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Ototoxicity: bioprotective mechanisms

Leonard P Rybak1, Thomas Kelly

  • 1Department of Surgery, Southern Illinois University School of Medicine, Springfield 62794-9653, USA. lrybak@siumed.edu

Current Opinion in Otolaryngology & Head and Neck Surgery
|September 23, 2003
PubMed
Abstract

Insights

Novel strategies are emerging to prevent drug-induced ototoxicity from cisplatin and aminoglycoside antibiotics, focusing on reactive oxygen species. Research explores interventions like free-radical scavengers to protect hearing during cancer therapy and infection treatment.

Area of Science:

  • Oto- and neurotoxicology
  • Pharmacology
  • Ototoxic drug mechanisms

Background:

  • Cisplatin and aminoglycoside antibiotics are crucial therapeutics but can cause ototoxicity, leading to hearing loss.
  • The exact mechanisms of drug-induced ototoxicity are complex and multifactorial.
  • Preventing ototoxicity is essential to maintain treatment adherence and patient quality of life.

Purpose of the Study:

  • To review current research on novel approaches for preventing cisplatin- and aminoglycoside-induced ototoxicity.
  • To examine the potential for these interventions to interfere with the therapeutic efficacy of these drugs.

Main Methods:

  • Literature review of preclinical and clinical studies.
  • Analysis of research investigating the role of reactive oxygen species in ototoxicity.
  • Evaluation of therapeutic strategies including free-radical scavengers, iron chelators, and apoptosis inhibitors.

Main Results:

  • Reactive oxygen species (ROS) play a significant role in the ototoxicity of both cisplatin and aminoglycosides.
  • Interventions targeting ROS, such as free-radical scavengers, show promise in preclinical models.
  • Iron chelators and inhibitors of cell death pathways are also being investigated as protective strategies.
  • Careful consideration is given to the potential for these protective agents to reduce the efficacy of the primary drugs.

Conclusions:

  • Emerging strategies targeting ROS and cell death pathways offer potential for preventing drug-induced ototoxicity.
  • Further research and clinical trials are needed to validate these findings in humans.
  • Translating animal model successes into effective clinical practice is a key future direction.

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