Aspirin attenuates gentamicin ototoxicity: From the laboratory to the clinic
Aspirin attenuates gentamicin ototoxicity: From the laboratory to the clinic
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DOI：
10.1016/j.heares.2006.05.008
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发表时间：
2007-04-01
期刊：
影响因子：
2.8
通讯作者：
Schacht, Jochen
中科院分区：
文献类型：
--
作者：
Chen, Yang;Huang, Wei-Guo;Schacht, Jochen
本文综述了氨基糖苷类抗生素在预防与抗菌治疗相关的听觉或前庭不良反应方面的最新进展。来自动物模型的令人信服的证据表明，活性氧是触发内部细胞凋亡和坏死细胞死亡的初始机制的一部分。因此，抗氧化剂保护动物免受氨基糖苷引起的听力损失，重要的是，它们在不影响药物血清水平或抗菌功效的情况下这样做。虽然临床研究早就证实了氨基糖苷类物质对人体的耳毒性，但最近才报道了一项关于保护作用的试验(Sha， S.-H.；邱j.h。Schacht， J., 2006。阿司匹林减轻庆大霉素引起的听力损失。新英格兰。医学杂志，354,1856-1857)。基于水杨酸对动物具有保护作用的发现，在一项随机双盲安慰剂对照研究中，在接受庆大霉素治疗急性感染的患者中测试了阿司匹林（乙酰水杨酸）的疗效。安慰剂组106例患者中有14例（13%）达到听力损失标准，而阿司匹林组只有3/89例（3%）达到听力损失标准（p = 0.013）。阿司匹林不影响庆大霉素的血清水平或疗程。这些结果表明，对氨基糖苷耳毒性的治疗保护可以从动物模型推断到临床。此外，像阿司匹林这样常见的药物可以显著降低庆大霉素引起的听力损失的风险。(C) 2006 Elsevier B.V.版权所有
This article reviews recent advances in the protection from the adverse auditory or vestibular side effects associated with antibacterial treatment with aminoglycoside antibiotics. Compelling evidence from animal models suggests that reactive oxygen species are part of the initial mechanisms that trigger apoptotic and necrotic cell death in the inner car. Consequently, antioxidants protect against aminoglycoside-induced hearing loss in animals and, importantly, they do so without compromising drug serum levels or antibacterial efficacy. While clinical studies have long confirmed the ototoxicity of aminoglycosides in human, a trial on protection was only recently reported (Sha, S.-H., Qiu, J.-H., Schacht, J., 2006. Aspirin attenuates gentamicin-induced hearing loss. New Engl. J. Med. 354, 1856-1857). Based on the finding that salicylate afforded protection in animals, the efficacy of aspirin (acetyl salicylate) was tested in a randomized double-blind placebo-controlled study in patients receiving gentamicin for acute infections. Fourteen of 106 patients (13%) met the criterion of hearing loss in the placebo group while only 3/89 (3%) were affected in the aspirin group (p = 0.013). Aspirin did not influence gentamicin serum levels or the course of therapy. These results indicate that therapeutic protection from aminoglycoside ototoxicity may be extrapolated from animal models to the clinic. Furthermore, medications as common as aspirin can significantly attenuate the risk of gentamicin-induced hearing loss. (C) 2006 Elsevier B.V. All rights reserved.