title: Otoprotective effect of recombinant erythropoietin in a model of newborn hypoxic-ischemic encephalopathy.
abstract: OBJECTIVE
  The aim of this study is to test the hypotheses that central auditory pathology as well as inner ear pathology is contributing mechanisms to observed hypoxic-ischemic encephalopathy (HIE) induced hearing loss and that recombinant erythropoietin (rhEPO) will reduce this cellular pathology and attenuate hearing loss.
  
  
  METHODS
  Twenty-eight 7-day Wistar albino rat pups were divided into four groups: Control group (n=8) was given only intraperitoneal saline solution. Sham group (n=5) had only a midline neck incisions without carotid ligation under general anesthesia and administration of intraperitoneal saline solution. HIE group (n=8) and rhEPO treated group (n=7) were subjected to left common carotid artery ligation followed by 2.5h hypoxia exposure to a mixture of 8% oxygen and 92% pure nitrogen. HIE group was injected with intraperitoneal saline solution, while the rhEPO treated group received rhEPO 100 U/kg within the same volume as the saline-alone solution. At the end of the seventh week of age hearing (ABRs) was evaluated in response to clicks, 6 kHz and 8 kHz tone burst stimuli. Animals were sacrificed and both temporal lobes, cochleas and brainstems of the animals were collected. Tissue samples were evaluated with light microscopy, immunohistochemical studies, including TUNEL and caspase-3 stainings, and electron microscopy.
  
  
  RESULTS
  Hearing thresholds were elevated in HIE animals. In rhEPO treated animals, ABR values were similar to controls. HIE caused apoptotic changes in brainstem structures as shown by light microscopy and immunohistochemical methods. Apoptotic changes also were found within the organ of Corti, spiral ganglion cells and neurons of temporal lobe by electron microscopic investigation. In rhEPO animals many of these apoptotic changes were observed, but reduced compared to untreated animals.
  
  
  CONCLUSIONS
  Mechanisms underlying HIE-induced hearing loss are based on apoptosis in inner ear; however central auditory pathway pathology occurs as well, likely contributing to changes in auditory processing and perception of complex signals not reflected by the ABR threshold shifts. For both clinical and basic significance 'rhRPO' is found to reduce those effects.
authors: Dokuz Eylül University, School of Medicine, Department of Otorhinolarngology, Turkey. yuksel.olgunn83@hotmail.com
authors: Yüksel
authors: Y
authors: Olgun
authors: Günay
authors: G
authors: Kırkım
authors: Efsun
authors: E
authors: Kolatan
authors: Müge
authors: M
authors: Kıray
authors: Alper
authors: A
authors: Bağrıyanık
authors: Bülent
authors: B
authors: Şerbetçioğlu
authors: Osman
authors: O
authors: Yılmaz
authors: Necati
authors: N
authors: Gökmen
authors: Hülya
authors: H
authors: Ellidokuz
authors: Abdullah
authors: A
authors: Kumral
authors: Semih
authors: S
authors: Sütay
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D053148:Caspase 3 / Q000378:metabolism; D004195:Disease Models, Animal; D004921:Erythropoietin / Q000627:therapeutic use*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects* / Q000502:physiology; D005260:Female; D034381:Hearing Loss / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000188:drug therapy*; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D007231:Infant, Newborn; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013136:Spiral Ganglion / Q000187:drug effects / Q000473:pathology*
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D053148:Caspase 3