Estudi d’un Model d’Exposició Subcrònica a IDPN en la Rata: Patologia Vestibular i Reparació

[cat] La pèrdua de funció del sistema vestibular causa vertigen, pèrdua d’equilibri i pèrdua de mirada fixa durant el moviment, sovint acompanyats de marejos i nàusees. Els trastorns de l’equilibri són comuns a les persones grans i alteren el seu patró de marxa, sent un important factor de risc per a les caigudes. En els éssers humans, una de les causes de pèrdua de funció vestibular és la toxicitat d’alguns fàrmacs, com antibiòtics aminoglicòsids, medicaments antipalúdics, diürètics de nansa, agents quimioterapèutics com el cisplatí, així com una sèrie de productes químics d’exposició laboral. La diana principal de la toxicitat són les cèl·lules ciliades. Estudis d’exposició aguda en animals han demostrat clarament que els components ototòxics poden causar discapacitat permanent perquè causen la degeneració de moltes o totes les cèl·lules ciliades. Aquestes cèl·lules no poden regenerar o ho poden fer de manera limitada en algunes espècies de mamífers com el conill d’Índies i la xinxilla i en qualsevol cas la recuperació funcional és limitada o nul·la. En peixos, amfibis i ocells les cèl·lules ciliades es produeixen i es poden regenerar al llarg de tota la vida. Les noves cèl·lules ciliades procedeixen de les cèl·lules de suport seguides de dos possibles mecanismes: mitosis o transdiferenciació. Aquestes evidències d’estudis experimentals no serveixen per explicar la recuperació funcional que té lloc en els humans després de la interrupció de l’exposició crònica ototòxica. Quan en pacients a qui s’ha diagnosticat ototoxicitat es para el tractament, els resultats són molt variables: des de la persistència completa dels símptomes fins una recuperació incompleta o completa. Encara que la recuperació comportamental es pot explicar en part per fenòmens de compensació al sistema nerviós central, es coneix molt poc sobre els mecanismes cel·lulars i moleculars involucrats en el dany vestibular crònic i la seva possible recuperació, així como la seva rellevància a nivell comportamental. Per a estudiar els processos involucrats en el dany i reparació vestibulars associats amb la ototoxicitat crònica i la subsegüent recuperació, es van exposar rates Long Evans mascles a IDPN (3,3’-iminodipropionitrilo) via l’agua de beguda durant vàries setmanes i es van avaluar al final del període d’exposició i al final d’un període de recuperació. Per a identificar les etapes de dany que són susceptibles de reparació i que poden ser la base de la recuperació funcional, es van examinar les característiques ultraestructurals de les crestes i els utricles. La intoxicació crònica per IDPN provoca pèrdua de les cèl·lules ciliades per extrusió. Per a revelar més característiques ultraestructurals del dany ototòxic i la seva posterior recuperació, així com dels efectes ciliars, es van examinar les crestes per microscòpia electrònica de transmissió. Per a caracteritzar la dinàmica del dany aferent i del procés de reparació, es van estudiar mitjançant immunohistoquímica i microscòpia de fluorescència confocal l’expressió de proteïnes prèviament identificades en el contacte entre el calze aferent i la cèl·lula ciliada de tipus I. El següent pas va ser estudiar que passava amb les cintes de les sinapsis aferents de les cèl·lules ciliades de tipus I i de tipus II. El model d’ototoxicitat crònica induït per IDPN a l’aigua de beguda, causa retracció i fragmentació del calze aferent abans que tingui lloc la mort de les cèl·lules ciliades per extrusió. En aquest treball es presenten les evidències que el desmantellament de les unions septades és un procés anterior al dany aferent durant la ototoxicitat crònica i que l’extensa reparació de les unions septades i del calze aferent són possibles després d’aturar-se l’agressió.[eng] Acute toxic insults to the mammalian vestibular system cause loss of the sensory hair cells and subsequent loss of equilibrium. In animal models, many studies have demonstrated apoptosis, sometimes necrosis, of the hair cells. In most mammalian species the functional loss is permanent because the hair cells do not regenerate. Human vestibular dysfunction most commonly arises progressively as a result of chronic exposure to ototoxic compounds such as the aminoglycoside antibiotics. If the exposure is discontinued, a highly variable degree of recovery is observed, being either complete, only partial, or minimal with persistent dysfunction. The cellular and molecular bases of the vestibular dysfunction associated with chronic toxicity and of its remarkable variability in the degree of recovery are not established. One reason for this limited knowledge is the scarcity of animal studies of chronic vestibular toxicity, owing to, at least in part, the resiliency of rats and mice to aminoglycoside ototoxicity. Ototoxic nitriles offer an alternative model to study vestibular toxicity in these species. A particularly dependable model is the one of chronic drinking water exposure of rats to 3,3’-iminodipropionitrile (IDPN). We have established a protocol to study the vestibular sensory epithelia simultaneously by scanning electron microscopy, transmission electron microscopy and confocal immunofluorescence microscopy in rats previously assessed for vestibular dysfunction during chronic ototoxic exposure followed by variable times of recovery. This allows identifying the structural and molecular events associated with the loss and recovery of vestibular function. Initial data indicate that a deep but fully reversible functional loss is associated with synaptic and afferent damage and intact ciliary structure. With continued IDPN exposure, hair cell damage and more persistent functional are observed. We hypothesize that similar events occur in humans and are relevant to chronic damage, including that associated with age

