Strategies to reduce the risk of platinum containing antineoplastic drug-induced ototoxicity.

Strategies to reduce the risk of platinum containing antineoplastic drug-induced ototoxicity.
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DOI:
10.1080/17425255.2020.1806235
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发表时间:
2020-10
影响因子:
4.3
通讯作者:
Rybak L
Rybak L
中科院分区:
医学2区
文献类型:
--
作者:
Mukherjea D;Dhukhwa A;Sapra A;Bhandari P;Woolford K;Franke J;Ramkumar V;Rybak L

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顺铂是一种针对成人和儿童的各种实体肿瘤的高效化疗剂。不幸的是,很大比例的患者患有永久性感音神经性听力损失。高达60%的儿童和至少50%的成人患有这种并发症,严重影响他们的生活质量。听力损失是由于内耳的感觉细胞受损,主要是外毛细胞和血管纹和螺旋神经节的细胞。耳蜗损伤的机制仍在研究中。然而,似乎大多数内耳损伤是由活性氧(ROS)形成和炎症引发的。在这篇综述中,我们讨论了一些潜在的治疗目标,可以解决提供听力保护。这些策略包括增强内源性抗氧化剂途径、热休克蛋白、G蛋白偶联受体和产生ROS和活性氮物质的抵消酶,以及阻断产生炎症的途径,包括TRPV 1和STAT 1。许多潜在的保护剂在动物模型中通过经鼓膜或颅内注射全身或局部给药显示出希望。然而,除了两项儿科肿瘤研究中的硫代硫酸钠给药外,迄今为止临床试验尚未显示出太多疗效。目前迫切需要发现安全有效的保护剂,不干扰顺铂对肿瘤的疗效,同时保护听力。
Cisplatin is a highly effective chemotherapeutic agent against a variety of solid tumors in adults and in children. Unfortunately, a large percentage of patients suffer permanent sensorineural hearing loss. Up to 60% of children and at least 50% of adults suffer this complication that seriously compromises their quality of life. Hearing loss is due to damage to the sensory cells in the inner ear, primarily the outer hair cells and cells of the stria vascularis and spiral ganglion. The mechanisms of cochlear damage are still being investigated. However, it appears that most damage to the inner ear is triggered by reactive oxygen species (ROS) formation and inflammation. In this review we discuss a number of potential therapeutic targets that can be addressed to provide hearing protection. These strategies include enhancing the endogenous antioxidant pathways, heat shock proteins, G protein coupled receptors and counteracting enzymes that produce ROS and reactive nitrogen species, and blocking pathways that produce inflammation, including TRPV1 and STAT1. A number of potential protective agents show promise in animal models by systemic or local administration by transtympanic or intracochlear injection. However, clinical trials have not shown much efficacy to date with the exception of sodium thiosulfate administration in two studies of pediatric tumors. There is an urgent need to discover safe and effective protective agents that do not interfere with the efficacy of cisplatin against tumors yet preserve hearing.
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发表时间: 2019-07-01
影响因子: 1.5
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DOI: 10.1016/s0378-5955(96)00152-9
发表时间: 1996-12-01
期刊: HEARING RESEARCH
影响因子: 2.8
作者:
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