title: Different strategies in treating noiseinduced hearing loss with N-acetylcysteine.
abstract: BACKGROUND
  The cellular mechanisms leading to noise-induced hearing loss (NIHL) involve the generation of reactive oxygen species (ROS). Recent studies on glutathione (GSH) and N-acetylcysteine (NAC) show that they can protect the cochlea from ROS-derived damage, increasing the levels of endogenous cellular defences. The purpose of this study was to verify NAC's oto-protective efficacy and determine if drug administration timing influences the degree of oto-protection.
  
  
  METHODS
  Forty male Sprague Dawley albino rats were divided in four groups exposed to 8-kHz 105-dB SPL continuous noise. The groups were treated with diverse NAC administration modalities: group A received 4 injections during 48 hours (pre- and post-noise exposure), group B 1 injection prior to exposure, group C 1 injection 24 h after exposure, and group D served as untreated controls. The single injection dosage was 375 mg/kg; the controls received an equal volume of saline solution. Cochlear function was assessed by pre- and post-noise (after 168 hours) recordings of distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR). DPOAEs were obtained by three different asymmetric protocols (P1=60-50, P2=50-40, P3=40-30 dB SPL) for frequencies of 4-16 kHz. ABR responses were elicited by tone-bursts at 8 and 16 kHz.
  
  
  RESULTS
  The most important outcome of the study was that the administration of NAC significantly reduced the threshold shifts in the treated animals. NAC provided different degrees of threshold reduction according to the timing of the drug injection.
  
  
  CONCLUSIONS
  The role played by the timing of NAC injection was important for the OHC protection index. From a DPOAE perspective, the best protection scheme was observed in the group receiving NAC after noise exposure, but full recovery of cochlear function was not observed in any of the tested groups.
authors.affiliation: Audiology Department, University of Ferrara, Ferrara, Italy.
authors.forename: Guiscardo
authors.initials: G
authors.lastname: Lorito
authors.forename: Pietro
authors.initials: P
authors.lastname: Giordano
authors.forename: Joseph
authors.initials: J
authors.lastname: Petruccelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
authors.forename: Stavros
authors.initials: S
authors.lastname: Hatzopoulos
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D001309:Auditory Threshold / Q000187:drug effects; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects; D006317:Hearing Loss, Noise-Induced / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D017084:Otoacoustic Emissions, Spontaneous / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D000111:Acetylcysteine