therapy. The mechanism and prevention of the ototoxicity of aminoglycosides are still limited although amounts of studies explored widely. Specifically, advancements in programmed cell death (PCD) provide more new perspectives. This review summarizes the general signal pathways in programmed cell death, including apoptosis, autophagy, and ferroptosis, as well as the mechanisms of aminoglycoside-induced ototoxicity. Additionally, novel interventions, especially gene therapy strategies, are also investigated for the prevention or treatment of aminoglycoside-induced hearing loss with prospective clinical applications.
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Affiliation(s)
- Lei Han
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Zijing Wang
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Daqi Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Ziwen Gao
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Shaowei Hu
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Dazhi Shi
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Yilai Shu
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
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Li G, Gao Y, Wu H, Zhao T. Gentamicin administration leads to synaptic dysfunction in inner hair cells. Toxicol Lett 2024; 391:86-99. [PMID: 38101494 DOI: 10.1016/j.toxlet.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/17/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
Ototoxicity is a major side effect of aminoglycosides, which can cause irreversible hearing loss. Previous studies on aminoglycoside-induced ototoxicity have primarily focused on the loss of sensory hair cells. Recent investigations have revealed that aminoglycosides can also lead to the loss of ribbon synapses in inner hair cells (IHCs). However, the functional implications of ribbon synapse loss and the underlying mechanisms remain unclear. In this study, we intraperitoneally injected C57BL/6 J mice with 300 mg/kg gentamicin once daily for 3, 10, and 20 days. Then, we performed immunofluorescence staining, patch-clamp recording, proteomics analysis and western blotting to characterize the changes in ribbon synapses in IHCs and the associated mechanisms. After gentamicin treatment, the auditory brainstem response (ABR) threshold was elevated, and the ABR wave I amplitude was decreased. We also observed loss of ribbon synapses in IHCs. Interestingly, ribbon synapse loss occurred on both the modiolar and pillar sides of IHCs. Whole-cell patch-clamp recordings in IHCs revealed a reduction in the calcium current amplitude, along with a shifted half-activation voltage and altered calcium voltage dependency. Moreover, exocytosis of IHCs was reduced, consistent with the reduction in the ABR wave I amplitude. Through proteomic analysis, western blotting, and immunofluorescence staining, we found that gentamicin treatment resulted in downregulation of myosin VI, a protein crucial for synaptic vesicle recycling and replenishment in IHCs. Furthermore, we evaluated the kinetics of endocytosis and found a significant reduction in IHC exocytosis, possibly reflecting the impact of myosin VI downregulation on synaptic vesicle recycling. In summary, our findings demonstrate that gentamicin treatment leads to synaptic dysfunction in IHCs, highlighting the important role of myosin VI downregulation in gentamicin-induced synaptic damage.
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Affiliation(s)
- Gen Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yunge Gao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Ting Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
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9
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Iruedo JO, Pather MK. Time-to-Treatment Initiation in a Decentralised Community-Care Model of Drug-Resistant Tuberculosis Management in the OR Tambo District Municipality of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6423. [PMID: 37510655 PMCID: PMC10379855 DOI: 10.3390/ijerph20146423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB) continues to challenge global efforts toward eradicating and having a tuberculosis-free world. Considering the high early mortality, especially among HIV-infected individuals, early diagnosis and prompt initiation of effective treatment are needed to significantly reduce mortality and halt transmission of DR-TB in the community. AIM This study aims to assess the effectiveness of a community DR-TB care model with the specific objective of determining the Time-to-treatment initiation of DR-TB among patients in the OR Tambo district municipality. METHODS A prospective cohort study of patients with DR-TB was conducted in the OR Tambo district municipality of Eastern Cape Province, South Africa. Patients were enrolled as they presented for treatment initiation at the decentralised facilities following a diagnosis of DR-TB and compared with a centralised site. RESULTS A total of 454 DR-TB patients from six facilities between 2018 and 2020 were included in the analysis. The mean age was 37.54 (SD = 14.94) years. There were slightly more males (56.2%) than females (43.8%). Most of the patients were aged 18-44 years (67.5%), without income (82.3%). Results showed that slightly over thirteen percent (13.4%) of patients initiated treatment the same day they were diagnosed with DR-TB, while 36.3% were on the time-to-treatment target of being initiated within 5 days. However, about a quarter (25.8%) of patients failed to initiate treatment two weeks after diagnosis. Time-to-treatment initiation (TTTI) varied according to the decentralised sites, with progressive improvement with each successive year between 2018 and 2021. No demographic factor was significantly associated with TTTI. CONCLUSION Despite rapid diagnosis, only 36% of patients were initiated on treatment promptly. Operational challenges remained, and services needed to be reorganised to maximise the exceptional potentials that a decentralised community DR-TB care model brings.
