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Fancello V, Fancello G, Palma S, Monzani D, Genovese E, Bianchini C, Ciorba A. The Role of Primary Mitochondrial Disorders in Hearing Impairment: An Overview. Medicina (B Aires) 2023; 59:medicina59030608. [PMID: 36984609 PMCID: PMC10058207 DOI: 10.3390/medicina59030608] [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: 02/13/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
Background. Defects of mitochondrial DNA (mtDNA) involved in the function of the mitochondrial electron transport chain can result in primary mitochondrial diseases (PMDs). Various features can influence the phenotypes of different PMDs, with relevant consequences on clinical presentation, including the presence of hearing impairment. This paper aims to describe the hearing loss related to different PMDs, and when possible, their phenotype. Methods. A systematic review was performed according to PRISMA guidelines, searching Medline until December 2022. A total of 485 papers were identified, and based on specified criteria, 7 were included in this study. Results. A total of 759 patients affected by PMDs and hearing loss were included. The age of patients ranged from 2 days to 78 years old, and the male-to-female ratio was 1.3:1. The percentage of subjects affected by hearing loss was 40.8%, (310/759), and in most cases, hearing impairment was described as sensorineural, bilateral, symmetrical, and progressive, with different presentations depending on age and syndrome severity. Conclusions. PMDs are challenging conditions with different clinical phenotypes. Hearing loss, especially when bilateral and progressive, may represent a red flag; its association with other systemic disorders (particularly neuromuscular, ocular, and endocrine) should alert clinicians, and confirmation via genetic testing is mandatory nowadays.
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Affiliation(s)
- Virginia Fancello
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
- Correspondence: (V.F.); (S.P.)
| | - Giuseppe Fancello
- Department of Otorhinolaryngology, Careggi University Hospital, 50134 Florence, Italy
| | - Silvia Palma
- ENT & Audiology Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
- Correspondence: (V.F.); (S.P.)
| | - Daniele Monzani
- ENT & Audiology Department, University of Verona, 37134 Verona, Italy
| | - Elisabetta Genovese
- ENT & Audiology Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Chiara Bianchini
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Andrea Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
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Kishimoto-Urata M, Urata S, Fujimoto C, Yamasoba T. Role of Oxidative Stress and Antioxidants in Acquired Inner Ear Disorders. Antioxidants (Basel) 2022; 11:antiox11081469. [PMID: 36009187 PMCID: PMC9405327 DOI: 10.3390/antiox11081469] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Oxygen metabolism in the mitochondria is essential for biological activity, and reactive oxygen species (ROS) are produced simultaneously in the cell. Once an imbalance between ROS production and degradation (oxidative stress) occurs, cells are damaged. Sensory organs, especially those for hearing, are constantly exposed during daily life. Therefore, almost all mammalian species are liable to hearing loss depending on their environment. In the auditory pathway, hair cells, spiral ganglion cells, and the stria vascularis, where mitochondria are abundant, are the main targets of ROS. Excessive generation of ROS in auditory sensory organs is widely known to cause sensorineural hearing loss, and mitochondria-targeted antioxidants are candidates for treatment. This review focuses on the relationship between acquired hearing loss and antioxidant use to provide an overview of novel antioxidants, namely medicines, supplemental nutrients, and natural foods, based on clinical, animal, and cultured-cell studies.
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Sakata A, Kashio A, Koyama H, Uranaka T, Iwasaki S, Fujimoto C, Kinoshita M, Yamasoba T. Long-Term Progression and Rapid Decline in Hearing Loss in Patients with a Point Mutation at Nucleotide 3243 of the Mitochondrial DNA. Life (Basel) 2022; 12:life12040543. [PMID: 35455034 PMCID: PMC9033132 DOI: 10.3390/life12040543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022] Open
Abstract
Patients with m.3243A>G mutation of mitochondrial DNA develop bilaterally symmetric sensorineural hearing loss. However, it is unclear how fast their hearing loss progresses over time, and whether they experience rapid progression of hearing loss. In the present study, we conducted a long-term hearing evaluation in patients with MELAS or MIDD who harbored the m.3243A>G mutation of mitochondrial DNA. A retrospective chart review was performed on 15 patients with this mutation who underwent pure-tone audiometry at least once a year for more than two years. The mean follow-up period was 12.8 years. The mean progression rate of hearing loss was 5.5 dB per year. Hearing loss progressed rapidly to be profoundly deaf in seven patients during the observation period. Heteroplasmy and age-corrected heteroplasmy levels correlated with the age of onset of hearing loss. These results indicate that patients with m.3243A>G mutation have a gradual progression of hearing loss in the early stages and rapid decline in hearing to be profoundly deaf in approximately half of the patients. Although it is possible to predict the age of onset of hearing loss from heteroplasmy and age-corrected heteroplasmy levels, it is difficult to predict whether and when the rapid hearing loss will occur.
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Affiliation(s)
- Aki Sakata
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Akinori Kashio
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Hajime Koyama
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Tsukasa Uranaka
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Shinichi Iwasaki
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Nagoya City University, Aichi 467-8601, Japan
| | - Chisato Fujimoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Makoto Kinoshita
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (A.S.); (A.K.); (H.K.); (T.U.); (S.I.); (C.F.); (M.K.)
- Correspondence: ; Tel.: +81-3-3815-5411
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Kanemoto K, Kashio A, Ogata E, Akamatsu Y, Koyama H, Uranaka T, Hoshi Y, Iwasaki S, Yamasoba T. Cochlear Implantation in Patients with Mitochondrial Gene Mutation: Decline in Speech Perception in Retrospective Long-Term Follow-Up Study. Life (Basel) 2022; 12:life12040482. [PMID: 35454973 PMCID: PMC9029697 DOI: 10.3390/life12040482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Clinical evidence of the effectiveness of cochlear implantation for hearing loss with mitochondrial DNA mutation is limited. Most reports have only described short-term postoperative speech perception, which may not reflect the limitations of cochlear implantation caused by progressive retrocochlear dysfunction. The present study aimed to investigate long-term speech perception after cochlear implantation in patients with severe to profound hearing loss associated with mitochondrial DNA mutation. A retrospective chart review was performed on patients with mitochondrial DNA mutation who had undergone cochlear implantation at the Department of Otolaryngology and Head and Neck Surgery at the University of Tokyo Hospital. We extracted data on causative mutations, clinical types, clinical course, perioperative complications, and short-term and long-term postoperative speech perception. Nine patients with mitochondrial DNA mutation underwent cochlear implantation. The mean observation period was 5.5 ± 4.2 years (range, 1–13 years), and seven patients were followed for more than 3 years. Two of the seven patients who initially showed good speech perception exhibited deterioration during long-term follow-up. The absence of an acute progression of cognitive decline in patients, showing a gradual decrease in speech perception, suggests that the deterioration of speech perception was caused by progressive retrocochlear degeneration. Although most patients with mitochondrial DNA mutation maintained good speech perception for more than 3 years after cochlear implantation, retrocochlear degeneration could cause the deterioration of speech perception during long-term follow-up.
