Interplay between Noise-Induced Sensorineural Hearing Loss and Hypertension: Pathophysiological Mechanisms and Therapeutic Prospects

Förster Carola ^1* Sergey Shityakov ² Stavros Stavrakis ³ Verena Scheper ^4,5,6* Thomas Lenarz ^4,5,6

• ¹ Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine Center of cerebrovascular sciences and neuromodulation, University Hospital Würzburg, Würzburg, Bavaria, Germany
• ² Laboratory of Chemoinformatics, Infochemistry Scientific Center, ITMO University, Saint Petersburg, Saint Petersburg, Russia
• ³ University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
• ⁴ Department of Otolaryngology, Hannover Medical School, Hanover, Germany
• ⁵ Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hannover, Germany
• ⁶ Cluster of Excellence Hearing4all EXC 1077, Hannover, Germany

More than 5% of the global population suffers from disabling hearing loss, primarily sensorineural hearing loss (SNHL). SNHL is often caused by factors such as vascular disorders, viral infections, ototoxic drugs, systemic inflammation, age-related labyrinthine membrane degeneration, and noiseinduced hearing loss (NIHL). NIHL, in particular, leads to changes in blood-labyrinth-barrier (BLB) physiology, increased permeability, and various health issues, including cardiovascular disease, hypertension, diabetes, neurological disorders, and adverse reproductive outcomes.Recent advances in neuromodulation and vector-based approaches offer hope for overcoming biological barriers such as the BLB in the development of innovative treatments. Computational methods, including molecular docking, molecular dynamics simulations, QSAR/QSPR analysis with machine/deep learning algorithms, and network pharmacology, hold potential for identifying drug candidates and optimizing their interactions with BLB transporters, such as the glutamate transporter.This paper provides an overview of NIHL, focusing on its pathophysiology; its impact on membrane transporters, ion channels, and BLB structures; and associated symptoms, comorbidities, and emerging therapeutic approaches. Recent advancements in neuromodulation and vector-based strategies show great promise in overcoming biological barriers such as BLB, facilitating the development of innovative treatment options. The primary aim of this review is to examine NIHL in detail and explore its underlying mechanisms, physiological effects, and cutting-edge therapeutic strategies for its effective management and prevention.