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Affiliation(s)
- Joshua Oise Iruedo
- Division Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Michael K Pather
- Division Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
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10
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Kim M, Park DH, Choi H, Song I, Lim KH, Yoon HS, Rah YC, Choi J. A Multicenter Cohort Study on the Association between Metformin Use and Hearing Loss in Patients with Type 2 Diabetes Mellitus Using a Common Data Model. J Clin Med 2023; 12:jcm12093145. [PMID: 37176586 PMCID: PMC10179543 DOI: 10.3390/jcm12093145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
We attempted to explore the association between metformin use and hearing loss in in a large-scale study. This retrospective multicenter cohort study assessed the data of patients with type 2 diabetes mellitus (DM) aged over 40 years using the Observational Health Data Science and Informatics open-source software and the Common Data Model database from 1 January 2002 to 31 December 2019. Each participant was selected using the ICD-10-CM diagnosis code E11 for type 2 DM with sensorineural hearing loss. The participants were divided into metformin and non-metformin users. The outcome measure was the first occurrence of hearing loss after the diagnosis of DM as measured by the CDM cohort study. A total of 80,596 patients, including 46,152 metformin users and 34,444 non-metformin users from three hospitals were assessed. After calibration, we compared the risk of hearing loss using Kaplan-Meier curves, and found significant differences between the groups. The calibrated hazard ratio in the three hospitals (0.79 [95% confidence interval, 0.57-1.12]) was summarized. These findings suggest that the probability of hearing loss-free survival in the metformin user group is higher than that in the non-metformin user group.
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Affiliation(s)
- Minjin Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul 02842, Republic of Korea
- Medical Science Research Center, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Dong Heun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Hangseok Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul 02842, Republic of Korea
- Medical Science Research Center, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Insik Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Kang Hyeon Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Hee Soo Yoon
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - June Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
- Department of Medical Informatics, Korea University College of Medicine, Seoul 02842, Republic of Korea
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11
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Freimane L, Barkāne L, Kivrane A, Sadovska D, Ulanova V, Ranka R. Assessment of Amikacin- and Capreomycin-Related Adverse Drug Reactions in Patients with Multidrug-Resistant Tuberculosis and Exploring the Role of Genetic Factors. J Pers Med 2023; 13:jpm13040599. [PMID: 37108985 PMCID: PMC10145258 DOI: 10.3390/jpm13040599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
Following the introduction of all-oral treatment regimens for patients with drug-resistant tuberculosis (TB), second-line injectable drug applications have been reduced in the last few years. However, they are still important for anti-TB therapy. This study aims to analyze the occurrence of amikacin- and capreomycin-related adverse drug reactions (ADR) in patients with multidrug-resistant tuberculosis (MDR-TB) and evaluate the role of multiple patient-, disease-, and therapy-related factors on the frequency of the observed adverse events. In addition, the possible role of genetic risk factors was studied by full-length mitochondrial DNA sequencing. Toward this aim, we retrospectively evaluated 47 patients with MDR-TB who received amikacin and/or capreomycin. In total, 16 (34.0%) patients developed ototoxicity and 13 (27.7%) developed nephrotoxicity, including 3 (6.4%) patients who experienced both adverse events. Ototoxicity development was more common in patients who received amikacin. No other factors showed a significant impact. Nephrotoxicity was likely associated with previous renal health impairment. Full mitochondrial genome sequencing did not reveal any specific ADR-associated variants, and results showed no differences in adverse event occurrence for any specific variants, mutation count, or mitochondrial haplogroup. The absence of the previously reported ototoxicity-related mtDNA variants in our patients with ototoxicity and nephrotoxicity highlighted the complex nature of the ADR occurrence.
