Aldo Ferraresi

Cisplatin ototoxicity in the guinea pig: vestibular and cochlear damage.

The aim of the present study was to investigate both vestibular and cochlear cisplatin toxicity. Twelve albino guinea pigs were divided into an experimental (n=8) and a control saline group (n=4) and were treated with cisplatin at a daily dose of 2.5 mg/kg for 6 consecutive days. Vestibular dysfunction was evaluated by computing the gain of the vestibular ocular reflex (VOR) evoked by stimulation in the horizontal (HVOR) and vertical (VVOR) planes. Changes in cochlear function were characterised as compound action potential threshold shifts. After the functional testing, tympanic bullae were removed and processed for morphological examination of the sensorineural epithelium. The onset of vestibular functional impairment was observed on the third day, although the VOR gain decrease was not significant. The impairment of the vestibular function progressed until the sixth day becoming statistically significant particularly at VVOR mid frequencies of stimulation. At these frequencies both macula and crista ampullaris functions are involved. Concomitantly a progressive auditory threshold shift was observed at all stimulus frequencies. The decline of the auditory function was statistically significant from the third day of treatment and it was more evident at high frequencies. Morphological observations showed a massive loss of outer hair cells and a degeneration of the organ of Corti in the basal/middle turns and only a slight loss of hair cells of the cristae ampullares and maculae. In conclusion, functional and morphological data provide evidence that the toxic effect of cisplatin is more pronounced in the organ of Corti than in the vestibular epithelium.

Protective Effects of α-Tocopherol Against Gentamicin-induced Oto-vestibulo Toxicity: An Experimental Study

Objective—Free radicals are involved in gentamicin ototoxicity and vestibular dysfunction and it has been demonstrated that free radical scavengers, such as α-tocopherol, are able to inactive free radicals, attenuating tissue damage. This study was designed to investigate the possible protective effects of α-tocopherol against gentamicin-induced oto-vestibulo toxicity.Material and Methods—Adult albino guinea pigs were divided into four groups and were treated for 2 weeks as follows: Group A, controls; Group B, gentamicin plus corn oil; Group C, gentamicin only; and Group D, gentamicin plus α-tocopherol. To evaluate vestibular function, the animals underwent sinusoidal oscillations in the dark about their vertical and longitudinal axes to evoke horizontal and vertical vestibulo-ocular reflexes (VORs), respectively. Electrocochleographic recordings were performed using an implanted round window electrode. The compound action potentials (CAPs) at 2, 4, 8 and 16 kHz were measured every 5 days. Morphological changes were analysed by means of scanning electron microscopy.Results—Gentamicin induced a consistent reduction in VOR responses and a progressive high-frequency hearing loss of 50–60 dB sound pressure level. α-Tocopherol co-therapy slowed the progression of hearing loss and significantly attenuated the final threshold shifts. The impairment of vestibular function was reduced, as evidenced by an increased VOR gain. The massive loss of outer hair cells in the cochlear basal turn and of cristae ampullaris stereocilia in gentamicin-treated animals was not observed in the cochlea of animals protected with α-tocopherol.Conclusion—This study supports the hypothesis that α-tocopherol interferes with gentamicin-induced free radical formation, and suggests that this drug may be useful in preventing aminoglycoside oto-vestibulo toxicity.

