Ототоксичность аминогликозидов современные представления

Аминогликозиды являются антибактериальными средствами широкого спектра действия и используются при лечении инфекций мочевыводящих путей, туберкулёза, висцерального лейшманиоза, сепсиса у новорождённых и муковисцидоза. Однако применение аминогликозидов ограничено в связи с их ототоксичностью — риском развития серьёзных нежелательных реакций, в частности стойкой необратимой потери слуха и вестибулярных нарушений, связанных с гибелью волосковых клеток во внутреннем ухе. В обзоре проанализированы научные данные о возможных механизмах повреждающего действия аминогликозидов на волосковые клетки внутреннего уха. Описаны генетически обусловленные причины, способствующие проявлению ототоксических свойств препаратов этой группы. Обоснована необходимость проведения генетического скрининга на носительство мутаций m.1555A>G и m.1494C>T в гене MT-RNR1 митохондриальной ДНК для минимизации риска развития нарушений со стороны органа слуха у пациентов, имеющих наследственную предрасположенность. Понимание механизмов ототокcичности аминогликозидов позволит найти пути для профилактики и коррекции потери слуха после их применения.

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