Hearing Following Prolonged and Delayed Ganciclovir Treatment in a Murine Cytomegalovirus Model

Author:

Hillam Katrina1,Suarez Daniel2,Nielson Christopher1,Traxler Abigail1,Sommer Elizabeth1,Winslow Anna1,Holley Anna1,Huang Emily3ORCID,Hughes Maura1,Firpo Matthew A.4,Rower Joseph5,Park Albert H.1ORCID

Affiliation:

1. Department of Otolaryngology‐Head and Neck Surgery University of Utah Salt Lake City Utah U.S.A.

2. Department of Otolaryngology State University of New York Downstate Medical Center Stony Brook New York U.S.A.

3. Johns Hopkins University School of Medicine Baltimore Maryland U.S.A.

4. Department of Surgery University of Utah Salt Lake City Utah U.S.A.

5. University of Utah Center for Human Toxicology and Department of Pharmacology and Toxicology Salt Lake City Utah U.S.A.

Abstract

ObjectiveCompare hearing outcomes utilizing standard, prolonged and delayed ganciclovir (GCV) therapy in a murine model of cytomegalovirus (CMV).MethodsBALB/c mice were inoculated with mouse cytomegalovirus (mCMV) or saline via intracerebral injection on postnatal day 3 (p3). Intraperitoneal GCV or saline was administered at 12 h intervals for the duration of the standard (p3‐p17), delayed (p30‐p44), or prolonged treatment windows (p3‐p31). Auditory thresholds were assessed using distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) testing at 4, 6, and 8 weeks of age. Blood and tissue samples were harvested from mice on p17 and p37 one hour after GCV administration, and their concentrations were assessed via liquid chromatography‐mass spectrometry.ResultsA delayed course of GCV improved ABR but not DPOAE thresholds in mCMV‐infected mice. A prolonged course of GCV did not provide better hearing thresholds than those administered standard treatment. The average GCV concentration in all 17‐day‐old mice tissue was significantly higher than those in older 37‐day‐old mice.ConclusionDelayed GCV treatment provided a hearing benefit on ABR over untreated mCMV infected mice. Prolonged CGV administration showed no benefit compared to a shorter duration GCV treatment. GCV drug concentrations both systemically and in the cochlea are much lower in older mice. These results have potential implications for the clinical management of cCMV infected children.Level of EvidenceNA Laryngoscope, 134:433–438, 2024

Publisher

Wiley

Subject

Otorhinolaryngology

Reference22 articles.

1. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection

2. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial

3. KimberlinDW JesterP SanchezPJ AhmedA Arav‐BogerR.Six Months Versus Six Weeks of Oral Valganciclovir for Infants with Symptomatic Congenital Cytomegalovirus (CMV) Disease with and without Central Nervous System (CNS) Involvement: Results of a Phase III Randomized Double‐Blind Placebo‐Controlled Multinational StudyID Week. San Francisco CA.2013.

4. Hearing outcome of infants with congenital cytomegalovirus and hearing impairment

5. Treatment of Late-Onset Hearing Loss in Infants With Congenital Cytomegalovirus Infection

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