Ascorbic acid prevents chloroquine-induced toxicity in inner glial cells

Oliveira, Karen Renata Matos; Anjos, Larissa Medeiros dos; Araújo, Ana Paula Sousa; Luz, Waldo Lucas; Kauffmann, Nayara; Braga, Danielle Valente; Passos, Adelaide da Conceição Fonseca; Moraes, Suellen Alessandra Soares de; Batista, Evander de Jesus Oliveira; Herculano, Anderson Manoel

doi:10.1016/j.tiv.2019.01.008

Cited by 15 publications

(21 citation statements)

References 44 publications

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“…Toxicity occurs via a multifactorial mechanism involving oxidative stress, ischemic damage, and potassium channel inhibition in outer cochlear hair cells leading to hearing loss and vertigo [ 70 , 77 , 78 ]. Loss of balance, sensorineural hearing loss, and ataxia are believed to be related to vestibular dysfunction [ 79 , 80 ].…”

Section: Discussionmentioning

confidence: 99%

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Porta

Bornstein

Coye

et al. 2020

The American Journal of Emergency Medicine

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Background Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality. Objective This review describes acute chloroquine and hydroxychloroquine toxicity, outlines the complex pathophysiologic derangements, and addresses the emergency department (ED) management of this patient population. Discussion Chloroquine and hydroxychloroquine are aminoquinoline derivatives widely used in the treatment of rheumatologic diseases including systemic lupus erythematosus and rheumatoid arthritis as well as for malaria prophylaxis. In early 2020, anecdotal reports and preliminary data suggested utility of hydroxychloroquine in attenuating viral loads and symptoms in patients with SARS-CoV-2 infection. Aminoquinoline drugs pose unique and significant toxicological risks, both during their intended use as well as in unsupervised settings by laypersons. The therapeutic range for chloroquine is narrow. Acute severe toxicity is associated with 10–30% mortality owing to a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias. Treatment in the ED is focused on decontamination, stabilization of cardiac dysrhythmias, hemodynamic support, electrolyte correction, and seizure prevention. Conclusions An understanding of the pathophysiology of acute chloroquine and hydroxychloroquine toxicity and available emergency treatments can assist emergency clinicians in reducing the immediate morbidity and mortality associated with this disease.

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Section: Discussionmentioning

confidence: 99%

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Porta

Bornstein

Coye

et al. 2020

The American Journal of Emergency Medicine

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“…The variance can be explained by the differences in analytical procedures, concerning the extraction process and HPLC analysis conditions. The effect of environmental factors such as insolation or amount of rainfall on phytochemical content in plant tissues can be significant [39,40]. According to Pawłowska et al, the total amount of quercetin derivatives in fruits was nearly fourfold higher than in the data published by Molodovan et al (Table 1).…”

Section: Phytocompounds Composition In Cornelian Cherry Fruitsmentioning

confidence: 91%

Functional properties of Cornelian cherry (Cornus mas L.): a comprehensive review

Szczepaniak

Kobus‐Cisowska

Kusek

et al. 2019

Eur Food Res Technol

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Cornus mas, also known as the Cornelian cherry, is a plant that grows in Eastern Europe and the Middle East. Its green leaves and reddish oval fruits are associated with many beneficial properties such as antioxidative and anti-inflammatory effects. These features are driven by the rich polyphenolic composition, with anthocyanins and iridoids in Cornelian cherry fruits as well as flavonoids and phenolic acids in leaves. The antioxidant behavior as well as the composition significantly depends on the cultivar of the plant and its genotype. The functional properties of Cornelian cherry have been recognized in many in vitro and toxicological studies. Cornus mas fruits and their extracts have been found to have significant antiatherogenic, anti-inflammatory, and neuroprotective effects. The beneficial effect of C. mas fruits as a food component has been determined in numerous papers focused on functional food. However, there is no information in existing literature about C. mas leaves in functional food applications. This paper presents the results of current studies including their synthesis to answer the question whether the Cornelian cherry exhibits positive properties due to its bioactive compound content.

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“…Thereby, the protective effect in glial cells observed with this essential vitamin can contribute to the treatment against ototoxicity induced by the use of chloroquine. 29 There is a predominance of adverse events related to chloroquine toxicity, but ototoxicity is also related to the use of hydroxychloroquine, which is theoretically known to be less toxic. Most of these cases are reported with chronic use of chloroquine, and it may be explained by a long-term retention and accumulation of the drug in the melanocytes in the inner ear cells, resulting in variable injuries to the cochlear sensory hair cells and decreasing neuronal population.…”

Section: Discussionmentioning

confidence: 99%

“…Thereby, the protective effect in glial cells observed with this essential vitamin can contribute to the treatment against ototoxicity induced by the use of chloroquine. 29 …”

Section: Discussionmentioning

confidence: 99%

Chloroquine and COVID-19: Should We Care about Ototoxicity?

Monteiro

Nascimento

Brito

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Severe acute respiratory syndrome coronavirus 2 was first described in December 2019 in China leading to a Public Health Emergency of International Concern. It was named by the World Health Organization as Coronavirus Disease 2019 (COVID-19), and it garnered unprecedented attention from public health researchers around the world, and studies analyzing chloroquine and hydroxychloroquine as a possible therapy have arisen in the last 2 months. Objective To review the literature and describe updated facts about the ototoxicity of chloroquine and hydroxychloroquine, an important side effect that can be present in patients with COVID-19 treated with these drugs. Data Synthesis The most typical treatment regimen is 5 days of hydroxychloroquine at daily doses of 400 to 600 mg. There is no randomized clinical trial that can prove so far the efficacy of this medication, and few studies have evaluated adverse events potentially linked to their use in patients with COVID-19. While there is no concrete evidence on the incidence of ototoxicity using chloroquine in the short term, we need to consider that, as a pandemic disease, millions of patients with COVID-19 may receive this treatment, and ototoxicity can be a possible adverse event. Conclusion Despite the urgent global situation caused by the COVID-19, the risk of irreversible hearing loss may outweigh the unproven benefit of using hydroxychloroquine or chloroquine, especially in patients with mild forms of COVID-19, who may be cured with supportive treatment. The potential hearing loss that can be caused by these medications may advise against their use in COVID-19 patients.

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Ascorbic acid prevents chloroquine-induced toxicity in inner glial cells

Cited by 15 publications

References 44 publications

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Functional properties of Cornelian cherry (Cornus mas L.): a comprehensive review

Chloroquine and COVID-19: Should We Care about Ototoxicity?

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