Assessment of nutrient supplement to reduce gentamicin-induced ototoxicity

J Assoc Res Otolaryngol. 2014 Jun;15(3):375-93. doi: 10.1007/s10162-014-0448-x. Epub 2014 Mar 4.

Abstract

Gentamicin is an aminoglycoside antibiotic used to treat gram-negative bacterial infections. Treatment with this antibiotic carries the potential for adverse side effects, including ototoxicity and nephrotoxicity. Ototoxic effects are at least in part a consequence of oxidative stress, and various antioxidants have been used to attenuate gentamicin-induced hair cell death and hearing loss. Here, a combination of nutrients previously shown to reduce oxidative stress in the hair cells and attenuate hearing loss after other insults was evaluated for potential protection against gentamicin-induced ototoxicity. Guinea pigs were maintained on a nutritionally complete standard laboratory animal diet or a diet supplemented with β-carotene, vitamins C and E, and magnesium. Three diets with iterative increases in nutrient levels were screened; the final diet selected for study use was one that produced statistically reliable increases in plasma levels of vitamins C and E and magnesium. In two separate studies, significant decreases in gentamicin-induced hearing loss at frequencies including 12 kHz and below were observed, with less benefit at the higher frequencies. Consistent with the functional protection, robust protection of both the inner and outer hair cell populations was observed, with protection largely in the upper half of the cochlea. Protection was independently assessed in two different laboratories, using two different strains of guinea pigs. Additional in vitro tests did not reveal any decrease in antimicrobial activity with nutrient additives. Currently, there are no FDA-approved treatments for the prevention of gentamicin-induced ototoxicity. The current data provide a rationale for continued investigations regarding translation to human patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / toxicity*
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / blood
  • Bacteria / drug effects
  • Dietary Supplements
  • Evoked Potentials, Auditory, Brain Stem / drug effects
  • Gentamicins / toxicity*
  • Guinea Pigs
  • Hair Cells, Auditory / drug effects*
  • Hair Cells, Auditory / pathology
  • Hair Cells, Auditory / physiology
  • Magnesium / administration & dosage
  • Magnesium / blood
  • Male
  • Vitamin E / administration & dosage
  • Vitamin E / blood
  • beta Carotene / administration & dosage
  • beta Carotene / blood

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • beta Carotene
  • Vitamin E
  • Magnesium
  • Ascorbic Acid