α-Tocopherol protective effects on gentamicin ototoxicity: an experimental study

Gentamicin, acting as an iron chelator, activates membrane lipid peroxidation (MPL) and induces free radical formation, as observed in vitro and in vivo. Antioxidants, such as α-tocopherol, are able to suppress MLP, thus attenuating tissue damage. The present study was designed to investigate the possible protective effects of α-tocopherol on gentamicin ototoxicity. The study was carried out on albino guinea pigs (250–350 g). The animals were divided into four groups: group A (n = 4), injected with corn oil daily at a dose of 100 mg/kg body weight intramuscularly (IM); group B (n = 10), treated with corn oil at a dose of 100 mg/kg body weight and gentamicin base at a dose of 100 mg/kg body weight (IM); group C (n = 10), treated with gentamicin alone at a dose of 100 mg/kg body weight (IM); and group D (n 10), treated with gentamicin at the same dose plus α-tocopherol acetate at dose of 100 mg/kg body weight (IM). Electrocochleographic recordings were made from an implanted round-window electrode. All animals were treated for 14 days. The compound action potentials (CAPs) were measured at 2–16 kHz at days 0, 10, 14 and 18 after treatment. Changes in cochlear function were characterized as CAP threshold shifts. Morphological changes were analysed by scanning electron microscopy. Gentamicin induced progressive high-frequency hearing loss of 50–60 dB SPL. α-tocopherol co-therapy slowed the progression of hearing loss. The significant loss of outer hair cells (OHCs) in the cochlear basal turn in gentamicin-treated animals was not observed in the cochleas of animals protected with α-tocopherol. This study supports the hypothesis that α-tocopherol interferes with gentamicin-induced free radical formation, and suggests that this drug may be useful in protecting OHC function from aminoglycoside ototoxicity, thus reducing hearing loss. Sumario La gentamicina como quelante de hierro, activa la peroxidación de la membrana lipídica (MPL) e induce la formación de los radicales libres, como se ha observado in vitro e in vivo. Los antioxidantes como el α tocoferol son capaces de suprimir la MPL, y por lo tanto atenuar el daño tisular. Este estudio fue diseñado para investigar los posibles efectos protectores del α tocoferol en la ototoxicidad de la gentamicina. El estudio se llevó a cabo en cobayos albinos (250–350 g). Los animales fueron divididos en cuatro grupos: grupo A (n = 4), inyectados intramuscularmente (IM) a diario con aceite de maiz a 100 mg/kg de peso; grupo B (n = 10), tratados con aceite de maiz a 100 mg/kg de peso y gentamicina base a 100 ng/kg (IM); grupo C (n = 10), tratados con gentamicina sola a 100 mg/kg (IM); y grupo D (n = 10), tratados con gentamicina a la misma dosis, más acetato de α-tocoferol a 100 mg/kg (IM). Se tomaron registros electrococleográficos a partir de un electrodo colocado en la ventana redonda. Todos los animales fueron tratados durante 14 días. Se midieron los potenciales de acción compuesta (CAPs) a 2–16 kHz los días 0, 10, 14 y 18 después del tratamiento. Los cambios en la función coclear se describieron como cambios del umbral de los CAP. Se analizaron los cambios morfológicos por medio de un barrido de microscopía electrónica. La gentamicina induce una hipoacusia progresiva para frecuencias agudas de 50–60 dB SPL. La terapia combinada con α-tocoferol disminuyó la progresión de la hipoacusia. La pérdida significativa de células ciliadas externas (OHCs) en la vuelta basal de las cócleas de los animales tratados con gentamicina no se observó en las cócleas de los animales protegidos con α-tocoferol. Este estudio apoya la hipótesis de que el α-tocoferol interfiere en la formación de radicales libres inducida por la gentamicina y sugiere que esta sustancia puede ser útil para la protección de la función de las OHC de la ototoxicidad por aminoglucósidos, con lo que se reduce la hipoacusia.

The role of antioxidants in protection from ototoxic drugs

A number of studies have shown that cisplatin and gentamicin ototoxic effects may result from free radical-mediated damage due to the reduction of antioxidant substances and an increased lipid peroxidation. The authors summarize the results obtained evaluating the auditory and vestibular functions and the inner ear hair cell morphology and survival after administration of antioxidant agents against cisplatin and gentamicin. In the first experiment, albino guinea pigs were treated with gentamicin (100 mg/kg per day, i.m.) alone or gentamicin (100 mg/kg per day, i.m.) plus α-tocopherol (100 mg/kg per day, i.m.) for 2 weeks. In a second experiment, albino guinea pigs were injected with cisplatin (2.5 mg/kg per day) or cisplatin (2.5 mg/kg per day) plus tiopronin (300 mg/kg) for 6 days. Electrocochleographic recordings were made from an implanted round window electrode. In all experiments compound action potentials (CAPs) were measured at 2–16 kHz. Changes in cochlear function were characterized as CAP threshold shifts. To evaluate vestibular function, the animals underwent sinusoidal oscillations in the dark about their vertical and longitudinal axes to evoke horizontal and vertical vestibulo-ocular reflexes (VOR). Frequency stimulation parameters ranged from 0.02 to 0.4 Hz and peak-to-peak amplitude was 20°. Morphological changes were analysed by light microscopy and scanning electron microscopy. Both hearing loss and vestibular dysfunction induced by gentamicin were significantly attenuated by α-tocopherol. However, tiopronin co-therapy slowed the progression of hearing loss in cisplatin-treated animals and significantly attenuated the final threshold shifts. Cisplatin had little effect on the hair cells of cristae ampullares and maculae. Vestibular function was completely preserved in tiopronin co-treated animals. In conclusion, antioxidants such as α-tocopherol or tiopronin interfere with gentamicin and cisplatin damage and this suggests that they may be useful in preventing oto-vestibulotoxicity. Therefore, it is important to develop protective strategies that permit the avoidance of the toxic side effects of these drugs without interfering with their therapeutic effects.

Antioxidant protection against acoustic trauma by coadministration of idebenone and vitamin E.

Idebenone, a synthetic analogue of coenzyme Q, attenuates noise-induced hearing loss by virtue of its antioxidant properties. This study involves a guinea pig model of acoustic trauma where the effectiveness of idebenone is analyzed in comparison with Vitamin E (&agr;-tocopherol) that exhibits a potent antioxidant activity in the inner ear. Idebenone and vitamin E were injected intraperitoneally 1u2009h before noise exposure and once daily for three days; functional and morphological studies were then carried out, respectively, by auditory brainstem responses evaluation, scanning electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assay identification of missing and apoptotic cells was also performed. The results showed that the protective effects of idebenone and vitamin E were not additive implying that the two antioxidants may share competitive mechanisms.