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Dheda K, Lange C. A revolution in the management of multidrug-resistant tuberculosis. Lancet 2022; 400:1823-1825. [PMID: 36368335 DOI: 10.1016/s0140-6736(22)02161-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, and UCT Lung Institute and South African MRC-UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town 7935, South Africa; Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, UK.
| | - Christoph Lange
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research, Clinical Tuberculosis Unit, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany; Global TB Program, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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13
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Mitochondrial tRNAGln 4394C>T Mutation May Contribute to the Clinical Expression of 1555A>G-Induced Deafness. Genes (Basel) 2022; 13:genes13101794. [PMID: 36292680 PMCID: PMC9602358 DOI: 10.3390/genes13101794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
The mitochondrial 1555A>G mutation plays a critical role in aminoglycoside-induced and non-syndromic hearing loss (AINSHL). Previous studies have suggested that mitochondrial secondary variants may modulate the clinical expression of m.1555A>G-induced deafness, but the molecular mechanism has remained largely undetermined. In this study, we investigated the contribution of a deafness-associated tRNAGln 4394C>T mutation to the clinical expression of the m.1555A>G mutation. Interestingly, a three-generation family with both the m.1555A>G and m.4394C>T mutations exhibited a higher penetrance of hearing loss than another family harboring only the m.1555A>G mutation. At the molecular level, the m.4394C>T mutation resides within a very conserved nucleotide of tRNAGln, which forms a new base-pairing (7T-66A) and may affect tRNA structure and function. Using trans-mitochondrial cybrid cells derived from three subjects with both the m.1555A>G and m.4394C>T mutations, three patients with only the m.1555A>G mutation and three control subjects without these primary mutations, we observed that cells with both the m.1555A>G and m.4394C>T mutations exhibited more severely impaired mitochondrial functions than those with only the m.1555A>G mutation. Furthermore, a marked decrease in mitochondrial RNA transcripts and respiratory chain enzymes was observed in cells harboring both the m.1555A>G and m.4394C>T mutations. Thus, our data suggest that the m.4394C>T mutation may play a synergistic role in the m.1555A>G mutation, enhancing mitochondrial dysfunctions and contributing to a high penetrance of hearing loss in families with both mtDNA pathogenic mutations.
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Yue F, Liu M, Bai M, Hu M, Li F, Guo Y, Vrublevsky I, Sun X. Novel Electrochemical Aptasensor Based on Ordered Mesoporous Carbon/2D Ti3C2 MXene as Nanocarrier for Simultaneous Detection of Aminoglycoside Antibiotics in Milk. BIOSENSORS 2022; 12:bios12080626. [PMID: 36005022 PMCID: PMC9405622 DOI: 10.3390/bios12080626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Abstract
Herein, a novel electrochemical aptasensor using a broad-spectrum aptamer as a biorecognition element was constructed based on a screen-printed carbon electrode (SPCE) for simultaneous detection of aminoglycoside antibiotics (AAs). The ordered mesoporous carbon (OMC) was firstly modified on 2D Ti3C2 MXene. The addition of OMC not only effectively improved the stability of the aptasensor, but also prevented the stacking of Ti3C2 sheets, which formed a good current passage for signal amplification. The prepared OMC@Ti3C2 MXene functioned as a nanocarrier to accommodate considerable aptamers. In the presence of AAs, the transport of electron charge on SPCE surface was influenced by the bio-chemical reactions of the aptamer and AAs, generating a significant decline in the differential pulse voltammetry (DPV) signals. The proposed aptasensor presented a wide linear range and the detection limit was 3.51 nM. Moreover, the aptasensor, with satisfactory stability, reproducibility and specificity, was successfully employed to detect the multi-residuals of AAs in milk. This work provided a novel strategy for monitoring AAs in milk.
