Published online Aug 28, 2013. doi: 10.5319/wjo.v3.i3.89
Revised: August 8, 2013
Accepted: August 20, 2013
Published online: August 28, 2013
Hearing loss is the most common sensory disability with considerable social and economic implications. According to recent World Health Organization estimates, 360 million people worldwide suffer from moderate to profound hearing loss. Exposure to excessive noise is one of the major causes of sensorineural hearing loss, secondary only to age-related hearing loss (presbyacusis). Since cochlear tissues have limited abilities of repair and regeneration, this damage can be irreversible, leading to cochlear dysfunction and permanent hearing loss. Recent studies have shown that cochlear inflammation can be induced by noise exposure and contribute to the overall pathogenesis of cochlear injury and hearing loss. The cochlea is separated from the systemic circulation by the blood-labyrinth barrier, which is physiologically similar to the blood-brain barrier of the central nervous system. Because of this feature, the cochlea was originally considered an immunologically privileged organ. However, this postulate has been challenged by the evidence of an inflammatory response in the cochlea in the presence of bacterial or viral pathogens or antigens that can cause labyrinthitis. Although the main purpose of the inflammatory reaction is to protect against invading pathogens, the inflammatory response can also cause significant bystander injury to the delicate structures of the cochlea. The cochlear inflammatory response is characterised by the generation of proinflammatory mediators (cytokines, chemokines and adhesion molecules), and the recruitment of inflammatory cells (leukocytes). Here, we present an overview of the current research on cochlear inflammation, with particular emphasis on noise-induced cochlear inflammation. We also discuss treatment strategies aimed at the suppression of inflammation, which may potentially lead to mitigation of hearing loss.
Core tip: Noise exposure, either occupational or recreational, is a major cause of sensorineural hearing loss in the industrialised world. Hearing loss is a devastating disability with considerable social and economic implications. Recent studies have demonstrated that an inflammatory response induced in the cochlea by noise exposure may contribute to the development of noise-induced hearing loss. Better understanding of the underlying inflammatory processes will help define pharmacological interventions that can potentially mitigate noise-induced cochlear inflammation and the associated hearing loss.