The Degeneration of the Vestibular Efferent Neurons After Intratympanic Gentamicin Administration
The Degeneration of the Vestibular Efferent Neurons After Intratympanic Gentamicin Administration
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鼓室内给予庆大霉素后前庭传出神经元的变性
DOI：
10.1369/0022155418773746
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发表时间：
2018-11-01
影响因子：
3.2
通讯作者：
Pan, Lijun
中科院分区：
文献类型：
--
作者：
Wu, Qianru;Zhang, Yibo;Pan, Lijun
鼓室内庆大霉素（ITG）已用于治疗难治性梅尼埃病。 ITG 后的不平衡对于一些患者来说仍然是一个挑战，并且其潜在机制知之甚少。我们前期的研究表明庆大霉素在ITG后分布于双侧前庭传出神经元（VEN）；然而，它是否会导致 VEN 损伤并导致 ITG 后患者进一步失衡？在这项研究中，我们在 ITG 后第 3 天在透射电子显微镜下观察到 VEN 的庆大霉素阳性神经元严重受损，神经纤维周围的髓磷脂层板严重断裂。第 30 天时，VEN 神经元呈现出相对正常的结构。与对照组相比，第3天和第30天双侧VEN中胆碱乙酰转移酶（CHAT）免疫标记神经元总数均显着减少，但第3天和第30天CHAT免疫标记神经元总数无显着差异。这表明庆大霉素不仅逆行转运至双侧VEN，而且导致ITG后VEN变性。这些发现可能与ITG后患者的不平衡症状有关。此外，我们推测 VEN 可能在前庭代偿中发挥作用。
Intratympanic gentamicin (ITG) has been used to treat refractory Meniere's disease. Disequilibrium after ITG was still a challenge for some patients, and the underlying mechanism is poorly understood. Our previous study demonstrated that gentamicin distributed in the bilateral vestibular efferent neurons (VEN) after ITG; however, does it lead to VEN damage and cause further disequilibrium in patients following ITG? In this study, we observed severe damaged gentamicin-positive neurons of VEN and severe fractured myelin layer plates around neural fibers when viewed under transmission electron microscopy at day 3 after ITG. At day 30, neurons of VEN presented with relatively normal structures. Compared with the control group, the total number of choline acetyltransferase (CHAT) immunolabeling neurons in bilateral VEN showed a significant decrease both at day 3 and day 30. However, there was no significant difference in the total number of CHAT immunolabeling neurons between day 3 and day 30. It indicates that gentamicin is not only retrogradely transported into bilateral VEN, but also results in the degeneration of VEN after ITG. These findings may be related to patients' disequilibrium symptom after ITG. Furthermore, we speculate that VEN may play a role in vestibular compensation.