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Affiliation(s)
- Fengling Yue
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
| | - Mengyue Liu
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
| | - Mengyuan Bai
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
| | - Mengjiao Hu
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
| | - Falan Li
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
- Shandong Provincial Engineering Research Center of Vegetable Safety and Quality Traceability, Zibo 255049, China
- Zibo City Key Laboratory of Agricultural Product Safety Traceability, Zibo 255049, China
| | - Yemin Guo
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
- Shandong Provincial Engineering Research Center of Vegetable Safety and Quality Traceability, Zibo 255049, China
- Zibo City Key Laboratory of Agricultural Product Safety Traceability, Zibo 255049, China
| | - Igor Vrublevsky
- Department of Information Security, Belarusian State University of Informatics and Radioelectronics, 220013 Minsk, Belarus
| | - Xia Sun
- School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo 255049, China
- Shandong Provincial Engineering Research Center of Vegetable Safety and Quality Traceability, Zibo 255049, China
- Zibo City Key Laboratory of Agricultural Product Safety Traceability, Zibo 255049, China
- Correspondence: ; Tel.: +86-0533-2786558
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15
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Borre ED, Ayer A, Der C, Ibekwe T, Emmett SD, Dixit S, Shahid M, Olusanya B, Garg S, Johri M, Saunders JE, Tucci DL, Wilson BS, Ogbuoji O, Sanders Schmidler GD. Validation of the Decision model of the Burden of Hearing loss Across the Lifespan (DeciBHAL) in Chile, India, and Nigeria. EClinicalMedicine 2022; 50:101502. [PMID: 35770254 PMCID: PMC9234074 DOI: 10.1016/j.eclinm.2022.101502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background There is no published decision model for informing hearing health care resource allocation across the lifespan in low- and middle-income countries. We sought to validate the Decision model of the Burden of Hearing loss Across the Lifespan International (DeciBHAL-I) in Chile, India, and Nigeria. Methods DeciBHAL-I simulates bilateral sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) acquisition, SNHL progression, and hearing loss treatment. To inform model inputs, we identified setting-specific estimates including SNHL prevalence from the Global Burden of Disease (GBD) studies, acute otitis media (AOM) incidence and prevalence of otitis-media related CHL from a systematic review, and setting-specific pediatric and adult hearing aid use prevalence. We considered a coefficient of variance root mean square error (CV-RMSE) of ≤15% to indicate good model fit. Findings The model-estimated prevalence of bilateral SNHL closely matched GBD estimates, (CV-RMSEs: 3.2-7.4%). Age-specific AOM incidences from DeciBHAL-I also achieved good fit (CV-RMSEs=5.0-7.5%). Model-projected chronic suppurative otitis media prevalence (1.5% in Chile, 4.9% in India, and 3.4% in Nigeria) was consistent with setting-specific estimates, and the incidence of otitis media-related CHL was calibrated to attain adequate model fit. DeciBHAL-projected adult hearing aid use in Chile (3.2-19.7% ages 65-85 years) was within the 95% confidence intervals of published estimates. Adult hearing aid prevalence from the model in India was 1.4-2.3%, and 1.1-1.3% in Nigeria, consistent with literature-based and expert estimates. Interpretation DeciBHAL-I reasonably simulates hearing loss natural history, detection, and treatment in Chile, India, and Nigeria. Future cost-effectiveness analyses might use DeciBHAL-I to inform global hearing health policy. Funding National Institutes of Health (3UL1-TR002553-03S3 and F30 DC019846).
