Prevention of noise damage and therapies for the regeneration of hair cells

Noise-induced hearing loss (NIHL) due to occupational or recreational noise exposure is a major cause of acquired hearing loss. In Europe it is the most common occupational disease, accounting for about one third of all work-related diseases, ahead of skin and respiratory problems. It is well established that NIHL is characterized by multi-target cochlear damage, which could differently affect all main cochlear substructures according to temporal and energetic exposure characteristics. Currently, many strategies to protect or regenerate NIHL cochlear damage are the subject of intensive research. However, despite in the last two decades researchers have made significant advancements in understanding pathophysiology of noise induced hearing loss, currently there are no pharmacological or biological interventions approved by the USA Food and Drug Administration or European Medicines Agency for the purpose of protecting from NIHL. In this review, the authors outline the pathology and pathophysiology of hearing loss and present the results from many promising molecular and biological studies that have provided the basis for future therapeutic strategies.