Cisplatin-induced ototoxicity: effects, mechanisms and protection strategies

Cisplatin is a highly effective chemotherapeutic agent that is widely used to treat solid organ malignancies. However, serious side effects have been associated with its use, such as bilateral, progressive, irreversible, dose-dependent neurosensory hearing loss. Current evidence indicates that cisplatin triggers the production of reactive oxygen species in target tissues in the inner ear. A variety of agents that protect against cisplatin-induced ototoxicity have been successfully tested in cell culture and animal models. However, many of them interfere with the therapeutic effect of cisplatin, and therefore are not suitable for systemic administration in clinical practice. Consequently, local administration strategies, namely intratympanic adminis- tration, have been developed to achieve otoprotection, without reducing the antitumoral effect of cisplatin. While a considerable amount of pre-clinical information is available, clinical data on treatments to prevent cisplatin ototoxicity are only just beginning to appear. This review summarizes clinical and experimental studies of cisplatin ototoxicity, and focuses on understanding its toxicity mechanisms, clinical repercussions and prevention strategies

Transient alteration of the vestibular calyceal junction and synapse in response to chronic ototoxic insult in rats

Aquest article conté una errata annexadaOtotoxicity is known to cause permanent loss of vestibule function through degeneration of sensory hair cells (HCs). However, functional recovery has been reported during washout after chronic ototoxicity, although the mechanisms underlying this reversible dysfunction are unknown. Here, we study this question in rats chronically exposed to the ototoxic compound 3,3′-iminodipropionitrile (IDPN). Pronounced alterations in vestibular function appeared before significant loss of HCs or stereociliary coalescence became evident by ultrastructural analyses. This early dysfunction was fully reversible if the exposure was terminated promptly. In cristae and utricles, the distinct junctions formed between type I HCs (HCI) and calyx endings were completely dismantled at these early stages of reversible dysfunction, and completely rebuilt during washout. Immunohistochemical observations revealed loss and recovery of the junction proteins CASPR1 and tenascin-C and RT-PCR indicated that their loss was not due to decreased gene expression. KCNQ4 was mislocalized during intoxication and recovered control-like localization after washout. At early stages of the intoxication, the calyces could be classified as showing intact or lost junctions, indicating that calyceal junction dismantlement is triggered on a calyx-by-calyx basis. Chronic toxicity also altered the presence of ribeye, PSD-95 and GluA2 puncta in the calyces. These synaptic alterations varied between the two types of calyx endings (formed by calyx-only or dimorphic afferents) and some persisted at the end of the washout period. The present data reveal new forms of plasticity of the calyx endings in adult mammals, including a robust capacity for rebuilding the calyceal junction. These findings contribute to a better understanding of the phenomena involved in progressive vestibular dysfunction and its potential recovery during and after ototoxic exposure

Vestibular damage in chronic ototoxicity: a mini-review

Ototoxicity is a major cause of the loss of hearing and balance in humans. Ototoxic compounds include pharmaceuticals such as aminoglycoside antibiotics, anti-malarial drugs, loop diuretics and chemotherapeutic platinum agents, and industrial chemicals including several solvents and nitriles. Human and rodent data indicate that the main target of toxicity is hair cells (HCs), which are the mechanosensory cells responsible for sensory transduction in both the auditory and the vestibular system. Nevertheless, the compounds may also affect the auditory and vestibular ganglion neurons. Exposure to ototoxic compounds has been found to cause HC apoptosis, HC necrosis, and damage to the afferent terminals, of differing severity depending on the ototoxicity model. One major pathway frequently involved in HC apoptosis is the c-jun N-terminal kinase (JNK) signaling pathway activated by reactive oxygen species, but other apoptotic pathways can also play a role in ototoxicity. Moreover, little is known about the effects of chronic low-dose exposure. In rodent vestibular epithelia, extrusion of live HCs from the sensory epithelium may be the predominant form of cell demise during chronic ototoxicity. In addition, greater involvement of the afferent terminals may occur, particularly the calyx units contacting type I vestibular HCs. As glutamate is the neurotransmitter in this synapse, excitotoxic phenomena may participate in afferent and ganglion neuron damage. Better knowledge of the events that take place in chronic ototoxicity is of great interest, as it will increase understanding of the sensory loss associated with chronic exposure and ageing

