IMPROVED STEROID THERAPY FOR HEARING LOSS

尽管多年来一直在治疗各种形式的听力损失 糖皮质激素(泼尼松、地塞米松)，几乎没有 临床或实验证据表明，耳部炎症是 潜在的病因学。事实上，泼尼松疗法被推荐用于 各种突发性和特发性听力障碍，但没有治疗方法 暗示潜在的免疫问题。来自不同品种的最新研究 的实验室已经证明血管纹积聚液体 发生在自身免疫性感音神经性耳聋，药物耳毒性， 类固醇缺乏等。因此，常见的问题是钠含量降低 由工业细胞运输，导致肿胀和耳部功能衰竭。 维持正常耳蜗电势所需的离子平衡。 糖皮质激素可能对这些听力有帮助 障碍是，他们也有轻微但严重的， 增加钠转运的有效性。如果是这样的话， 有更有效的类固醇来促进钠的运输， 矿物皮质激素。然而，这些类固醇从未被评估过。 为了改善内耳功能，尽管耳朵已经 大量的盐皮质激素受体。这些发现导致了 假设矿物质皮质激素，如醛固酮，比 在这些不同形式的耳蜗术中有效逆转耳蜗功能障碍 听力损失。因此，这个研究计划的长期目标是 是为了开发一种更有效的疾病介入疗法 耳朵。这项研究的总体目的是评估其有效性。 矿物质皮质激素和糖皮质激素在逆转或预防 听力损失。 拟议研究的具体目的是：目标1：比较 强的松龙联合醛固酮逆转听力损失的疗效观察 一旦它发生了。目的2：比较强的松龙和强的松龙的疗效 醛固酮在预防听力损失中的作用 在所有研究中，内耳病理的评估将通过 听性脑干反应测听、耳蜗光和电子 耳蜗镜、激素和受体免疫组织化学研究 组织。

In spite of years of treating various forms of hearing loss with glucocorticoids (prednisone, dexamethasone), there is virtually no clinical or experimental evidence that inflammation of the ear is the underlying etiology. In fact, prednisone therapy is recommended for various sudden and idiopathic hearing disorders for which there is no implication of underlying immune problems. Recent studies from a variety of laboratories have shown that stria vascularis fluid accumulation occurs with autoimmune sensorineural hearing loss, drug ototoxicity, steroid deficiencies, etc. Thus, the common problem is decreased sodium transport by strial cells, leading to edema and failure of the ear to maintain the ionic balances necessary for normal cochlear potentials. The reason glucocorticoids are probably helping in these hearing disorders is that they also have a slight, but significant, effectiveness in increasing sodium transport. If this is the case, there are more effective steroids for sodium transport, the mineralocorticoids. However, these steroids have never been evaluated for improving inner ear function, in spite of the fact that the ear has numerous mineralocorticoid receptors. These findings have led to the hypothesis that mineralcorticoids, such as aldosterone, are more efficient in reversing cochlear dysfunction in these various forms of hearing loss. Thus, the long term objective of this research program is to develop a more effective interventional therapy for diseases on the ear. The general aim of this study is evaluate the effectiveness of mineralcorticoids and glucocorticoids in reversing or preventing the hearing loss. The specific aims of the proposed study are to: Aim 1: To compare the effectiveness of prednisolone and aldosterone in reversing hearing loss once it occurs. Aim 2: To compare the effectiveness of prednisolone and aldosterone in preventing hearing loss. In all studies, assessment of inner ear pathology will be made with auditory brainstem response audiometry, cochlear light and electron microscopy, and hormone and receptor immunohistochemistry of cochlear tissue.