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特发性突发性感音神经性听力损失氧化应激的重新评估及生理浓度褪黑素对预后影响的初步探索

Reassessment of oxidative stress in idiopathic sudden hearing loss and preliminary exploration of the effect of physiological concentration of melatonin on prognosis.

作者信息

Song Jianxiong, Ouyang Fang, Xiong Yuanping, Luo Qing, Jiang Hongqun, Fan Li, Zhang Zhiyuan

机构信息

Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

Front Neurol. 2023 Sep 6;14:1249312. doi: 10.3389/fneur.2023.1249312. eCollection 2023.

Abstract

BACKGROUND AND PURPOSE

The pathogenesis of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unclear, and there is no targeted treatment. This research aimed to verify the role of oxidative stress in ISSNHL and explore whether melatonin has a protective effect on hearing.

MATERIALS AND METHODS

A total of 43 patients with ISSNHL and 15 healthy controls were recruited to detect the level of melatonin, reactive oxygen species (ROS), and total antioxidant capacity (TAC) in the blood and compared before and after treatment. Multivariate logistic regression models were performed to assess the factors relevant to the occurrence and improvement of ISSNHL.

RESULTS

The patients with ISSNHL showed significantly higher ROS levels than controls (4.42 ± 4.40 vs. 2.30 ± 0.59; = 0.031). The levels of basal melatonin were higher (1400.83 ± 784.89 vs. 1095.97 ± 689.08; = 0.046) and ROS levels were lower (3.05 ± 1.81 vs. 5.62 ± 5.56; = 0.042) in the effective group as compared with the ineffective group. Logistic regression analysis showed that melatonin (OR = 0.999, 95% CI 0.997-1.000, = 0.049), ROS (OR = 1.154, 95% CI 1.025-2.236, = 0.037), and vertigo (OR = 3.011, 95% CI 1.339-26.983, = 0.019) were independent factors associated with hearing improvement. Besides, the level of melatonin (OR = 0.999, 95% CI 0.998-1.000, = 0.023) and ROS (OR = 3.248, 95% CI 1.109-9.516, = 0.032) were associated with the occurrence of ISSNHL.

CONCLUSION

Our findings may suggest oxidative stress involvement in ISSNHL etiopathogenesis. The level of melatonin and ROS, and vertigo appear to be predictive of the effectiveness of hearing improvement following ISSNHL treatment.

摘要

背景与目的

特发性突发性感音神经性听力损失(ISSNHL)的发病机制仍不清楚,且尚无针对性治疗方法。本研究旨在验证氧化应激在ISSNHL中的作用,并探讨褪黑素是否对听力具有保护作用。

材料与方法

共招募43例ISSNHL患者和15名健康对照者,检测其血液中褪黑素、活性氧(ROS)和总抗氧化能力(TAC)水平,并在治疗前后进行比较。采用多因素逻辑回归模型评估与ISSNHL发生及改善相关的因素。

结果

ISSNHL患者的ROS水平显著高于对照组(4.42±4.40 vs. 2.30±0.59;P = 0.031)。与无效组相比,有效组的基础褪黑素水平较高(1400.83±784.89 vs. 1095.97±689.08;P = 0.046),ROS水平较低(3.05±1.81 vs. 5.62±5.56;P = 0.042)。逻辑回归分析显示,褪黑素(OR = 0.999,95%CI 0.997 - 1.000,P = 0.049)、ROS(OR = 1.154,95%CI 1.025 - 2.236,P = 0.037)和眩晕(OR = 3.011,95%CI 1.339 - 26.983,P = 0.019)是与听力改善相关的独立因素。此外,褪黑素水平(OR = 0.999,95%CI 0.998 - 1.000,P = 0.023)和ROS(OR = 3.248,95%CI 1.109 - 9.516,P = 0.032)与ISSNHL的发生有关。

结论

我们的研究结果可能提示氧化应激参与了ISSNHL的发病机制。褪黑素和ROS水平以及眩晕似乎可预测ISSNHL治疗后听力改善的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd20/10511764/32cdb2c02702/fneur-14-1249312-g001.jpg

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