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Affiliation(s)
- Ethan D. Borre
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham NC, USA
| | - Austin Ayer
- Duke University School of Medicine, Durham, NC, USA
| | - Carolina Der
- Facultad de Medicina Universidad del Desarrollo, Clínica Alemana de Santiago, Santiago, Chile
| | - Titus Ibekwe
- Department of Ear, Nose and Throat, Head & Neck, University of Abuja Teaching Hospital, Gwagwalada Abuja, Nigeria
| | - Susan D. Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Siddharth Dixit
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham NC, USA
| | - Minahil Shahid
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham NC, USA
| | | | - Suneela Garg
- Maulana Azad Medical College and Associated Hospitals, New Delhi, India
| | - Mohini Johri
- Duke-Margolis Center for Health Policy, Duke University, Durham NC, USA
| | - James E. Saunders
- Department of Surgery, Geisel School of Medicine, Dartmouth University, Lebanon, NH, USA
| | - Debara L. Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Blake S. Wilson
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
- Department of Electrical & Computer Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Osondu Ogbuoji
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham NC, USA
| | - Gillian D. Sanders Schmidler
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham NC, USA
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16
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Wu EL, Al-Heeti O, Hoff BM, Williams JL, Krueger KM, Santoiemma PP, Rhodes NJ. Role of Therapeutic Drug Monitoring in the Treatment of Persistent Mycobacterium abscessus Central Nervous System Infection: A Case Report and Review of the Literature. Open Forum Infect Dis 2022; 9:ofac392. [PMID: 35983263 PMCID: PMC9379816 DOI: 10.1093/ofid/ofac392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022] Open
Abstract
A patient presenting with recurrent ventriculoperitoneal shunt infection was found to have Mycobacterium abscessus growing from cerebrospinal fluid (CSF), which remained persistently positive. Therapeutic monitoring of clarithromycin, imipenem, and linezolid in CSF and plasma revealed lower than expected concentrations, prompting alternative therapy and culture clearance on hospital day 42.
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Affiliation(s)
- En-Ling Wu
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Omar Al-Heeti
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian M Hoff
- Department of Pharmacy, Loyola University Medical Center, Maywood, Illinois, USA
| | - Janna L Williams
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karen M Krueger
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Phillip P Santoiemma
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nathaniel J Rhodes
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Downers Grove Campus, Downers Grove, Illinois, USA
- Pharmacometrics Center of Excellence, Midwestern University College of Pharmacy, Downers Grove Campus, Downers Grove, Illinois, USA
- Department of Pharmacy, Northwestern Medicine, Chicago, Illinois, USA
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17
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Dillard LK, Lopez-Perez L, Martinez RX, Fullerton AM, Chadha S, McMahon CM. Global burden of ototoxic hearing loss associated with platinum-based cancer treatment: A systematic review and meta-analysis. Cancer Epidemiol 2022; 79:102203. [PMID: 35724557 PMCID: PMC9339659 DOI: 10.1016/j.canep.2022.102203] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 11/06/2022]
Abstract
Platinum-based chemotherapeutic agents cisplatin and carboplatin are widely used in cancer treatment worldwide and may result in ototoxic hearing loss. The high incidence of cancer and salient ototoxic effects of platinum-based compounds pose a global public health threat. The purpose of this study was twofold. First, to estimate the prevalence of ototoxic hearing loss associated with treatment with cisplatin and/or carboplatin via a systematic review and meta-analysis. Second, to estimate the annual global burden of ototoxic hearing loss associated with exposure to cisplatin and/or carboplatin. For the systematic review, three databases were searched (Ovid Medline, Ovid Embase, and Web of Science Core Collection) and studies that reported prevalence of objectively measured ototoxic hearing loss in cancer patients were included. A random effects meta-analysis determined pooled prevalence (95% confidence intervals [CI]) of ototoxic hearing loss overall, and estimates were stratified by treatment and patient attributes. Estimates of ototoxic hearing loss burden were created with published global estimates of incident cancers often treated with platinum-based compounds and cancer-specific treatment rates. Eighty-seven records (n = 5077 individuals) were included in the meta-analysis. Pooled prevalence of ototoxic hearing loss associated with cisplatin and/or carboplatin exposure was 43.17% [CI 37.93–48.56%]. Prevalence estimates were higher for regimens involving cisplatin (cisplatin only: 49.21% [CI 42.62–55.82%]; cisplatin & carboplatin: 56.05% [CI 45.12–66.43%]) versus carboplatin only (13.47% [CI 8.68–20.32%]). Our crude estimates of burden indicated approximately one million individuals worldwide are likely exposed to cisplatin and/or carboplatin, which would result in almost half a million cases of hearing loss per year, globally. There is an urgent need to reduce impacts of ototoxicity in cancer patients. This can be partially achieved by implementing existing strategies focused on primary, secondary, and tertiary hearing loss prevention. Primary ototoxicity prevention via otoprotectants should be a research and policy priority. An estimated one million people are exposed to chemotherapeutic drugs per year. An estimated half a million cases of hearing loss per year are from chemotherapy. Hearing loss prevalence after exposure to cisplatin and/or carboplatin is 43%. Primary, secondary and tertiary prevention of hearing loss should be prioritized. Ototoxic hearing loss prevention is a global public health priority.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States.
