Noiseinduced hearing loss NIHL is a major health

前言 • Noise-induced hearing loss (NIHL) is a major health issue around the world. – 12. 5% NIHL in children(6 -19 y/o) – 12. 8% NIHL in adults Pediatrics 2001; 108: 40– 43 Euro. Arch. Otorhinolaryngol. 2012; 269: 839– 845 • Noise：continuous, impact/impulse • Cochlear damage from noise – Mechanical damage – Metabolic damage – Combined Hear. Res. 1984; 13: 229– 247 Hear. Res. 2003; 175: 82– 100

Management of NIHL • Prevention • Protection or rescue – Pharmacological agents • Anti-inflammation • Antioxidants, pro-antioxidants • Anti-apoptosis • Stop neuro-toxic – Acupuncture? ? Otolaryngol. Head Neck Surg. 1993; 109: 1052– 1056 , Hear. Res. 1994; 74: 217– 220; 2007; 226: 114– 125; 2007; 226: 92– 103, Brain Res. 1999; 815: 317– 325, Laryngoscope 2004; 114: 333– 337, Acta Otolaryng. 2007; 127: 914– 919, Int. J. Audiol. 2013; 52: 801– 807 Drug Discovery Today 2015; 20 : 760 -765

Materials and Methods Post 4 W, sacrifice animals Immunohistochemistry Immunofluorescence EA: electroacupuncture

Hearing assessment Auditory brainstem responses (ABR)： • Animals were anesthetized with Zoletil and Xylazine • Tone-burst stimuli (0. 5, 1, 2, 4, 8, 16, and 32 k. Hz)

噪音處理、電針中渚穴 • Noise-induced hearing loss animal model 1. Animals were anesthetized with Zoletil and Xylazine 2. acoustic stimulus ： 121 d. B SPL，2 h • Electroacupuncture animal model 1. 右側中渚穴 2. electroacupuncture stimulus ： 2 m. A，1 h

Results: Serial auditory threshold shifts

Results: Serial auditory threshold shifts

Results: Serial auditory threshold shifts

Results: Serial auditory threshold shifts

Hair cell preparation • Normal hair cell preparation in control and EA only • Moderate hair cell loss in noise group • Mild hair cell loss in pre or post treatment with EA

DHE staining: expression of superoxide * * ** ** * *P <. 05, denoting comparison between control and individual time points. * * P <. 01, denoting comparison between control and individual time points. * * * P <. 001, denoting comparison between control and individual time points.

8 -isoprostane staining: lipid peroxidation *P <. 05, denoting comparison between control and individual time points. * * P <. 01, denoting comparison between control and individual time points. * * * P <. 001, denoting comparison between control and individual time points.

IHC of IL-1β，Caspase 3，p-JNK in cochlea

IHC of IL-1β，Caspase 3，p-JNK in brain

TUNEL in brain

TUNEL in cochlea

Discussion and conclusion • EA may provide some otoprotective or therapeutic effect for NIHL – The auditory recovery after NIHL was significantly better in the pretreatment group and posttreatment group than the noise group. – Such recovery was more obvious 1 -2 weeks after noise exposure.

Discussion and conclusion 2 • Noise may induce overexpression of superoxide and lipid peroxidation. – EA may reduce the oxidative stress after noise trauma. • EA may also explicit its otoprotective effect through the central auditory pathway. • The cellular reaction and the role of acupuncture in the early phase of noise trauma remained to be elucidated.

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