Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Han, Jae Joon; Jung, Jae Yeup; Park, Kye Hoon; Lee, Ho Yun; Lee, Byung Don; Choi, Seong–Jun; Lee, Chi-Kyou

doi:10.1097/mao.0000000000002695

Cited by 9 publications

(8 citation statements)

References 43 publications

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“…Recent studies further investigating the mineralocorticoid function in the inner ear highlight how this mechanism may help identify additional treatment options for SSNHL. For example, the calcium channel blocker, nimodipine, has been shown to have a synergistic effect on hearing recovery rates in patients with SSNHL when used in conjunction with corticosteroid therapy ( 39 ). Interestingly, nimodipine targets mineralocorticoid receptors, Nr3c2 and Cacna1d ( https://pharos.ncats.nih.gov/ligands/nimodipine ), whose genes are expressed in both SV cell types ( 16 ) ( Figure 6 ) and SGN subtypes ( 18 ) ( Figure 7 ).…”

Section: Discussionmentioning

confidence: 99%

In silico Single-Cell Analysis of Steroid-Responsive Gene Targets in the Mammalian Cochlea

et al. 2022

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BackgroundTreatment of many types of hearing instability in humans, including sudden sensorineural hearing loss, Meniere's disease, and autoimmune inner ear disease, rely heavily on the utilization of corticosteroids delivered both by oral and transtympanic routes. Despite this use, there is heterogeneity in the response to treatment with corticosteroids in humans with these diseases. The mechanisms by which corticosteroids exert their effect and the cell types in which they exert their effects in the inner ear remain poorly characterized. In this study, we localize steroid-responsive genes to cochlear cell types using previously published transcriptome datasets from the mammalian cochlea.MethodsSteroid-responsive genes were localized to specific cochlear cell types using existing transcriptome datasets from wild-type mammalian cochlea exposed to systemic and transtympanic steroids, as well as previously published single-cell and single-nucleus RNA-sequencing datasets from the mammalian cochlea. Gene ontology (GO) analysis of differentially expressed genes (DEGs) was performed using PANTHER to investigate cellular processes implicated in transtympanic vs. systemic steroid action in the cochlea.ResultsSteroid-responsive genes were localized to specific cell types and regions in the cochlea including the stria vascularis, organ of Corti, and spiral ganglion neurons (SGN). Analyses demonstrate differential prevalence of steroid-responsive genes. GO analysis demonstrated steroid-responsive DEGs in the SGN to be associated with angiogenesis, apoptosis, and cytokine-mediated anti-inflammatory pathways.ConclusionsSingle-cell and single-nucleus transcriptome datasets localize steroid-responsive genes to specific regions in the cochlea. Further study of these regionally-specific steroid-responsive genes may provide insight into the mechanisms of and clinical response to corticosteroids in diseases of hearing instability.

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Section: Discussionmentioning

confidence: 99%

In silico Single-Cell Analysis of Steroid-Responsive Gene Targets in the Mammalian Cochlea

et al. 2022

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“…Sudden deafness, also known as idiopathic deafness, refers to the sudden onset of unexplained sensorineural hearing loss within 72 hours [ 1 ]. In the process of diagnosis and treatment, it can be divided into low-frequency descending type, high-frequency descending type, flat descending type, and total deafness type.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Ginkgo biloba Extract Combined with Hormones in the Treatment of Sudden Deafness and Its Effect on the Reactivity of Peripheral Blood T Cell Subsets