| | - Lucero Lopez-Perez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Ricardo X Martinez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Amanda M Fullerton
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | - Shelly Chadha
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
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18
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Abstract
PURPOSE OF REVIEW Diagnosis and treatment of drug-resistant tuberculosis (DR-TB) is undergoing substantial changes, owing availability of new diagnostic tools and drugs, coupled with global underdiagnosis and undertreatment. Recent developments are reviewed. RECENT FINDINGS Molecular diagnostics, for Mycobacterium tuberculosis complex detection and prediction of drug resistance, implemented in the last decade, accelerated TB diagnosis with improved case detection. Nevertheless, access and coverage of drug-resistance testing remain insufficient. Genome sequencing-technologies, based on targeted next-generation sequencing show early potential to mitigate some of the challenges in the future. The recommendation to use an all oral, bedaquiline based regimen for treatment of multidrug-resistant/rifampicin-resistant TB is major advancement in DR-TB care. TB regimen using new and repurposed TB drugs demonstrate in recent clinical trials like, NIX-TB, ZeNIX and TB PRACTECAL considerable treatment success, shorten treatment duration and reduce toxicity. Their optimal use is threatened by the rapid occurrence and spread of strains, resistant to new drugs. Children benefit only very slowly from the progress. SUMMARY There is notable progress in improved diagnosis and treatment of drug-resistant TB, but complicated by the COVID-19 pandemic the majority of TB patients worldwide don't have (yet) access to the advances.
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19
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Stevenson LJ, Biagio-de Jager L, Graham MA, Swanepoel DW. A longitudinal community-based ototoxicity monitoring programme and treatment effects for drug-resistant tuberculosis treatment, Western Cape. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e13. [PMID: 35384675 PMCID: PMC8991219 DOI: 10.4102/sajcd.v69i1.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background South Africa has a high burden of drug-resistant tuberculosis (DRTB) and until recently, ototoxic aminoglycosides were predominant in treatment regimens. Community-based ototoxicity monitoring programmes (OMPs) have been implemented for early detection of hearing loss and increased patient access. Objectives A longitudinal study was conducted to describe the service delivery characteristics of a community-based OMP for DRTB patients facilitated by CHWs as well as observed ototoxic hearing loss in this population. Method A descriptive retrospective record review of longitudinal ototoxicity monitoring of 194 DRTB patients undergoing treatment at community-based clinics in the city of Cape Town between 2013 and 2017. Results Follow-up rates between consecutive monitoring assessments reached as high as 80.6% for patients assessed by CHWs. Few patients (14.2% – 32.6%) were assessed with the regularity (≥ 6 assessments) and frequency required for effective ototoxicity monitoring, with assessments conducted, on average, every 53.4–64.3 days. Following DRTB treatment, 51.5% of patients presented with a significant ototoxic shift meeting one or more of the American Speech-Language-Hearing Association (ASHA) criteria. Deterioration in hearing thresholds was bilateral and most pronounced at high frequencies (4 kHz – 8 kHz). The presence of pre-existing hearing loss, human immunodeficiency virus co-infection and a history of noise exposure were significant predictors of ototoxicity in patients. Conclusion DRTB treatment with kanamycin resulted in significant deterioration of hearing longitudinally, predominantly at high frequencies. With ongoing training and supportive supervision, CHWs can facilitate community-based ototoxicity monitoring of DRTB patients. Current protocols and guidelines may require reassessment for appropriate community-based ototoxicity monitoring.