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Affiliation(s)
- Kai Kanemoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
- Department of Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Akinori Kashio
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
- Correspondence: ; Tel.: +81-3-3815-5411
| | - Erika Ogata
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
| | - Yusuke Akamatsu
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
| | - Hajime Koyama
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
| | - Tsukasa Uranaka
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
| | - Yujiro Hoshi
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
- Department of Otolaryngology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan
| | - Shinichi Iwasaki
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Nagoya City University, Nagoya 467-8601, Japan;
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan; (K.K.); (E.O.); (Y.A.); (H.K.); (T.U.); (Y.H.); (T.Y.)
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Handzel O, Ungar OJ, Lee DJ, Nadol JB. Temporal bone histopathology in MELAS syndrome. Laryngoscope Investig Otolaryngol 2020; 5:152-156. [PMID: 32128442 PMCID: PMC7042650 DOI: 10.1002/lio2.344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/26/2019] [Accepted: 12/24/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Describe the histopathology of the temporal bones in MELAS (myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) syndrome. The syndrome results from a known point mutation in mitochondrial DNA. METHODS Histopathology analysis of a pair of temporal bones from the oldest surviving MELAS syndrome temporal bone donor. Histopathologic findings were correlated with known premortem clinical data. RESULTS The inner ears showed severe but incomplete atrophy of the stria vascularis for the length of the cochleae. In contrast, the organ of Corti and inner hair cells appeared intact with some loss of outer hair cells. Other than moderate loss at the basal turn, spiral ganglion cells numbers were normal. The vestibular neuroepithelium was mostly normal with the exception of moderate degeneration of the macula sacculi and partial collapse of the saccular wall on the right. The cerebral cortex had infarct-like lesions with adjacent gliosis. CONCLUSION This is an analysis of the oldest patient with MELAS syndrome to date, an addition to only two previously published patients. It supports the notion that hearing loss is a result of dysfunction of the stria vascularis and not loss of hair cells or neurons. Patterns of vestibular pathology are in agreement to in-vivo measurements. These findings support auditory rehabilitation with cochlear implants and may be relevant to hearing loss due to other mitochondrial mutations. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Ophir Handzel
- Cochlear Implant Center, Department of Otolaryngology/Head, Neck & Maxillofacial SurgeryTel‐Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel‐Aviv UniversityIsrael
| | - Omer J. Ungar
- Department of Otolaryngology/Head, Neck & Maxillofacial SurgeryTel‐Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel‐Aviv UniversityIsrael
| | - Dan J. Lee
- Otopathology Laboratory, Department of Otolaryngology‐Head and Neck Surgery, Massachusetts Eye and EarHarvard Medical SchoolBostonMassachusetts
| | - Joseph B. Nadol
- Otopathology Laboratory, Department of Otolaryngology‐Head and Neck Surgery, Massachusetts Eye and EarHarvard Medical SchoolBostonMassachusetts
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Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, Hollingsworth DB, Kelley DM, Kmucha ST, Moonis G, Poling GL, Roberts JK, Stachler RJ, Zeitler DM, Corrigan MD, Nnacheta LC, Satterfield L. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg 2020; 161:S1-S45. [PMID: 31369359 DOI: 10.1177/0194599819859885] [Citation(s) in RCA: 314] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently but not universally accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged ≥18 years and primarily on those with idiopathic sudden sensorineural hearing loss. Prompt recognition and management of sudden sensorineural hearing loss may improve hearing recovery and patient quality of life. The guideline update is intended for all clinicians who diagnose or manage adult patients who present with sudden hearing loss. PURPOSE The purpose of this guideline update is to provide clinicians with evidence-based recommendations in evaluating patients with sudden hearing loss and sudden sensorineural hearing loss, with particular emphasis on managing idiopathic sudden sensorineural hearing loss. The guideline update group recognized that patients enter the health care system with sudden hearing loss as a nonspecific primary complaint. Therefore, the initial recommendations of this guideline update address distinguishing sensorineural hearing loss from conductive hearing loss at the time of presentation with hearing loss. They also clarify the need to identify rare, nonidiopathic sudden sensorineural hearing loss to help separate those patients from those with idiopathic sudden sensorineural hearing loss, who are the target population for the therapeutic interventions that make up the bulk of the guideline update. By focusing on opportunities for quality improvement, this guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. METHODS Consistent with the American Academy of Otolaryngology-Head and Neck Surgery Foundation's "Clinical Practice Guideline Development Manual, Third Edition" (Rosenfeld et al. Otolaryngol Head Neck Surg. 2013;148[1]:S1-S55), the guideline update group was convened with representation from the disciplines of otolaryngology-head and neck surgery, otology, neurotology, family medicine, audiology, emergency medicine, neurology, radiology, advanced practice nursing, and consumer advocacy. A systematic review of the literature was performed, and the prior clinical practice guideline on sudden hearing loss was reviewed in detail. Key Action Statements (KASs) were updated with new literature, and evidence profiles were brought up to the current standard. Research needs identified in the original clinical practice guideline and data addressing them were reviewed. Current research needs were identified and delineated. RESULTS The