EFFECTS OF ORGANIC ACIDS ON LOOP DIURETIC OTOTOXICITY

一些有机酸化合物如袢利尿剂已被证明 对患者的耳蜗功能以及 实验动物模型。 不幸的是，这些的分子基础 耳毒性作用尚未阐明。 最近的实验发现 已经表明某些有机酸化合物可以降低耳蜗 呋塞米的作用 拟议的研究将检查相互作用 有机酸转运抑制剂与两种耳毒性袢利尿剂： 依他尼酸和呋塞米。 这些研究将调查是否 相互作用导致这些耳毒性环耳蜗效应降低 利尿剂 具体的电生理实验将着眼于 耳蜗内电位、第八神经动作电位和 内淋巴钾和氯离子浓度的测定 敏感微电极 这些发现与 制作血管纹的超微结构。 的血液水平 将在对照和实验动物中测量袢利尿剂， 确定它们是否被减少耳蜗的药物改变， 方面的影响. 此外，对照组和实验组的利尿反应 将对动物进行评估，以确定是否有药物改变了 耳蜗效应也改变了对袢利尿剂的利尿反应。 的 研究结果表明，特异性抑制环的不良耳毒性作用， 不改变药代动力学或预期药效学的利尿剂 效果将强烈地表明存在有机酸的载体， 耳蜗，类似于在其他组织中看到的。 此外，这种 这些发现将具有非常具有挑战性的治疗意义。 的 操作袢利尿剂耳毒性作用的可能性， 改变从患者体内移除多余液体的必要反应 将具有重要的临床意义

A number of organic acid compounds such as loop diuretics have been shown to adversely effect cochlear function in patients as well as in experimental animal models. Unfortunately, the molecular basis for these ototoxic effects has not yet been elucidated. Recent experimental findings have suggested that certain organic acid compounds can reduce the cochlear effects of furosemide. The proposed research will examine the interaction of organic acid transport inhibitors with two ototoxic loop diuretics: ethacrynic acid and furosemide. The studies will investigate whether such interactions result in a reduced cochlear effect of these ototoxic loop diuretics. The specific electrophysiologic experiments will look at changes in endocochlear potential, eighth nerve action potential, and the measurement of potassium and chloride concentration in endolymph using ion sensitive microelectrodes. Correlation of these findings with the ultrastructure of the stria vascularis will be made. The blood levels of loop diuretics will be measured in controls and experimental animals to determine whether they are altered by drugs which reduce the cochlear effects. In addition, the diuretic response in control and experimental animals will be evaluated to determine whether drugs which alter the cochlear effects also change the diuretic response to loop diuretics. The findings that specific inhibition of undesirable ototoxic effects of loop diuretics without changing the pharmacokinetics or desired pharmacodynamic effect will strongly suggest the presence of a carrier for organic acids in the cochlear, analogous to that seen in other tissues. Furthermore, such findings would have extremely provocative therapeutic implications. The possibility of manipulation of ototoxic effects of loop diuretics without altering the necessary response of removing excess fluid from the patient would be of major clinical importance.