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Ototoxicity can ultimately lead to sensory hair cell
death, causing hearing loss and vestibular disorders. Yet clinical use of
aminoglycoside antibiotics is essential against life-threatening bacterial
infections, e.g., meningitis, encephalitis, tuberculosis, and large wound
injuries. But, there are serious ototoxic and nephrotoxic side-effects in
4-14% of all aminoglycoside prescriptions (4 million annually), leading to
mental, educational, language, and renal difficulties in patients suffering
these side-effects. The overall aim of our studies are to identify, and
then prevent the cellular mechanisms that initiate ototoxic drug-induced
hair cell death, and allow clinicians to use aminoglycosides without
serious side effects.
We have developed confocal microscopy techniques to document the
cellular responses of live hair cells to ototoxic drugs.
Gentamicin, an aminoglycoside, and forskolin are two unrelated ototoxic
drugs that induce mitochondrial depolarization, and sustained increases in
intracellular calcium levels, which are powerful triggers for activating
cell death pathways. These common cellular responses suggest that unrelated
ototoxic drugs trigger common pathways leading to hair cell death.
Therefore, we will use in vitro confocal microscopy of fluorescent probes
in living hair cells to:
(1) Identify the acute effects
of ototoxic drugs in hair cells and supporting cells, and determine if
gentamicin and forskolin trigger similar or differing hair cell
responses
(2) Determine if inhibitors of intracellular calcium increases prevent
activation of hair cell death pathways
(3) Determine if cytoskeletal mechanisms actively extrude dying hair cells,
since the cellular mechanisms of hair cell extrusion are not known.
These confocal microscopy studies of cellular responses
of live hair cells ototoxic drugs provide a direct link between the
molecular and biochemical studies of ototoxic drugs and the morphological
analysis of fixed tissues after drug treatment. This knowledge will
significantly advance development of clinical strategies to rescue hair
cells from drug-induced cell death, and preserve inner ear function during
this critical pharmaceutical therapy.
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