guideline update group made strong recommendations for the following: (KAS 1) Clinicians should distinguish sensorineural hearing loss from conductive hearing loss when a patient first presents with sudden hearing loss. (KAS 7) Clinicians should educate patients with sudden sensorineural hearing loss about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy. (KAS 13) Clinicians should counsel patients with sudden sensorineural hearing loss who have residual hearing loss and/or tinnitus about the possible benefits of audiologic rehabilitation and other supportive measures. These strong recommendations were modified from the initial clinical practice guideline for clarity and timing of intervention. The guideline update group made strong recommendations against the following: (KAS 3) Clinicians should not order routine computed tomography of the head in the initial evaluation of a patient with presumptive sudden sensorineural hearing loss. (KAS 5) Clinicians should not obtain routine laboratory tests in patients with sudden sensorineural hearing loss. (KAS 11) Clinicians should not routinely prescribe antivirals, thrombolytics, vasodilators, or vasoactive substances to patients with sudden sensorineural hearing loss. The guideline update group made recommendations for the following: (KAS 2) Clinicians should assess patients with presumptive sudden sensorineural hearing loss through history and physical examination for bilateral sudden hearing loss, recurrent episodes of sudden hearing loss, and/or focal neurologic findings. (KAS 4) In patients with sudden hearing loss, clinicians should obtain, or refer to a clinician who can obtain, audiometry as soon as possible (within 14 days of symptom onset) to confirm the diagnosis of sudden sensorineural hearing loss. (KAS 6) Clinicians should evaluate patients with sudden sensorineural hearing loss for retrocochlear pathology by obtaining magnetic resonance imaging or auditory brainstem response. (KAS 10) Clinicians should offer, or refer to a clinician who can offer, intratympanic steroid therapy when patients have incomplete recovery from sudden sensorineural hearing loss 2 to 6 weeks after onset of symptoms. (KAS 12) Clinicians should obtain follow-up audiometric evaluation for patients with sudden sensorineural hearing loss at the conclusion of treatment and within 6 months of completion of treatment. These recommendations were clarified in terms of timing of intervention and audiometry and method of retrocochlear workup. The guideline update group offered the following KASs as options: (KAS 8) Clinicians may offer corticosteroids as initial therapy to patients with sudden sensorineural hearing loss within 2 weeks of symptom onset. (KAS 9a) Clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy within 2 weeks of onset of sudden sensorineural hearing loss. (KAS 9b) Clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy as salvage therapy within 1 month of onset of sudden sensorineural hearing loss. DIFFERENCES FROM PRIOR GUIDELINE Incorporation of new evidence profiles to include quality improvement opportunities, confidence in the evidence, and differences of opinion Included 10 clinical practice guidelines, 29 new systematic reviews, and 36 new randomized controlled trials Highlights the urgency of evaluation and initiation of treatment, if treatment is offered, by emphasizing the time from symptom occurrence Clarification of terminology by changing potentially unclear statements; use of the term sudden sensorineural hearing loss to mean idiopathic sudden sensorineural hearing loss to emphasize that >90% of sudden sensorineural hearing loss is idiopathic sudden sensorineural hearing loss and to avoid confusion in nomenclature for the reader Changes to the KASs from the original guideline: KAS 1-When a patient first presents with sudden hearing loss, conductive hearing loss should be distinguished from sensorineural. KAS 2-The utility of history and physical examination when assessing for modifying factors is emphasized. KAS 3-The word "routine" is added to clarify that this statement addresses nontargeted head computerized tomography scan that is often ordered in the emergency room setting for patients presenting with sudden hearing loss. It does not refer to targeted scans, such as temporal bone computerized tomography scan, to assess for temporal bone pathology. KAS 4-The importance of audiometric confirmation of hearing status as soon as possible and within 14 days of symptom onset is emphasized. KAS 5-New studies were added to confirm the lack of benefit of nontargeted laboratory testing in sudden sensorineural hearing loss. KAS 6-Audiometric follow-up is excluded as a reasonable workup for retrocochlear pathology. Magnetic resonance imaging, computerized tomography scan if magnetic resonance imaging cannot be done, and, secondarily, auditory brainstem response evaluation are the modalities recommended. A time frame for such testing is not specified, nor is it specified which clinician should be ordering this workup; however, it is implied that it would be the general or subspecialty otolaryngologist. KAS 7-The importance of shared decision making is highlighted, and salient points are emphasized. KAS 8-The option for corticosteroid intervention within 2 weeks of symptom onset is emphasized. KAS 9-Changed to KAS 9A and 9B. Hyperbaric oxygen therapy remains an option but only when combined with steroid therapy for either initial treatment (9A) or salvage therapy (9B). The timing of initial therapy is within 2 weeks of onset, and that of salvage therapy is within 1 month of onset of sudden sensorineural hearing loss. KAS 10-Intratympanic steroid therapy for salvage is recommended within 2 to 6 weeks following onset of sudden sensorineural hearing loss. The time to treatment is defined and emphasized. KAS 11-Antioxidants were removed from the list of interventions that the clinical practice guideline recommends against using. KAS 12-Follow-up audiometry at conclusion of treatment and also within 6 months posttreatment is added. KAS 13-This statement on audiologic rehabilitation includes patients who have residual hearing loss and/or tinnitus who may benefit from treatment. Addition of an algorithm outlining KASs Enhanced emphasis on patient education and shared decision making with tools provided to assist in same.
