Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (3): 31-35.doi: 10.6040/j.issn.1673-3770.1.2018.044

• Research Progress • Previous Articles     Next Articles

A new mechanism of bilirubin-induced auditory nervous system injury

Ling ZHANG,Haibo YE,Haibo SHI()   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital
  • Received:2018-12-03 Revised:2019-05-09 Online:2019-05-20 Published:2019-08-07
  • Contact: Haibo SHI E-mail:haibo99@hotmail.com

Abstract:

Severe hyperbilirubinemia (jaundice) may lead to functional damage of a specific nervous system, presenting clinical characteristics such as nucleus selectivity and neonatal susceptibility. The auditory nervous system is extremely sensitive to bilirubin toxicity. The clinical manifestations comprise of acute functional impairment, which might be the first or only manifestation, or hidden and adult onset auditory neuropathy spectrum disorder. Scattered clinical and basic studies have shown that excitotoxicity is the main pathway of bilirubin-induced neurological dysfunction. However, the characteristics and mechanism of hearing impairment are still unknown. The generation and transmission of electrical signals in an auditory circuit depend on both the rhythmic firing of action potential of neurons and the synchronous transmission among nerve fibers. Moderate excitability is the basis of maintaining normal hearing, but “epilepsy-like” overexcitation may lead to an impairment of cell energy metabolism, increase in intracellular Ca2+, and eventual cell apoptosis or necrosis. Exploring the mechanism of bilirubin-induced auditory neurotoxicity is not only helpful in revealing the pathophysiological characteristics of auditory circuits, but also in shedding light on the pathogenesis and antagonistic measures of bilirubin encephalopathy.

Key words: Bilirubin, Auditory system, Neuron, Excitotoxicity

CLC Number: 

  • R764
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