The p38α MAPK function in osteoprecursors is required for bone formation and bone homeostasis in adult mice

p38 MAPK activity plays an important role in several steps of the osteoblast lineage progression through activation of osteoblast-specific transcription factors and it is also essential for the acquisition of the osteoblast phenotype in early development. Although reports indicate p38 signalling plays a role in early skeletal development, its specific contributions to adult bone remodelling are still to be clarified. Methodology/Principal Findings: We evaluated osteoblast-specific deletion of p38 alpha to determine its significance in early skeletogenesis, as well as for bone homeostasis in adult skeleton. Early p38 alpha deletion resulted in defective intramembranous and endochondral ossification in both calvaria and long bones. Mutant mice showed reduction of trabecular bone volume in distal femurs, associated with low trabecular thickness. In addition, knockout mice also displayed decreased femoral cortical bone volume and thickness. Deletion of p38 alpha did not affect osteoclast function. Yet it impaired osteoblastogenesis and osteoblast maturation and activity through decreased expression of osteoblast-specific transcription factors and their targets. Furthermore, the inducible Cre system allowed us to control the onset of p38 alpha disruption after birth by removal of doxycycline. Deletion of p38 alpha at three or eight weeks postnatally led to significantly lower trabecular and cortical bone volume after 6 or 12 months. Conclusions: Our data demonstrates that, in addition to early skeletogenesis, p38 alpha is essential for osteoblasts to maintain their function in mineralized adult bone, as bone anabolism should be sustained throughout life. Moreover, our data also emphasizes that clinical development of p38 inhibitors should take into account their potential bone effects

Vestibulotoxic properties of potential metabolites of allylnitrile

This study addressed the hypothesis that epoxidation of the double bond in allylnitrile mediates its vestibular toxicity, directly or after subsequent metabolism by epoxide hydrolases. The potential metabolites 3,4-epoxybutyronitrile and 3,4-dihydroxybutyronitrile were synthesized and characterized. In aqueous solutions containing sodium or potassium ions, 3,4-epoxybutyronitrile rearranged to 4-hydroxybut-2-enenitrile, and this compound was also isolated for study. Male adult Long-Evans rats were exposed to allylnitrile or 3,4-epoxybutyronitrile by bilateral transtympanic injection, and vestibular toxicity was assessed using a behavioral test battery and scanning electron microscopy (SEM) observation of the sensory epithelia. Overt vestibular toxicity was caused by 3,4-epoxybutyronitrile at 0.125 mmol/ear and by allylnitrile in some animals at 0.25 mmol/ear. Additional rats were exposed by unilateral transtympanic injection. In these studies, behavioral evidences and SEM observations demonstrated unilateral vestibular toxicity after 0.125 mmol of 3,4-epoxybutyronitrile and bilateral vestibular toxicity after 0.50 mmol of allylnitrile. However, 0.25 mmol of allylnitrile did not cause vestibular toxicity. Unilateral administration of 0.50 mmol of 3,4-dihydroxybutyronitrile or 4-hydroxybut-2-enenitrile caused no vestibular toxicity. The four compounds were also evaluated in the mouse utricle explant culture model. In 8-h exposure experiments, hair cells completely disappeared after 3,4-epoxybutyronitrile at concentrations of 325 or 450μM but not at concentrations of 150μM or lower. In contrast, no difference from controls was recorded in utricles exposed to 450μM or 1.5mM of allylnitrile, 3,4-dihydroxybutyronitrile, or 4-hydroxybut-2-enenitrile. Taken together, the present data support the hypothesis that 3,4-epoxybutyronitrile is the active metabolite of allylnitrile for vestibular toxicity