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Affiliation(s)
- Sujana S Chandrasekhar
- 1 ENT & Allergy Associates, LLP, New York, New York, USA.,2 Zucker School of Medicine at Hofstra-Northwell, Hempstead, New York, USA.,3 Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Laura J Bontempo
- 6 University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Sandra A Finestone
- 8 Consumers United for Evidence-Based Healthcare, Baltimore, Maryland, USA
| | | | - David M Kelley
- 10 University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Steven T Kmucha
- 11 Gould Medical Group-Otolaryngology, Stockton, California, USA
| | - Gul Moonis
- 12 Columbia University Medical Center, New York, New York, USA
| | | | - J Kirk Roberts
- 12 Columbia University Medical Center, New York, New York, USA
| | | | | | - Maureen D Corrigan
- 15 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Lorraine C Nnacheta
- 15 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Lisa Satterfield
- 15 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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In Response to the Letter to the Editor: Auditory and Vestibular Dysfunction in M. 3243A>G Carriers. Otol Neurotol 2019; 40:1260-1261. [DOI: 10.1097/mao.0000000000002412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cochlear implantation for hearing loss due to an A8296G mitochondrial DNA mutation. OTOLARYNGOLOGY CASE REPORTS 2019. [DOI: 10.1016/j.xocr.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Progression of Peripheral Vestibular Dysfunctions in Patients With a Mitochondrial A3243G Mutation. Otol Neurotol 2019; 40:359-364. [PMID: 30742597 DOI: 10.1097/mao.0000000000002091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the progression of peripheral vestibular dysfunction in patients with an A-to-G point mutation at nucleotide pair 3243 in mitochondrial DNA (A3243G mutation). STUDY DESIGN Retrospective patient series. SETTING Tertiary referral center. PATIENTS Six unrelated patients with an A3243G mutation (four mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes; and two maternally inherited diabetes and deafness; five females and one male; average age 41 ± 11.3 yr old), who underwent repeated vestibular examinations, were included (average interval between the first and second examinations: 5.7 ± 2.1 yr). INTERVENTION Diagnostic. MAIN OUTCOME MEASURE Results of caloric testing and cervical vestibular evoked myogenic potential testing in response to air-conducted sound were analyzed. RESULTS All the patients except one, who was already completely deaf in both ears at the first examination, showed progression of hearing loss (average 4.0 ± 6.3 dB per year). Five of the six patients had vestibular symptoms at the first examination. The other patient developed dizziness later. Caloric responses were abnormal in four patients at the first examination and in five patients at the second examination. Cervical vestibular evoked myogenic potential responses were bilaterally absent in three patients at the first examination and in five patients at the second examination. CONCLUSIONS The A3243G mutation causes progression of peripheral vestibular dysfunction as well as that of hearing loss.
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Di Stadio A, Angelini C. MicroRNAs are appropriate in mitochondrial related hearing loss? Answer to the skepticism. Orphanet J Rare Dis 2018; 13:119. [PMID: 30021602 PMCID: PMC6052642 DOI: 10.1186/s13023-018-0865-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/02/2018] [Indexed: 11/10/2022] Open
Abstract
AIM We aim to clarify some points that have been criticized about our previous paper "Hearing Impairment in MELAS: new prospective in clinical use of microRNA, a systematic review". MATERIAL AND METHOD We answered to the criticism of Dr. Finsterer point by point, by citing all literature in support of our previous paper. CONCLUSION The point by point answering allows us to clarify doubts and to support the proposal that we exposed in our review, the possibility to use microRNA for detecting the hearing damage in patients affected from mitochondrial disease.
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Di Stadio A, Pegoraro V, Giaretta L, Dipietro L, Marozzo R, Angelini C. Hearing impairment in MELAS: new prospective in clinical use of microRNA, a systematic review. Orphanet J Rare Dis 2018; 13:35. [PMID: 29466997 PMCID: PMC5822652 DOI: 10.1186/s13023-018-0770-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022] Open
Abstract
AIM To evaluate the feasibility of microRNAs (miR) in clinical use to fill in the gap of current methodology commonly used to test hearing impairment in MELAS patients. MATERIAL AND METHOD A literature review was performed using the following keywords, i.e., MELAS, Hearing Loss, Hearing Impairment, Temporal Bone, Otoacustic Emission (OTOAE), Auditory Brain Response (ABR), and microRNA. We reviewed the literature and focused on the aspect of the temporal bone, the results of electrophysiological tests in human clinical studies, and the use of miR for detecting lesions in the cochlea in patients with MELAS. RESULTS In patients with MELAS, Spiral Ganglions (SG), stria vascularis (SV), and hair cells are damaged, and these damages affect in different ways various structures of the temporal bone. The function of these cells is typically investigated using OTOAE and ABR, but in patients with MELAS these tests provide inconsistent results, since OTOAE response is absent and ABR is normal. The normal ABR responses are unexpected given the SG loss in the temporal bone. Recent studies in humans and animals have shown that miRs, and in particular miRs 34a, 29b, 76, 96, and 431, can detect damage in the cells of the cochlea with high sensitivity. Studies that focus on the temporal bone aspects have reported that miRs increase is correlated with the death of specific cells of the inner ear. MiR - 9/9* was identified as a biomarker of human brain damage, miRs levels increase might be related to damage in the central auditory pathways and these increased levels could identify the damage with higher sensitivity and several months before than electrophysiological testing. CONCLUSION We suggest that due to their accuracy and sensitivity, miRs might help monitor the progression of SNHL in patients with MELAS.
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Affiliation(s)
| | | | - Laura Giaretta
- San Camillo Hospital IRCCS, Via Alberoni, 70, Venice, Italy
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Reactive oxygen species, apoptosis, and mitochondrial dysfunction in hearing loss. BIOMED RESEARCH INTERNATIONAL 2015; 2015:617207. [PMID: 25874222 PMCID: PMC4385658 DOI: 10.1155/2015/617207] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 09/10/2014] [Indexed: 12/20/2022]
Abstract
Reactive oxygen species (ROS) production is involved in several apoptotic and necrotic cell death pathways in auditory tissues. These pathways are the major causes of most types of sensorineural hearing loss, including age-related hearing loss, hereditary hearing loss, ototoxic drug-induced hearing loss, and noise-induced hearing loss. ROS production can be triggered by dysfunctional mitochondrial oxidative phosphorylation and increases or decreases in ROS-related enzymes. Although apoptotic cell death pathways are mostly activated by ROS production, there are other pathways involved in hearing loss that do not depend on ROS production. Further studies of other pathways, such as endoplasmic reticulum stress and necrotic cell death, are required.
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Nishimura K, Weichert RM, Liu W, Davis RL, Dabdoub A. Generation of induced neurons by direct reprogramming in the mammalian cochlea. Neuroscience 2014; 275:125-35. [PMID: 24928351 DOI: 10.1016/j.neuroscience.2014.05.067] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/15/2014] [Accepted: 05/14/2014] [Indexed: 01/27/2023]
Abstract
Primary auditory neurons (ANs) in the mammalian cochlea play a critical role in hearing as they transmit auditory information in the form of electrical signals from mechanosensory cochlear hair cells in the inner ear to the brainstem. Their progressive degeneration is associated with disease conditions, excessive noise exposure and aging. Replacement of ANs, which lack the ability to regenerate spontaneously, would have a significant impact on research and advancement in cochlear implants in addition to the amelioration of hearing impairment. The aim of this study was to induce a neuronal phenotype in endogenous non-neural cells in the cochlea, which is the essential organ of hearing. Overexpression of a neurogenic basic helix-loop-helix transcription factor, Ascl1, in the cochlear non-sensory epithelial cells induced neurons at high efficiency at embryonic, postnatal and juvenile stages. Moreover, induced neurons showed typical properties of neuron morphology, gene expression and electrophysiology. Our data indicate that Ascl1 alone or Ascl1 and NeuroD1 is sufficient to reprogram cochlear non-sensory epithelial cells into functional neurons. Generation of neurons from non-neural cells in the cochlea is an important step for the regeneration of ANs in the mature mammalian cochlea.