Otolithic and Extraocular Muscle Proprioceptive Influences on the Spatial Organization of the Vestibulo- and Cervico-Ocular Quick Phases

The cervico-ocular reflex (COR) was studied alone or in combination with the vestibulo-ocular reflex (VOR) in the rabbit. Step stimulations of the body with respect to the fixed head induced small slow compensatory responses followed by large compensatory quick phases (QP). These responses remained aligned with the horizon at different head pitch angles. The QP reorientation in space was due to the gravity influence on the otolithic receptors. The vestibular induced QPs exhibit a similar pattern. Because of this reorientation, the reduction of the amplitude of the vestibular induced QPs, due to the addition of the COR, was maintained even at different static head positions. The electrolytic lesion of the ophthalmic branch of the trigeminal nerve deeply affected the space orientation of the COR. In particular, the cervically induced compensatory QPs of the eye ipsilateral to the lesion showed a remarkable variability of their trajectories and they lost space reorientation. These findings suggest that the coordinate system controlling the QPs is influenced by signals originating from both head position in space and eye position in the orbit.

Influence of the Extraocular Muscle Proprioceptors on the Orientation of the Vestibulo-Ocular Reflex

In the intact brain lamb, unilateral electrolytic lesion of the medial dorso-lateral portion of the semilunar ganglion containing the first order neurons of the eye muscle proprioception induced modifications of the horizontal and vertical vestibulo-ocular reflex (HVOR and VVOR) which consisted in marked alterations of the trajectories of the quick phases, while the slow phases were scarcely affected. Similar results were observed after section of the branches described by Winckler in the retrobulbar region along the extraocular muscle proprioceptive information travels. These findings extend those of previous investigations carried out in decorticate animals.

Influence of Gravity on the Orientation of Vestibular Induced Quick Phases

In rabbits and cats the orientation of the quick phases (QPs) of the vestibulo-ocular reflex (VOR) was studied varying the head position in space. At different head tilt positions, QPs induced by step vestibular stimulation disaligned with respect to the stimulus toward the orientation of the earths horizontal axis. The rabbits QPs were horizontal during yaw stimulation and remained horizontal in a range of head pitch of +/- 90 degrees (reorientation gain = 1). Therefore, the slow compensatory responses (CSPs) progressively disaligned compared with the QPs. QPs induced by roll stimulation also showed horizontal orientation, although these were rare in the upright position and occurred more frequently when the head was pitched. In cats only the yaw-induced QPs were coplanar with the stimulus, while QPs induced by pitching were mostly oblique. It followed that in either yawing or pitching, the QPs had their end point scattered within a horizontally elongated area of the visual field. When tilting cats in the frontal plane, the orientation of QP trajectories changed with respect to the stimulus so that the end point distribution tended to remain aligned toward the horizontal instead of being fixed in the orbit. The reorientation gain decreased from 1 to 0.5 by increasing the head tilt. On the basis of difference regarding eye implantation and motility it was suggested that the effect of gravity on the orientation of QPs could be aimed at maintaining the interocular axis aligned with the horizon in the rabbit and at orientating the visual scanning system in the horizontal plane in the cat.

Eye instability induced by vestibular stimulation in rabbits

The slow compensatory phases of the vestibulo-ocular reflex (VOR) in the rabbit tend to drift and the drift reverses the direction. This periodic alternating drift (PAD) has two peculiar characteristics: (1) it is induced by sinusoidal vestibular stimulation in naive animals, being evoked immediately after stimulus onset and persisting after the end of stimulation; (2) the peak velocity and period of the drift are dependent on stimulus amplitude. PAD of the rabbit has strong similarities with PAN, a periodic alternating nystagmus observed in humans with cerbellar disorders and in monkeys after nodulo-uvulectomy, although its peak velocity is smaller. It is hypothesized that PAD is due to a slight instability, caused by vestibular stimulation in darkness, of the cerebellar adaptive loop, which exerts a variable gain control on the time constant of the velocity storage integrator.

Gravity load related asymmetries in the sagittal vestibulo-collic reflex

EMG recordings of the neck muscles (biventer cervicis, complexus, splenius, longus capitis) of decerebrate cats were obtained during pitch and roll stimulations (sinusoidal stimulation: 30 degrees p-p amplitude, 0.2 Hz frequency). Most of the EMG responses to pitch showed activation peaks leading the position stimuli by 56 degrees and inhibition peaks leading by 11 degrees. Conversely, in response to roll the activation peak led by 16 degrees and the inhibition peak by 10 degrees. The activation peaks of the pitch responses were, thus, more asymmetric and more leading than those of the roll responses. Consequently, the harmonic distortion coefficient was significantly higher in pitch than in roll. Moreover, when the vertical semicircular canals were activated in absence of otolithic modulation, the pitch and roll responses maintained the same difference in timing observed in the presence of otolithic coactivation. It appeared that the simultaneous stimulation of both anterior semicircular canals (pitch) induces a greater lead than that of combined anterior and posterior canals (roll). Thus the timing of neck muscle responses to vestibular stimulation depends on the pair of activated vertical semicircular canals.