Zhu

et al. 2022

Computational and Mathematical Methods in Medicine

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This work was aimed at exploring the efficacy of Ginkgo biloba extract combined with hormones in the treatment of sudden deafness and the influence on the reactivity of peripheral blood T cell subsets (PBTCSs). In this work, 64 patients with sudden deafness who were treated in The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from August 2019 to August 2022 were selected as the research objects. The patients were randomly divided into a hormone group (treatment with prednisone acetate, n = 34 ) and a combination group (treatment with Ginkgo-Damole combined with prednisone acetate, n = 30 ). After the two groups of patients were treated in different ways, their efficacy, symptom improvement, changes in blood rheology, and PBTCSs were compared. The total effective rates (TERs) of the hormone group and the combination group were 76.32% and 95.73%, respectively ( P < 0.05 ). The fibrinogen contents of the patients in the combination group were obviously lower than those in the hormone group after 5 d, 7 d, and 10 d of treatment ( P < 0.05 ). The high blood viscosity (HBV) values of patients in the combination group at 5 d, 7 d, and 10 d after treatment were greatly lower than those in the hormone group ( P < 0.05 ). The low blood viscosity (LBV) values after 3 d, 7 d, and 10 d of treatment in the combined group were much lower in contrast to those in the hormone group ( P < 0.05 ). The CD3+, CD4+, and CD4+/CD8+ in peripheral blood in the combination group were sharply higher while the CD8+ in the combined group was lower in contrast to the hormone group ( P < 0.05 ). There was no visible difference in the incidence of adverse reactions between the two groups of patients after treatment ( P > 0.05 ). In conclusion, the combined application of Ginkgo biloba extract and hormones could effectively improve the abnormal hemorheological indexes of patients with sudden deafness and effectively relieve the imbalance of PBTCSs, which was safe.

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“…However, considering that metabolic syndrome is a risk factor for the prognosis of SSNHL, any preemptive drug use at the pre-stage might improve the outcome. There was a study that co-administration with nimodipine, which has an antihypertensive effect, and systemic steroid deduced the better prognosis in SSNHL [ 24 ]; it may also be the effect of the preemptive use of the medication. Therefore, in future studies, it would be necessary to identify the effectiveness of the early use of either antihypertensive medication or the lowering of glucose medication.…”

Section: Discussionmentioning

confidence: 99%

Does Metabolic Syndrome Affect the Incidence and Prognosis of Sudden Sensorineural Hearing Loss?

Park

Kim

et al. 2022

Life

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Earlier studies reported that the occurrence of sudden sensorineural hearing loss (SSNHL) is associated with chronic metabolic disorders such as hypertension, diabetes, and hyperlipidemia. Instead of focusing on the relationship between SSNHL and each metabolic disorder, this study aimed to identify the association with metabolic syndrome as a whole, including either prehypertension or prediabetes. As a case-control study, we reviewed 239 patients who experienced SSNHL, and compared them with the same number of healthy subjects (N = 478). Metabolic syndrome-related variables of SSNHL patients were compared to those of healthy control subjects. In addition, patients with SSNHL were classified into two subgroups: the first subgroup showed improvement in hearing (‘response group’), and the second did not present significant improvement (‘non-response group’). Metabolic syndrome was diagnosed according to the US National Heart, Lung, and Blood Institute’s National Cholesterol Education Program Adult Treatment Panel III criteria. The risk for SSNHL was 4.3 times higher in patients with metabolic syndrome compared with patients without the syndrome (95% confidence interval, 1.98 to 9.33), even after adjusting for variables that showed significant between-group differences. The likelihood of being unresponsive to treatment was higher in those with metabolic syndrome (1.21 to 3.93; adjusted odds ratio = 2.18), and when the initial hearing loss pattern on a pure-tone audiometry was high tone or flat. Metabolic syndrome appears to be an independent risk factor for SSNHL and, simultaneously, a predictor of poor prognosis.

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Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Cited by 9 publications

References 43 publications

In silico Single-Cell Analysis of Steroid-Responsive Gene Targets in the Mammalian Cochlea

In silico Single-Cell Analysis of Steroid-Responsive Gene Targets in the Mammalian Cochlea

Efficacy of Ginkgo biloba Extract Combined with Hormones in the Treatment of Sudden Deafness and Its Effect on the Reactivity of Peripheral Blood T Cell Subsets

Does Metabolic Syndrome Affect the Incidence and Prognosis of Sudden Sensorineural Hearing Loss?

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