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Affiliation(s)
- K Nishimura
- Biological Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
| | - R M Weichert
- Department of Surgery/Otolaryngology, UCSD School of Medicine, La Jolla, CA 92093, USA.
| | - W Liu
- Department of Cell Biology and Neuroscience, Nelson Laboratories, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA.
| | - R L Davis
- Department of Cell Biology and Neuroscience, Nelson Laboratories, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA.
| | - A Dabdoub
- Biological Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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Kimura Y, Kubo S, Koda H, Shigemoto K, Sawabe M, Kitamura K. RNA analysis of inner ear cells from formalin fixed paraffin embedded (FFPE) archival human temporal bone section using laser microdissection--a technical report. Hear Res 2013; 302:26-31. [PMID: 23660400 DOI: 10.1016/j.heares.2013.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 04/16/2013] [Accepted: 04/22/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Molecular analysis using archival human inner ear specimens is challenging because of the anatomical complexity, long-term fixation, and decalcification. However, this method may provide great benefit for elucidation of otological diseases. Here, we extracted mRNA for RT-PCR from tissues dissected from archival FFPE human inner ears by laser microdissection. METHODS Three human temporal bones obtained at autopsy were fixed in formalin, decalcified by EDTA, and embedded in paraffin. The samples were isolated into spiral ligaments, outer hair cells, spiral ganglion cells, and stria vascularis by laser microdissection. RNA was extracted and heat-treated in 10 mM citrate buffer to remove the formalin-derived modification. To identify the sites where COCH and SLC26A5 mRNA were expressed, semi-nested RT-PCR was performed. We also examined how long COCH mRNA could be amplified by semi-nested RT-PCR in archival temporal bone. RESULTS COCH was expressed in the spiral ligament and stria vascularis. However, SLC26A5 was expressed only in outer hair cells. The maximum base length of COCH mRNA amplified by RT-PCR was 98 bp in 1 case and 123 bp in 2 cases. CONCLUSION We detected COCH and SLC26A5 mRNA in specific structures and cells of the inner ear from archival human temporal bone. Our innovative method using laser microdissection and semi-nested RT-PCR should advance future RNA study of human inner ear diseases.
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Affiliation(s)
- Yurika Kimura
- Department of Otolaryngology, Tokyo Metropolitan Geriatric Medical Hospital, 35-2, Itabashi, Tokyo 173 0015, Japan.
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Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, Brown SR, Fife TD, Ford P, Ganiats TG, Hollingsworth DB, Lewandowski CA, Montano JJ, Saunders JE, Tucci DL, Valente M, Warren BE, Yaremchuk KL, Robertson PJ. Clinical Practice Guideline. Otolaryngol Head Neck Surg 2012; 146:S1-35. [DOI: 10.1177/0194599812436449] [Citation(s) in RCA: 659] [Impact Index Per Article: 54.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL. Purpose. The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. Results. The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants to patients with ISSNHL. The panel made strong recommendations against clinicians (1) ordering computerized tomography of the head/brain in the initial evaluation of a patient with presumptive SSNHL and (2) obtaining routine laboratory tests in patients with ISSNHL.
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Affiliation(s)
- Robert J. Stachler
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan, USA
| | | | - Sanford M. Archer
- Division of Otolaryngology–Head & Neck Surgery, University of Kentucky Chandler Medical Center, Lexington, Kentucky, USA
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center and Long Island College Hospital, Brooklyn, New York, USA
| | - Seth R. Schwartz
- Department of Otolaryngology, Virginia Mason Hospital and Medical Center, Seattle, Washington, USA
| | - David M. Barrs
- Department of Otolaryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Steven R. Brown
- Department of Family and Community Medicine, University of Arizona School of Medicine, Phoenix, Arizona, USA
| | - Terry D. Fife
- Department of Neurology, University of Arizona, Phoenix, Arizona, USA
| | | | - Theodore G. Ganiats
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California, USA
| | | | | | | | | | - Debara L. Tucci
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael Valente
- Department of Otolaryngology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Barbara E. Warren
- Center for LGBT Social Science & Public Policy, Hunter College, City University of New York, New York, New York, USA
| | | | - Peter J. Robertson
- American Academy of Otolaryngology–Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Mutai H, Kouike H, Teruya E, Takahashi-Kodomari I, Kakishima H, Taiji H, Usami SI, Okuyama T, Matsunaga T. Systematic analysis of mitochondrial genes associated with hearing loss in the Japanese population: dHPLC reveals a new candidate mutation. BMC MEDICAL GENETICS 2011; 12:135. [PMID: 21989059 PMCID: PMC3207971 DOI: 10.1186/1471-2350-12-135] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 10/12/2011] [Indexed: 11/17/2022]
Abstract
Background Variants of mitochondrial DNA (mtDNA) have been evaluated for their association with hearing loss. Although ethnic background affects the spectrum of mtDNA variants, systematic mutational analysis of mtDNA in Japanese patients with hearing loss has not been reported. Methods Using denaturing high-performance liquid chromatography combined with direct sequencing and cloning-sequencing, Japanese patients with prelingual (N = 54) or postlingual (N = 80) sensorineural hearing loss not having pathogenic mutations of m.1555A > G and m.3243A > G nor GJB2 were subjected to mutational analysis of mtDNA genes (12S rRNA, tRNALeu(UUR), tRNASer(UCN), tRNALys, tRNAHis, tRNASer(AGY), and tRNAGlu). Results We discovered 15 variants in 12S rRNA and one homoplasmic m.7501A > G variant in tRNASer(UCN); no variants were detected in the other genes. Two criteria, namely the low frequency in the controls and the high conservation among animals, selected the m.904C > T and the m.1105T > C variants in 12S rRNA as candidate pathogenic mutations. Alterations in the secondary structures of the two variant transcripts as well as that of m.7501A > G in tRNASer(UCN) were predicted. Conclusions The m.904C > T variant was found to be a new candidate mutation associated with hearing loss. The m.1105T > C variant is unlikely to be pathogenic. The pathogenicity of the homoplasmic m.7501T > A variant awaits further study.