Vestibular toxicity of cis-2-pentenenitrile in the rat

cis-2-Pentenenitrile, an intermediate in the synthesis of nylon and other products, causes permanent behavioral deficits in rodents. Other low molecular weight nitriles cause degeneration either of the vestibular sensory hair cells or of selected neuronal populations in the brain. Adult male Long-Evans rats were exposed to cis-2-pentenenitrile (0, 1.25, 1.50, 1.75, or 2.0 mmol/kg, oral, in corn oil) and assessed for changes in open field activity and rating scores in a test battery for vestibular dysfunction. Surface preparations of the vestibular sensory epithelia were observed for hair cell loss using scanning electron microscopy. A separate experiment examined the impact of pre-treatment with the universal CYP inhibitor,1-aminobenzotriazole, on the effect of cis-2-pentenenitrile on vestibular rating scores. The occurrence of degenerating neurons in the central nervous system was assessed by Fluoro-Jade C staining. cis-2-Pentenenitrile had a dose-dependent effect on body weight. Rats receiving 1.50 mmol/kg or more of cis-2-pentenenitrile displayed reduced rearing activity in the open field and increased rating scores on the vestibular dysfunction test battery. Hair cell loss was observed in the vestibular sensory epithelia and correlated well with the behavioral deficits. Pre-treatment with 1-aminobenzotriazole blocked the behavioral effect. Fluoro-Jade C staining did not reveal significant neuronal degeneration in the central nervous system apart from neurite labeling in the olfactory glomeruli. We conclude that cis-2-pentenenitrile causes vestibular toxicity in a similar way to allylnitrile, cis-crotononitrile and 3,3′-iminodipropionitrile (IDPN), and also shares other targets such as the olfactory system with these other nitriles. The present data also suggest that CYP-mediated bioactivation is involved in cis-2-pentenenitrile toxicity

Cisplatin-Induced Ototoxicity: Effects, Mechanisms and Protection Strategies

Cisplatin is a highly effective chemotherapeutic agent that is widely used to treat solid organ malignancies. However, serious side effects have been associated with its use, such as bilateral, progressive, irreversible, dose-dependent neurosensory hearing loss. Current evidence indicates that cisplatin triggers the production of reactive oxygen species in target tissues in the inner ear. A variety of agents that protect against cisplatin-induced ototoxicity have been successfully tested in cell culture and animal models. However, many of them interfere with the therapeutic effect of cisplatin, and therefore are not suitable for systemic administration in clinical practice. Consequently, local administration strategies, namely intratympanic administration, have been developed to achieve otoprotection, without reducing the antitumoral effect of cisplatin. While a considerable amount of pre-clinical information is available, clinical data on treatments to prevent cisplatin ototoxicity are only just beginning to appear. This review summarizes clinical and experimental studies of cisplatin ototoxicity, and focuses on understanding its toxicity mechanisms, clinical repercussions and prevention strategies

Transient alteration of the vestibular calyceal junction and synapse in response to chronic ototoxic insult in rats

Ototoxicity is known to cause permanent loss of vestibule function through degeneration of sensory hair cells (HCs). However, functional recovery has been reported during washout after chronic ototoxicity, although the mechanisms underlying this reversible dysfunction are unknown. Here, we study this question in rats chronically exposed to the ototoxic compound 3,3′-iminodipropionitrile (IDPN). Pronounced alterations in vestibular function appeared before significant loss of HCs or stereociliary coalescence became evident by ultrastructural analyses. This early dysfunction was fully reversible if the exposure was terminated promptly. In cristae and utricles, the distinct junctions formed between type I HCs (HCI) and calyx endings were completely dismantled at these early stages of reversible dysfunction, and completely rebuilt during washout. Immunohistochemical observations revealed loss and recovery of the junction proteins CASPR1 and tenascin-C and RT-PCR indicated that their loss was not due to decreased gene expression. KCNQ4 was mislocalized during intoxication and recovered control-like localization after washout. At early stages of the intoxication, the calyces could be classified as showing intact or lost junctions, indicating that calyceal junction dismantlement is triggered on a calyx-by-calyx basis. Chronic toxicity also altered the presence of ribeye, PSD-95 and GluA2 puncta in the calyces. These synaptic alterations varied between the two types of calyx endings (formed by calyx-only or dimorphic afferents) and some persisted at the end of the washout period. The present data reveal new forms of plasticity of the calyx endings in adult mammals, including a robust capacity for rebuilding the calyceal junction. These findings contribute to a better understanding of the phenomena involved in progressive vestibular dysfunction and its potential recovery during and after ototoxic exposure

Cisplatin-induced ototoxicity: effects, mechanisms and protection strategies

Cisplatin is a highly effective chemotherapeutic agent that is widely used to treat solid organ malignancies. However, serious side effects have been associated with its use, such as bilateral, progressive, irreversible, dose-dependent neurosensory hearing loss. Current evidence indicates that cisplatin triggers the production of reactive oxygen species in target tissues in the inner ear. A variety of agents that protect against cisplatin-induced ototoxicity have been successfully tested in cell culture and animal models. However, many of them interfere with the therapeutic effect of cisplatin, and therefore are not suitable for systemic administration in clinical practice. Consequently, local administration strategies, namely intratympanic adminis- tration, have been developed to achieve otoprotection, without reducing the antitumoral effect of cisplatin. While a considerable amount of pre-clinical information is available, clinical data on treatments to prevent cisplatin ototoxicity are only just beginning to appear. This review summarizes clinical and experimental studies of cisplatin ototoxicity, and focuses on understanding its toxicity mechanisms, clinical repercussions and prevention strategies