IMPROVED STEROID THERAPY FOR HEARING LOSS

尽管多年来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，耳朵的炎症是 潜在病因学。 事实上，泼尼松治疗被推荐用于 各种突发性和特发性听力障碍， 潜在免疫问题的影响。最近的研究从各种 的实验室表明血管纹积液 发生于自身免疫性感音神经性听力损失，药物耳毒性， 类固醇缺乏症等。因此，常见的问题是钠减少 通过耳蜗细胞运输，导致水肿和耳朵的失败， 维持正常耳蜗电位所需的离子平衡。 糖皮质激素可能对这些听力有帮助的原因 他们也有一个轻微的，但重要的， 增加钠转运的有效性。 如果是这样， 有更有效的类固醇钠转运， 盐皮质激素然而，这些类固醇从未被评估过 改善内耳功能，尽管事实上， 多种盐皮质激素受体。这些发现导致了 假设盐皮质激素（例如醛固酮）更多 有效逆转这些不同形式的耳蜗功能障碍， 听力损失 因此，本研究项目的长期目标 是开发一种更有效的介入治疗方法， 耳朵 本研究的总体目的是评价 盐皮质激素和糖皮质激素在逆转或预防 听力损失 拟议研究的具体目标是：目标1：比较 泼尼松龙和醛固酮逆转听力损失疗效观察 一旦它发生。 目的2：比较泼尼松龙与 醛固酮预防听力损失。 在所有研究中，将使用以下方法进行内耳病理学评估： 听性脑干反应测听，耳蜗光电 耳蜗组织病理学检查及激素和受体免疫组化 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.