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Affiliation(s)
- Hideki Mutai
- Laboratory of Auditory Disorders, Division of Hearing and Balance Research, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan
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Iwasaki S, Egami N, Fujimoto C, Chihara Y, Ushio M, Kashio A, Yamasoba T. The mitochondrial A3243G mutation involves the peripheral vestibule as well as the cochlea. Laryngoscope 2011; 121:1821-4. [PMID: 21792976 DOI: 10.1002/lary.21879] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Shinichi Iwasaki
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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Pisani V, Tirabasso A, Mazzone S, Terracciano C, Botta A, Novelli G, Bernardi G, Massa R, Di Girolamo S. Early subclinical cochlear dysfunction in myotonic dystrophy type 1. Eur J Neurol 2011; 18:1412-6. [DOI: 10.1111/j.1468-1331.2011.03470.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Peng W, Hu Y, Zhong Y, Chen B, Sun Y, Yang Y, Kong W. Protective roles of alpha-lipoic acid in rat model of mitochondrial DNA4834bp deletion in inner ear. ACTA ACUST UNITED AC 2010; 30:514-8. [PMID: 20714881 DOI: 10.1007/s11596-010-0460-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Indexed: 10/19/2022]
Abstract
The protective roles of alpha-lipoic acid in the rat model of mitochondrial DNA (mtDNA) 4834bp deletion in inner ear were investigated. Forty female Wistar rats at 4 weeks of age were divided into four groups: group A (D-galactose group, n=10), group B (D-galactose+alpha-lipoic acid group, n=10), group C (alpha-lipoic acid group, n=10), and group D (control group, n=10). Auditory brainstem response (ABR) was used to detect the hearing threshold. Colorimetry was used to analyze activity of superoxide dismutase (SOD) and concentration of malondialdehyde (MDA). The percentage of mtDNA4834bp deletion in inner ear was identified by real-time PCR. There was no significant difference in ABR threshold shift among all groups. The percentage of mtDNA4834bp deletion in group A was higher than that in other groups, but there was no significant difference in percentage of mtDNA4834bp deletion among groups B, C, and D. The activity of SOD in group A was lower than that in other groups. The concentration of MDA in group A was higher than that in other groups. It was concluded that there was no significant hearing loss when the percentage of mtDNA4834bp deletion was lower than 12.5%. Alpha-lipoic acid could prevent the reactive oxygen species (ROS)-induced mtDNA4834bp deletion in inner ear of rats.
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Affiliation(s)
- Wei Peng
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Takahashi M, Kimura Y, Sawabe M, Kitamura K. Modified paraffin-embedding method for the human cochlea that reveals a fine morphology and excellent immunostaining results. Acta Otolaryngol 2010; 130:788-92. [PMID: 20082565 DOI: 10.3109/00016480903426626] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION A modified paraffin-embedding method could be applied to histopathological and immunohistochemical studies of the human cochlea. The complementary use of molecular and immunohistochemical techniques by means of this method is thus considered to be a valuable tool for the future study of the human inner ear. OBJECTIVE To propose a new paraffin-embedding method for the morphological and immunohistochemical study of the human cochlea. METHODS Five human temporal bones were harvested at autopsy. The temporal bone specimens were fixed in 20% buffered formalin, decalcified with EDTA, cropped to a cube of approximately 15 mm, embedded in paraffin, and then cut into 6 microm thick sections. The sections were stained with hematoxylin and eosin, and immunostained with anti-prestin and anti-neurofilament antibodies. RESULTS Although paraffin-embedded sections cannot show the excellent morphology of the delicate membranous labyrinth obtained with celloidin, this technique successfully preserved the morphology of the cochlea, especially the organ of Corti, thereby enabling us to obtain excellent immunostaining results.
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Koda H, Kimura Y, Ishige I, Eishi Y, Iino Y, Kitamura K. Quantitative cellular level analysis of mitochondrial DNA 3243A > G mutations in individual tissues from the archival temporal bones of a MELAS patient. Acta Otolaryngol 2010. [DOI: 10.3109/00016480903148282] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kawashima Y, Noguchi Y, Ito T, Kitamura K. Vestibular evoked myogenic potentials in patients with the mitochondrial A1555G mutation. Laryngoscope 2009; 119:1874-9. [DOI: 10.1002/lary.20584] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yamasoba >T, Tsukuda K, Suzuki M. Isolated hearing loss associated with T7511C mutation in mitochondrial DNA. Acta Otolaryngol 2007:13-8. [PMID: 18340555 DOI: 10.1080/03655230701595345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION The T7511C mutation is considered responsible for maternally inherited, isolated sensorineural hearing loss of cochlear origin. This mutation should be screened for in cases of nonsyndromic, familial sensorineural hearing loss compatible with maternal transmission. OBJECTIVES To clarify the audiovestibular phenotype characteristics associated with a T7511C mutation in mitochondrial DNA and determine whether it causes isolated sensorineural hearing loss unaccompanied by other neuromuscular symptoms or signs. SUBJECTS AND METHODS A proband and affected members of a Japanese family harboring a T7511C mutation in the mitochondrial tRNA(Ser(UCN)) gene were enrolled. Mutation analysis was done on genomic DNA extracted from blood samples. Auditory pathways involved were investigated in examinations that included pure-tone audiograms, acoustic reflexes, speech discrimination testing, distortion-product otoacoustic emissions, and auditory brainstem responses. The presence of other signs and symptoms, including vestibular ones, was investigated. RESULTS We identified a homoplasmic T7511C mutation in the mitochondrial tRNA(Ser(UCN)) gene in this family. No other pathogenic mutations associated with hearing loss or common mitochondrial diseases were found. Hearing loss of cochlear origin mainly developed at mid to high frequencies. Vestibular systems were well preserved. No symptoms or signs characteristic of mitochondrial diseases were present in any family members.
