School of Aerospace and Mechanical Engineering, University of Oklahoma, Norman, OK 73019, USA.
Mil Med. 2024 Aug 19;189(Suppl 3):407-415. doi: 10.1093/milmed/usae142.
Auditory injuries induced by repeated exposures to blasts reduce the operational performance capability and the life quality of military personnel. The treatment for blast-induced progressive hearing damage is lacking. We have recently investigated the therapeutic function of liraglutide, a glucagon-like peptide-1 receptor agonist, to mitigate blast-induced hearing damage in the animal model of chinchilla, under different blast intensities, wearing earplugs (EPs) or not during blasts, and drug-treatment plan. The goal of this study was to investigate the therapeutical function of liraglutide by comparing the results obtained under different conditions.
Previous studies on chinchillas from two under-blast ear conditions (EP/open), two blast plans (G1: 6 blasts at 3-5 psi or G2:3 blasts at 15-25 psi), and three treatment plans (blast control, pre-blast drug treatment, and post-blast drug treatment) were summarized. The auditory brainstem response (ABR), distortion product otoacoustic emission (DPOAE), and middle latency response (MLR) recorded within 14 days after the blasts were used. Statistical analysis was performed to evaluate the effect of liraglutide under different conditions.
ABR threshold shifts indicated that the conditions of the EP and open ears were substantially different. Results from EP chinchillas indicated that the pre-blast treatment reduced the acute ABR threshold elevation on the day of blasts, and the significance of such an effect increased with the blast level. Liraglutide-treated open chinchillas showed lower ABR threshold shifts at the later stage of the experiment regardless of the blast levels. The DPOAE was less damaged after G2 blasts compared to G1 when pre-blast liraglutide was administrated. Lower post-blast MLR amplitudes were observed in the pre-blast treatment groups.
This study indicated that the liraglutide mitigated the blast-induced auditory injuries. In EP ears, the pre-blast administration of liraglutide reduced the severity of blast-induced acute damage in ears with EP protection, especially under G2. In animals with open ears, the effect of liraglutide on the restoration of hearing increased with time. The liraglutide potentially benefits post-blast hearing through multiple approaches with different mechanics.
反复暴露于爆炸中引起的听觉损伤降低了军事人员的作战性能和生活质量。目前缺乏针对爆炸引起的渐进性听力损伤的治疗方法。我们最近研究了胰高血糖素样肽-1 受体激动剂利拉鲁肽在不同爆炸强度、佩戴耳塞（EP）或不佩戴耳塞的情况下、以及不同药物治疗方案下，对 chinchilla 动物模型中爆炸诱导性听力损伤的治疗作用。本研究的目的是通过比较不同条件下的结果来研究利拉鲁肽的治疗作用。
总结了两项关于两种爆震耳条件（EP/open）、两种爆震方案（G1：3-5psi 下 6 次爆震或 G2：15-25psi 下 3 次爆震）和三种治疗方案（爆震对照、爆震前药物治疗和爆震后药物治疗）的 chinchilla 前爆震研究。记录了爆震后 14 天内的听性脑干反应（ABR）、畸变产物耳声发射（DPOAE）和中潜伏期反应（MLR）。进行了统计学分析以评估不同条件下利拉鲁肽的效果。
ABR 阈值变化表明 EP 和开放耳朵的条件有很大不同。EP chinchilla 的结果表明，爆震前治疗可降低爆震当天的急性 ABR 阈值升高，并且这种效果的显著性随着爆震水平的增加而增加。无论爆震水平如何，利拉鲁肽治疗的开放 chinchilla 在实验后期的 ABR 阈值变化较低。与 G1 相比，G2 爆震后 DPOAE 损伤较小，并且当预爆震时给予利拉鲁肽。在预爆震治疗组中观察到较低的 post-blast MLR 振幅。
本研究表明利拉鲁肽减轻了爆震引起的听觉损伤。在 EP 耳朵中，爆震前给予利拉鲁肽可降低 EP 保护下爆震引起的急性损伤的严重程度，尤其是在 G2 下。在开放耳朵的动物中，利拉鲁肽对听力恢复的影响随着时间的推移而增加。利拉鲁肽通过不同的机制对 post-blast 听力产生潜在的益处。
