Hu Shiyu, Sun Qingru, Xu Fei, Jiang Ninghua, Gao Jianli
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, People's Republic of China.
School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, People's Republic of China.
Chin Med. 2023 Sep 20;18(1):121. doi: 10.1186/s13020-023-00825-6.
Age-related hearing loss (ARHL) is one of the main illnesses afflicting the aged population and has a significant negative impact on society, economy, and health. However, there is presently no appropriate therapeutic treatment of ARHL due to the absence of comprehensive trials.
The goal of this review is to systematically evaluate and analyze recent statistics on the pathologic classifications, risk factors, treatment strategies, and drug candidates of ARHL, including that from traditional Chinese medicine (TCM), to provide potential new approaches for preventing and treating ARHL.
Literature related to ARHL was conducted in databases such as PubMed, WOS, China National Knowledge Infrastructure (CNKI), and Wanfang from the establishment of the database to Jan, 2023. The pathology, causal factor, pathophysiological mechanism, treatment strategy, and the drug candidate of ARHL were extracted and pooled for synthesis.
Many hypotheses about the etiology of ARHL are based on genetic and environmental elements. Most of the current research on the pathology of ARHL focuses on oxidative damage, mitochondrial dysfunction, inflammation, cochlear blood flow, ion homeostasis, etc. In TCM, herbs belonging to the kidney, lung, and liver meridians exhibit good hearing protection. Seven herbs belonging to the kidney meridian, 9 belonging to the lung meridian, and 4 belonging to the liver meridian were ultimately retrieved in this review, such as Polygonum multiflorum Thunb., Panax ginseng C.A. Mey, and Pueraria lobata (Willd.) Ohwi. Their active compounds, 2,3,4',5-Tetrahydroxystilbene-2-O-D-glucoside, ginsenoside Rb1, and puerarin, may act as the molecular substance for their anti-ARHL efficacy, and show anti-oxidative, neuroprotective, anti-inflammatory, anti-apoptotic, or mitochondrial protective effects.
Anti-oxidants, modulators of mitochondrial function, anti-inflammation agents, vasodilators, K channel openers, Ca channel blockers, JNK inhibitors, and nerve growth factors/neurotrophic factors all contribute to hearing protection, and herbs are an important source of potential anti-ARHL drugs.
年龄相关性听力损失（ARHL）是困扰老年人群的主要疾病之一，对社会、经济和健康有重大负面影响。然而，由于缺乏全面的试验，目前尚无针对ARHL的合适治疗方法。
本综述的目的是系统评价和分析ARHL的病理分类、危险因素、治疗策略和候选药物（包括来自中医的药物）的最新统计数据，为预防和治疗ARHL提供潜在的新方法。
在PubMed、WOS、中国知网（CNKI）和万方等数据库中检索从数据库建立至2023年1月与ARHL相关的文献。提取并汇总ARHL的病理、病因、病理生理机制、治疗策略和候选药物进行综合分析。
关于ARHL病因的许多假说是基于遗传和环境因素。目前关于ARHL病理的大多数研究集中在氧化损伤、线粒体功能障碍、炎症、耳蜗血流、离子稳态等方面。在中医中，归肾、肺、肝经络的草药表现出良好的听力保护作用。本综述最终检索到归肾经的7种草药、归肺经的9种草药和归肝经的4种草药，如何首乌、人参、葛根。它们的活性成分，2,3,4',5-四羟基二苯乙烯-2-O-D-葡萄糖苷、人参皂苷Rb1和葛根素，可能是其抗ARHL疗效的分子物质，并具有抗氧化、神经保护、抗炎、抗凋亡或线粒体保护作用。
抗氧化剂、线粒体功能调节剂、抗炎剂、血管扩张剂、钾通道开放剂、钙通道阻滞剂、JNK抑制剂和神经生长因子/神经营养因子均有助于听力保护，草药是潜在抗ARHL药物的重要来源。