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Kimura Y, Kubo S, Koda H, Noguchi Y, Sawabe M, Maruyama N, Kitamura K. Quantitative analysis of mRNA in human temporal bones. Acta Otolaryngol 2007; 127:1024-30. [PMID: 17851964 DOI: 10.1080/00016480701200202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION Well-preserved mRNA could be extracted from frozen human inner ears. Therefore, this study demonstrates that analysis of mRNA could be performed to study the molecular mechanisms of inner ear disorders using human specimens. OBJECTIVES Analysis of RNA as well DNA is requisite to study the molecular mechanisms of inner ear disorders. Methods of isolating RNA from experimental animals have been established, while isolation of RNA from human inner ears is much more challenging. In the present study, we demonstrate a method by which messenger RNA (mRNA) was extracted from human inner ears and quantitatively analyzed. MATERIALS AND METHODS COCH mRNA as well as GAPDH mRNA was extracted from membranous labyrinths dissected from three formalin-fixed and three frozen human temporal bones, removed at autopsy. The length of COCH mRNA and quantity of GAPDH mRNA was compared between the two groups by quantitative RT-PCR. RESULTS COCH mRNA could be amplified as much as 976 bp in all three frozen specimens. By contrast, it was amplified to 249 bp in two of the three formalin-fixed specimens, with no amplification observed in the remaining. The quantity of amplifiable GAPDH mRNA in the formalin specimens was only 1% of that of the frozen specimens.
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Affiliation(s)
- Yurika Kimura
- Department of Otolaryngology, Tokyo Metropolitan Geriatric Hospital, Japan
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Niu X, Trifunovic A, Larsson NG, Canlon B. Somatic mtDNA mutations cause progressive hearing loss in the mouse. Exp Cell Res 2007; 313:3924-34. [PMID: 17662273 DOI: 10.1016/j.yexcr.2007.05.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Revised: 05/29/2007] [Accepted: 05/30/2007] [Indexed: 10/23/2022]
Abstract
Mitochondrial dysfunction has been implicated in the commonly occurring age-associated hearing loss (presbyacusis). We have previously generated mtDNA mutator mice with increased levels of somatic mtDNA point mutations causing phenotypes consistent with premature ageing. We have now utilized these mice to investigate whether elevated levels of somatic mtDNA mutations affect the auditory system. The mtDNA mutator mice develop a progressive impairment of hearing (ABR thresholds). Quantitative assessment of hair cell loss in the cochlea did not show any significant difference between the mutator and wild-type mice. The mtDNA mutator mice showed progressive apoptotic cell loss in the spiral ganglion and increased pathology with increasing age in the stria vascularis. The neurons in the cochlear nucleus showed an accelerated progressive degeneration with increasing age in the mutator mice compared to the wild-type mice. Both physiological and histological characterization thus reveals a striking resemblance between the auditory system pathology of mtDNA mutator mice and humans with presbyacusis. Somatic mtDNA mutations accumulate during normal ageing and further studies in humans are now warranted to investigate whether presbyacusis can be linked to mitochondrial dysfunction.
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Affiliation(s)
- Xianzhi Niu
- Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden
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Yamasoba T, Someya S, Yamada C, Weindruch R, Prolla TA, Tanokura M. Role of mitochondrial dysfunction and mitochondrial DNA mutations in age-related hearing loss. Hear Res 2007; 226:185-93. [PMID: 16870370 DOI: 10.1016/j.heares.2006.06.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 05/29/2006] [Accepted: 06/12/2006] [Indexed: 10/24/2022]
Abstract
Mitochondrial DNA (mtDNA) mutations/deletions are considered to be associated with the development of age-related hearing loss (AHL). We assessed the role of accumulation of mtDNA mutations in the development of AHL using Polg(D257A) knock-in mouse, which exhibited increased spontaneous mtDNA mutation rates during aging and showed accelerated aging primarily due to increased apoptosis. They exhibited moderate hearing loss and degeneration of the hair cells, spiral ganglion cells and stria vascularis by 9 month of age, while wild-type animals did not. We next examined if mitochondrial damage induced by systemic application of germanium dioxide caused progressive hearing loss and cochlear damage. Guinea pigs and mice given germanium dioxide exhibited degeneration of the muscles and kidney and developed hearing loss due to degeneration of cochlear tissues, including the stria vascularis. Calorie restriction, which causes a metabolic shift toward increased energy metabolism in some organs, has been shown to attenuate AHL and age-related cochlear degeneration and to lower quantity of mtDNA deletions in the cochlea of mammals. Together these findings indicate that decreased energy metabolism due to accumulation of mtDNA mutations/deletions and decline of respiratory chain function play an important role in the manifestation of AHL.
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Affiliation(s)
- Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, University of Tokyo, Hongo 7-3-1, Tokyo 113-8665, Japan.
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Ishikawa K, Tamagawa Y, Takahashi K, Iino Y, Murakami Y, Kakizaki K, Kimura H, Kusakari J, Hara A, Ichimura K. Temporal bone histopathologic abnormalities associated with mitochondrial mutation T7511C. Laryngoscope 2006; 116:1982-6. [PMID: 17075421 DOI: 10.1097/01.mlg.0000237440.51542.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We previously reported a mitochondrial T7511C mutation in the tRNA gene in a Japanese family with nonsyndromic hearing loss (HL). However, the temporal bone histopathology associated with T7511C has not been reported. The aim of the present study is to report histopathologic findings of a temporal bone from a patient in the Japanese family with this mutation. STUDY DESIGN Single case study. METHODS A temporal bone was obtained from the right ear of a male subject with progressive HL from 5 years of age and who died at 60 years of age from cerebral infarction. The bone was embedded, sectioned, and stained with hematoxylin-eosin for light microscopic study. Graphic reconstruction of the cochlea was performed using the method described by Schuknecht to determine loss of the stria vascularis and neurosensory elements including hair cells and spiral ganglion neurons. RESULTS The most significant histopathologic finding was severe loss of spiral ganglion cells in all turns of the cochlea. Severe loss of neuronal filaments in Rosenthal's canal was also observed. The organ of Corti showed scattered loss of inner and outer hair cells in the basal turn. Partial atrophy of the stria vascularis was observed in all turns of the cochlea. CONCLUSION Our results suggest that severe loss of spiral ganglion cells was the main cause of sensorineural HL associated with the T7511C mutation.