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Affiliation(s)
- Lucia J Stevenson
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria.
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20
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Mantefardo B, Sisay G. Case Report: Kanamycin Ototoxicity and MDR-TB Treatment Regimen. Int Med Case Rep J 2021; 14:815-817. [PMID: 34858067 PMCID: PMC8631973 DOI: 10.2147/imcrj.s336259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Aminoglycosides are ototoxic drugs because they have the ability to destroy the inner ear structures irreversibly. They are used to treat Gram-negative bacterial infections that are aerobic and as a second-line treatment for tuberculosis. Case Presentation A 40-year-old male from Dilla presented with right side chest pain and cough which is productive of whitish sputum of one-year duration, after investigation the diagnosis of multiple-drug resistant tuberculosis (MDR-TB) was made and the patient was started with a short-term MDR-TB treatment regimen (4–6 KM-Mf-Pto-Cfz-Z-HH-E/5Mfx-Cfz-Z-E). Two and half months after the initiation of treatment, he developed decreased bilateral hearing ability and he had also vertigo, but this patient has no hearing impairment before the initiation of the anti-TB treatment. Then the diagnosis of sensor neural hearing loss secondary to drug toxicity (kanamycin) was made. Then the treatment was discontinued for four days as a result of ototoxicity and the patient was referred to Yirgalem Hospital for further workup and management. Conclusion Injectable-containing MDR-TB regimens can cause permanent hearing loss. Hearing loss during treatment for MDR-TB with kanamycin can occur at any time. Systematic monitoring of AEs during and after the end of treatment needs to be strengthened in most TB programs. It is important to monitor for hearing loss and kidney function.
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Affiliation(s)
- Bahru Mantefardo
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Gizaw Sisay
- School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
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21
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Szczepek AJ, Stankovic KM. Editorial: Emerging Ototoxic Medications and Their Role in Cochlear and Vestibular Disorders. Front Neurol 2021; 12:773714. [PMID: 34744994 PMCID: PMC8569918 DOI: 10.3389/fneur.2021.773714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
| | - Kostantina M Stankovic
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
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22
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Dillard LK, Wu CZ, Saunders JE, McMahon CM. A scoping review of global aminoglycoside antibiotic overuse: A potential opportunity for primary ototoxicity prevention. Res Social Adm Pharm 2021; 18:3220-3229. [PMID: 34711521 DOI: 10.1016/j.sapharm.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Aminoglycosides are widely used, broad-spectrum antibiotics with significant potential for ototoxicity. Global efforts to prevent ototoxicity must account for aminoglycoside overuse and non-prescription use. OBJECTIVES The goals of this study were to a) estimate the prevalence of aminoglycoside overuse by synthesizing evidence on self-medication, over the counter (OTC) availability, and household antibiotic storage for later use, and to report the specific aminoglycosides used and the predictors of overuse, and b) leverage this information to comment on potential risk of ototoxicity. METHODS Two systematic search strings were conducted to extract peer-reviewed articles published from 2005 to 2020. The first focused on overuse of aminoglycoside antibiotics. The second focused on potentially ototoxic effects of aminoglycosides related to drug overuse. RESULTS A total of 26 articles were included (first search string: n = 21; second search string: n = 5). The prevalence of aminoglycoside self-medication was high and household storage and OTC availability of aminoglycosides was common. Gentamicin was the most commonly overused aminoglycoside. No studies provided information on antibiotic dosing or resultant toxicities, including ototoxicity. CONCLUSIONS The limited available evidence indicates that antibiotic overuse (self-medication, home storage, and non-prescription availability) is relatively common, especially in low resource settings, and that aminoglycoside antibiotics comprise a variable, but concerning, proportion of non-prescribed antibiotics. Additional evidence is needed to evaluate the relationship between these dispensing patterns and ototoxicity.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA.
| | - Cecilia Z Wu
- Mass General Brigham Home Care, Department of Staff Education, Waltham, MA, USA
| | - James E Saunders
- Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
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