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2 Mechanism of cisplatin ototoxicity Cisplatin enters the cochlea, mainly through the blood-strial barrier and the blood-perilymph barrier ( 2.1 Cisplatin-induced DNA damage and apoptosis Once cisplatin enters the cell it can be hydrolyzed to form toxic aqua-cisplatin complexes and form intra-and interstrand crosslinks with DNA (Figure 1) FIGURE 1 2.2 Cisplatin induces oxidative stress The cochleas high metabolic rate results in its production of abundant reactive oxygen species (ROS), so it requires an active antioxidant defense system [glutathione (GSH), oxidized glutathione (GSSG), and antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione reductase (GR)] to achieve a dynamic oxidant-antioxidant balance to maintain healthy hearing

These findings suggested that Sirt1 may affect microglial activation through various signaling pathways

Int J Mol Sci 2021;22:1514

Ingredients: HYDROLYZED COLLAGEN (FISH) 500 MG L-LYSINE (HYDROCHLORIDE) 50 MG VITAMIN C (ASCORBIC ACID) 30 MG