An update on drug design strategies to prevent acquired sensorineural hearing loss

ABSTRACT

Introduction: Acute sensorineural hearing loss is a dramatic event for the patient. Different pathologies might result in acute sensorineural hearing loss, such as sudden hearing loss, exposure to medications/drugs or loud sound. Current therapeutic approaches include steroids and hyperbaric oxygen in addition to other methods. Research activities of the past have shed light on the molecular mechanisms involved in damage to hair cells, the synapses at the hair cell spiral ganglion junction and the stria vascularis. Molecular events and signaling pathways which underlie damage to these structures have been discovered.

Areas covered: This paper summarizes current research efforts involved in investigating the molecular mechanisms involved in acute sensorineural hearing loss.

Expert opinion: While progress has been made in unraveling basic mechanisms involved in acute sensorineural hearing loss, it is difficult to translate basic concepts to the clinic. There are often conflicting data in animal and human studies on the effect of a given intervention. There is also a lack of high quality clinical trials (double blind, placebo controlled and high powered). However, this author is confident that research efforts will pay out and that some of these efforts will translate into new therapeutic options for patients with acute hearing loss.

KEYWORDS:

• Apoptosis
• auditory hair cells
• cochlea
• hearing loss
• inner ear

Article highlights

• The treatment options today for acute sensorineural hearing loss are very limited.

• Treatment options for acute sensorineural hearing loss today are mainly steroids, either systemically or intratympanic

• Auditory hair cells, the synapse between hair cells and spiral ganglion neurons and the stria vascularis are the most vulnerable elements in the inner ear.

• Different drugs protect hair cells and hearing in vitro and in vivo in animal models, such as members of the MAPK family, ROS scavengers, growth factors, immunomodulatory drugs, etc.

• Clinical studies are ongoing to test these concepts and will hopefully see some of these concepts entering clinical practice in the near future.

This box summarizes key points contained in the article

Declaration of interest

D Bodmer is a co-founder and consultant to Strekin AG, Basel, Switzerland which develops therapies for inner ear disorders. He has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This manuscript was not funded.