氨基糖苷类抗生素对耳蜗螺旋神经节的损害作用  

Damaging Effects of Aminoglycoside Antibiotics on Cochlear Spiral Ganglion Neurons

作　　者：高可雷 丁大连[1,2,3] 李鹏[2,3] 孙虹[1,2] Richard Salvi 

机构地区：[1]中南大学湘雅医院耳鼻喉头颈外科,湖南410013 [2]Center for hearing and Deafness,University at buffalo,SUNY,buffalony14214 [3]中山大学附属第三医院耳鼻咽喉-头颈外科,广州510630

出　　处：《中华耳科学杂志》2015年第1期37-42,共6页Chinese Journal of Otology

基　　金：国家自然科学基金面上项目:81170912;国家教育部博士点专项基金(博导类);编号20110162110007

摘　　要：氨基糖苷类药物(Am An)是一类经典的治疗革兰阴性菌感染的抗生素,但具有耳毒性和肾毒性。以往的研究认为Am An的耳毒性仅仅针对内耳毛细胞并可引起继发的延迟性螺旋神经节细胞(SGNs)死亡。但是随着关于Am An耳毒性和对耳蜗其他细胞的研究进展,人们逐渐意识到耳蜗内支持细胞的损害也是引起SGNs延迟死亡的重要原因之一。我们发现,不同的Am An对内耳的损害方式不同,以硫酸链霉素为代表的少数Am An可以不受血-迷路屏障阻碍直接进入内耳并首先损害内耳的周边神经元;而以往认为只能间接损害SGNs的其他那些难以跨越血-迷路屏障的Am An,比如卡那霉素,对出生后三天大鼠处于发育阶段的SGNs也具有直接的损害作用。因此我们提出一个根据不同内耳损害方式来区分Am An的分类建议,并希望本文介绍的新内容能够为更深入理解不同种类Am An的不同耳毒性机制以及听觉系统各个重要组织成分之间的相互作用关系提供新的参考信息。Aminoglycoside antibiotics （AmAn） are widely used for gram negative bacterial infections while they are al- so notorious for their ototoxicity and nephrotoxicity. Conventional view is that the ototoxic effects of AmAn can only damage sensory hair cells in the inner ear, and can cause delayed spiral ganglion neurons （SGNs） degeneration as a result of the loss of sensory hair cells. But with deepening of research, people have come to realize that supporting cell damage is also one of the important reasons for the delayed SGNs death. Meanwhile, it has been found that different AmAns may exert their ototoxic ef- fects through different approaches to different target cells via different pathways. Streptomycin sulfate, which represents a mi- nor category of AmAn, passes easily through the blood-labyrinth barrier and can directly damage peripheral neurons in the in- ner ear. AmAns that are believed to have little influence upon SGNs can directly hurt juvenile SGNs harvested from newborn rats at postnatal day 3. Based on the target of drug-specific damage, we propose a new classification criterion that categorizes AmAn according to their different mechanisms of ototoxicity. We hope this review can provide new insights and information for further understanding ototoxic mechanisms by AmAn as well as interrelations among different tissues within the cochlea.

关 键 词：氨基糖苷类抗生素 耳毒性 螺旋神经节神经元 硫酸链霉素 卡那霉素 

分 类 号：R764.43[医药卫生—耳鼻咽喉科] R978.12[医药卫生—临床医学]