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Affiliation(s)
- Kotaro Ishikawa
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
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Yamasoba T, Goto YI, Komaki H, Mimaki M, Sudo A, Suzuki M. Cochlear damage due to germanium-induced mitochondrial dysfunction in guinea pigs. Neurosci Lett 2006; 395:18-22. [PMID: 16289317 DOI: 10.1016/j.neulet.2005.10.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Revised: 10/17/2005] [Accepted: 10/17/2005] [Indexed: 11/19/2022]
Abstract
This investigation addressed the effect of germanium dioxide (GeO(2))-induced mitochondrial dysfunction on hearing acuity. Guinea pigs were fed chow that contained 0%, 0.15%, or 0.5% GeO(2). The animals that were fed 0.5% GeO(2) for 2 months developed hearing impairment chiefly due to degeneration of stria vascularis and cochlear supporting cells, which exhibited electron-dense mitochondrial inclusions. Cytochrome c oxidase activity was decreased in the skeletal muscles and kidney, which also exhibited electron-dense mitochondrial inclusions. No apparent pathological changes were observed in the utricle, semicircular canal, or among the vestibular nerve fibers, or in the liver or heart. The untreated animals and those treated with 0.15% GeO(2) did not exhibit hearing impairment or pathological changes in any organs. These findings suggest that administration of 0.5% GeO(2) induces mitochondrial dysfunction in the stria vascularis and supporting cells in the cochlea, as in the skeletal muscles and kidney, thereby causing hearing impairment in the guinea pigs.
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Affiliation(s)
- Tatsuya Yamasoba
- Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
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Kimura Y, Kouda H, Eishi Y, Kobayashi D, Suzuki Y, Ishige I, Iino Y, Kitamura K. Detection of mitochondrial DNA from human inner ear using real-time polymerase chain reaction and laser microdissection. Acta Otolaryngol 2005; 125:697-701. [PMID: 16012029 DOI: 10.1080/00016480510027510] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
CONCLUSIONS In this study we were able to amplify and analyze extremely small amounts of template DNA from only a few individually dissected cells. We anticipate that this approach will facilitate the detection and analysis of mitochondrial (mt) DNA mutations in specific cell types in the inner ear, which should shed new light on genetic disorders leading to hearing loss. OBJECTIVE To isolate mtDNA from selected tissues in the inner ear. Although several methods for extracting DNA from formalin-fixed, celloidin-embedded, archival human temporal bones have been reported, the isolation of DNA from the inner ear by means of laser microdissection has not been previously demonstrated. MATERIAL AND METHODS This was a retrospective study. Temporal bones were obtained from subjects with no known otological history at autopsy. The combined method of laser microdissection and real-time polymerase chain reaction was used to isolate mtDNA from selected tissues in the inner ear. RESULTS mtDNA could be isolated from the stria vascularis, spiral ligament, spiral ganglion cells and organ of Corti.
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Affiliation(s)
- Yurika Kimura
- The Department of Otolaryngology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Kornblum C, Broicher R, Walther E, Herberhold S, Klockgether T, Herberhold C, Schröder R. Sensorineural hearing loss in patients with chronic progressive external ophthalmoplegia or Kearns–Sayre syndrome. J Neurol 2005; 252:1101-7. [PMID: 15827867 DOI: 10.1007/s00415-005-0827-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2004] [Revised: 01/11/2005] [Accepted: 01/27/2005] [Indexed: 11/26/2022]
Abstract
In the present study we assessed the prevalence and nature of hearing loss in patients with chronic progressive external ophthalmoplegia (CPEO) or Kearns-Sayre syndrome (KSS) due to single large-scale mitochondrial DNA (mtDNA) deletion or mtDNA tRNA (Leu (UUR)) A3243G point mutation (A3243G PM). 14 patients with mtDNA deletion and three patients with A3243G PM underwent audiological evaluation comprising pure-tone and speech audiometry as well as transient evoked otoacoustic emissions (OAE). Audiological evaluation revealed hearing impairment in 10/17 patients. Hearing loss was mild to moderate predominantly affecting high frequencies in five patients with subjective hearing problems (three patients with mtDNA deletions, two patients with A3243G PM). Subclinical hearing deficits restricted to high frequencies were seen in further five asymptomatic patients (four patients with mtDNA deletions, one patients with A3243G PM). Audiological findings suggested a cochlear origin of hearing loss in all subjects. Our results demonstrate that CPEO or KSS patients due to mtDNA deletion or A3243G PM are at high risk of developing sensorineural hearing deficits.
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Affiliation(s)
- C Kornblum
- Dept. of Neurology, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
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Komlósi K, Kellermayer R, Maász A, Havasi V, Hollódy K, Vincze O, Merkli H, Pál E, Melegh B. Maternally inherited deafness and unusual phenotypic manifestations associated with A3243G mitochondrial DNA mutation. Pathol Oncol Res 2005; 11:82-6. [PMID: 15999151 DOI: 10.1007/bf02893371] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2005] [Accepted: 05/15/2005] [Indexed: 11/30/2022]
Abstract
The mitochondrial DNA A3243G transition is a fairly common mutation which often associates with a MELAS (mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes) phenotype, however, a broad variety in the associated clinical picture has also been described. The patient reported here developed a generalized seizure at age 12, which was followed by bilateral hearing loss and occasional fatigue. The maternal inheritance pattern of hearing loss pointed to a possible mitochondrial origin, which was confirmed by molecular analysis of the mitochondrial DNA, revealing a heteroplasmic A3243G transition. Interestingly, muscle biopsy showed ragged-red fibers in the proband, which is unusual in the deafness-associated forms of this mitochondrial disorder. In addition to hearing impairment in four generations of the family, fatal cerebral embolization in the mother and fatal heart attack in the maternal grandmother (both at age 33) also occurred. On the contrary, diabetes, which usually accompanies the hearing loss variant, was specifically absent in all generations. The unusual manifestations associated with this mutation somewhat differentiate this family from the already known variants.
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Affiliation(s)
- Katalin Komlósi
- Department of Medical Genetics and Child Development, University of Pécs, Pécs, H-7624, Hungary
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