Current concepts in age-related hearing loss: epidemiology and mechanistic pathways.

Current concepts in age-related hearing loss: epidemiology and mechanistic pathways.
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DOI:
10.1016/j.heares.2013.01.021
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发表时间:
2013-09
期刊:
影响因子:
2.8
通讯作者:
Kondo K
Kondo K
中科院分区:
医学1区
文献类型:
--
作者:
Yamasoba T;Lin FR;Someya S;Kashio A;Sakamoto T;Kondo K

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年龄相关性听力损失(AHL),也称为老年性耳聋,是哺乳动物衰老的普遍特征,其特征是听觉功能下降,如听力阈值升高和频率分辨率降低。AHL的原发病理包括毛细胞、血管纹、传入螺旋神经节神经元以及中枢听觉通路。越来越多的动物研究表明,氧化应激的累积效应可导致线粒体DNA(MtDNA)等大分子的损伤,由此导致的mtDNA突变/缺失的积累和线粒体功能的下降在诱导耳蜗细胞凋亡从而发展为AHL中起着重要作用。流行病学研究已经证实了人类AHL的四类危险因素:耳蜗老化、环境如噪声暴露、遗传易感性以及健康并存如吸烟和动脉粥样硬化。遗传学研究已经确定了几个可能的关联基因,包括那些与抗氧化防御和动脉粥样硬化相关的基因。众所周知,暴露在噪声中会导致耳蜗内产生过量的活性氧物种(ROS),而动脉粥样硬化导致的耳蜗血供应动态平衡受损导致的相对低氧情况会增强累积的氧化应激,而遗传因素和并存疾病因素可能会加速这一过程。抗氧化防御系统也可能受到遗传背景的影响。这可能解释了AHL的发病和程度在老年人之间有很大的差异。
Age-related hearing loss (AHL), also known as presbycusis, is a universal feature of mammalian aging and is characterized by a decline of auditory function, such as increased hearing thresholds and poor frequency resolution. The primary pathology of AHL includes the hair cells, stria vascularis, and afferent spiral ganglion neurons as well as the central auditory pathways. A growing body of evidence in animal studies has suggested that cumulative effect of oxidative stress could induce damage to macromolecules such as mitochondrial DNA (mtDNA) and that the resulting accumulation of mtDNA mutations/deletions and decline of mitochondrial function play an important role in inducing apoptosis of the cochlear cells, thereby the development of AHL. Epidemiological studies have demonstrated four categories of risk factors of AHL in humans: cochlear aging, environment such as noise exposure, genetic predisposition, and health co-morbidities such as cigarette smoking and atherosclerosis. Genetic investigation has identified several putative associating genes, including those related to antioxidant defense and atherosclerosis. Exposure to noise is known to induce excess generation of reactive oxygen species (ROS) in the cochlea, and cumulative oxidative stress can be enhanced by relatively hypoxic situations resulting from the impaired homeostasis of cochlear blood supply due to atherosclerosis, which could be accelerated by genetic and co-morbidity factors. Antioxidant defense system may also be influenced by genetic backgrounds. These may explain the large variations of the onset and extent of AHL among elderly subjects.
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