Indian Journal of Public Health Research & Development

Ratna Anggraeni ¹, Arif Darmawan ¹, F. Febri Wisudawan ¹

Affiliations
1 Department of Otorhinolaryngology‑Head and Neck, Faculty of Medicine, Universitas Padjajaran, ID

Abstract

Introduction: Kanamycin therapy in Multi‑Drug Resistance Tuberculosis (MDR‑TB) patients increases the possibility of sensorineural hearing loss through increasing the level of Reactive Oxygen Species (ROS) production in cochlea, particularly in hair cells. In normal state, ROS is detoxicated by numerous antioxidant enzymes, including glutathione peroksidase‑1 (GPx‑1). Imbalance of antioxidant enzymes and ROS production leads to death of hair cells and eventually sensorineural hearing loss. Objective: This study aimed to observe the association of GPx‑1 level and sensorineural hearing loss in MDR‑TB patients with Kanamycin therapy. Method: This study was a prospective observational study conducted at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between February to April 2017. 17 patients were included into the study with pre‑ and post‑kanamycin therapy examination within 3 weeks duration using pure tone audiometry and serum level of GPx‑1. Statistic analysis was done using Man Whitney test with significant level of p < 0.05. Result: A significant reduction of GPx‑1 level in 3 weeks period after the initial Kanamycin administration was found in the study; p <0.001. Furthermore, there was a significant alteration in the hearing threshold on frequency of 500‑800 Hz after Kanamycin administration; p < 0.05. There was a significant association between GPx‑1 level and sensorineural hearing loss in Kanamycin therapy; p < 0.05. Conclusion: Sensorineural hearing loss in patient with history of Kanamycin therapy was associated with level of GPx‑1 degradation.

Keywords

GPx‑1, Kanamycin, MDR TB, Sensorineural hearing loss

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Ratna Anggraeni ¹, Sally Mahdiani ¹, Nindya Pratita ¹

Affiliations
1 Universitas Padjajaran-Hasan Sadikin General Hospital Bandung, West Java, ID

Abstract

Introduction:Systemic Lupus Erythematous (SLE) is a disease characterized by the involvement of antibodies in the immune system-mediated inflammation, including the auditory system. One of the things that causes hearing loss in SLE is the occurrence of vasculitis and the process of oxidative stress which results in decreasing the activity of Glutathione Peroxidase (GPx) which is one of the important antioxidants in the human body against ROS. Provision of Prednisone therapy in SLE patients with hearing loss will improve hearing. It is expected that there will be an increase in GPx-1 levels along with hearing improvement in SLE patients with hearing loss after receiving prednisone.

Objective:To determine the correlation of hearing threshold with changes of serum GPx-1 levels in systemic lupus erythematosus patients who receiving prednisone therapy.

Method:A comparative analytic study conducted with pre-post design which analyzed the correlation between elevated serum GPx-1 levels and hearing threshold of SLE patients receiving prednisone therapy.

Results:This study found significant changes in GPx-1 levels after SLE patients with hearing loss received prednisone therapy. Comparison of serum GPx-1 levels of SLE patients who experience sensorineural hearing loss before and after prednisone therapy. The statistical test used is the Wilcoxon test and significant if p value <0.05. Comparative test of GPx-1 levels showed a significant number (p <0.001) with increase difference about 3.69U/g Hb. There is significant correlation between the increased serum GPx-1 levels with a decreased hearing threshold shown at high-frequency frequencies at 10,000 Hz and 14,000 Hz (p <0.05).

Conclusion:There is a correlation between improved hearing threshold in increased serum GPx-1 levels in patients receiving prednisone therapy.

Keywords

GPx-1, Hearing Loss, Oxidative Stress, Prednisone, ROS, SLE.

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Ratna Anggraeni ¹, Arif Dermawan ¹, F. Febri Wisudawan ¹

Affiliations
1 Department of Otorhinolaryngology-Head and Neck, Universitas Padjajaran, ID

Abstract

Introduction: Kanamycin therapy in Multi-Drug Resistance Tuberculosis (MDR-TB) patients increases the possibility of sensorineural hearing loss through increasing the level of Reactive Oxygen Species (ROS) production in cochlea, particularly in hair cells. In normal state, ROS is detoxicated by numerous antioxidant enzymes, including glutathione peroksidase-1 (GPx-1). Imbalance of antioxidant enzymes and ROS production leads to death of hair cells and eventually sensorineural hearing loss. Objective: This study aimed to observe the association of GPx-1 level and sensorineural hearing loss in MDR-TB patients with Kanamycin therapy.

Method: This study was a prospective observational study conducted at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between February to April 2017. 17 patients were included into the study with pre- and post-kanamycin therapy examination within 3 weeks duration using pure tone audiometry and serum level of GPx-1. Statistic analysis was done using Mann Whitney test with significant level of p < 0.05.

Result: A significant reduction of GPx-1 level in 3 weeks period after the initial Kanamycin administration was found in the study; p <0.001. Furthermore, there was a significant alteration in the hearing threshold on frequency of 500-800 Hz after Kanamycin administration; p < 0.05. There was a significant association between GPx-1 level and sensorineural hearing loss in Kanamycin therapy; p < 0.05.

Conclusion: Sensorineural hearing loss in patient with history of Kanamycin therapy was associated with level of GPx-1 degradation.

Keywords

GPx-1, Kanamycin, MDR TB, Sensorineural Hearing Loss.

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