Citation

Prasad KN (2019) Involvement of Oxidative Stress, Inflammation, and Glutamate in Ototoxicity, and their Attenuation by Simultaneous Activation of Nrf2 and Elevation of Antioxidant Compounds. Int J Neurol Neurother 6:083. doi.org/10.23937/2378-3001/1410083

Copyright

© 2019 Prasad KN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

REVIEW ARTICLE | OPEN ACCESS DOI: 10.23937/2378-3001/1410083

Involvement of Oxidative Stress, Inflammation, and Glutamate in Ototoxicity, and their Attenuation by Simultaneous Activation of Nrf2 and Elevation of Antioxidant Compounds

Kedar N Prasad*

Engage Global, 245 El Faisan Drive, San Rafael, CA, USA

Abstract

Diverse groups of ototoxic agents and gene mutation induce hearing disorders. Several studies showed that increased oxidative stress, inflammation, and glutamate are involved in the initiation and progression of hearing disorders. Therefore, reducing these biochemical defects before and after exposure to ototoxic agents may prevent and improve the management of hearing loss. Previous studies with a single agent have yielded variable benefits in hearing disorders. This review briefly presents evidence for the involvement of oxidative stress, inflammation, and glutamate in the initiation and progression of hearing disorders. It proposes a novel concept that simultaneous elevation of the levels of antioxidant enzymes, dietary and endogenous antioxidant compounds, and reduction in the levels of glutamate may be necessary for the optimal benefits in prevention and improved management of hearing disorders. Supplementation with micronutrients can elevate the levels of antioxidant compounds and reduce the levels of glutamate. However, increasing the levels of antioxidant enzymes is complex requiring an activation of the nuclear transcriptional factor-2 (Nrf2). This review briefly describes the regulation of activation of Nrf2, and proposes a micronutrient mixture that can simultaneously activate Nrf2, enhance the dietary and endogenous antioxidant compounds levels, and inhibit the release and toxicity of glutamate for prevention and improved management of hearing loss.