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Biochemical changes to the inner ear contributing to diabetes-induced hearing loss: possible pharmacological targets
Ahmed Gedawy1,2, Hani Al-Salami1,2, Crispin R Dass1,2
1Curtin Medical School, Curtin University, Bentley 6102, Australia.
Objectives:
Biochemical alterations due to diabetes development and progress are complex and diabetes-associated injury to various tissues has been well reported. Nevertheless, a close investigation of the literature demonstrates limited coverage regarding these biochemical and molecular alterations within the inner ear and their impact on the vestibulocochlear environment. A closer look at these may reveal pharmacological targets that could alleviate the severity of disease in patients.
Key Findings:
Tight control of glucose levels within the highly metabolic inner ear structures is crucial for their physiology and function. Impaired glucose homeostasis is well known to occur in vestibulocochlear malfunctioning. Moreover, the involvement of insulin signalling, and glucose transporters were recently confirmed in vestibulocochlear structures and are believed to play a crucial role in auditory and vestibular functions.
Conclusion:
Oxidative overload, glucolipotoxicity, perturbed blood rheology, endothelial dysfunction, compromised microvascular supply, and neurotoxicity are reported in many diabetic complications such as nephropathy, retinopathy, and diabetic neuropathy and are incriminated in the disruption of blood labyrinth barrier as well as vestibulocochlear neuritis. Dysfunctional insulin signalling was recently reported in the Organ of Corti. Insulin resistance in the inner ear niche warrants further studies to verify and uncover new pharmacological targets to manage this debilitating condition better.
Insights
Diabetes can cause inner ear damage, affecting hearing and balance. Understanding these biochemical changes may lead to new treatments for diabetic vestibulocochlear dysfunction.
Area of Science:
- Oto-neuroscience
- Endocrinology
- Metabolic disorders
Background:
- Diabetes mellitus is associated with widespread tissue injury, yet its specific impact on the inner ear remains underexplored.
- The vestibulocochlear system's function is intricately linked to metabolic homeostasis, particularly glucose regulation.
Purpose of the Study:
- To review the biochemical and molecular alterations in the inner ear due to diabetes.
- To identify potential pharmacological targets for managing diabetes-related vestibulocochlear complications.
Main Methods:
- Literature review and synthesis of existing research on diabetes and inner ear physiology.
- Analysis of biochemical pathways, including glucose metabolism, insulin signaling, and oxidative stress in the context of vestibulocochlear function.
Main Results:
- Tight glucose control is essential for inner ear structure and function; impaired homeostasis is linked to vestibulocochlear issues.
- Insulin signaling and glucose transporters play critical roles in auditory and vestibular functions.
- Diabetic complications like oxidative stress and endothelial dysfunction disrupt the blood-labyrinth barrier and can cause vestibulocochlear neuritis.
Conclusions:
- Inner ear insulin resistance and associated metabolic disturbances contribute to vestibulocochlear dysfunction in diabetes.
- Further research into these mechanisms may reveal novel therapeutic targets for conditions like diabetic neuropathy affecting hearing and balance.
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