Molecular regulation of auditory hair cell death and approaches to protect sensory receptor cells and/or stimulate repair following acoustic trauma

Loss of auditory sensory hair cells is the most common cause of hearing loss. This review addresses the signaling pathways that are involved in the programmed and necrotic cell death of auditory hair cells that occur in response to ototoxic and traumatic stressor events. The roles of inflammatory processes, oxidative stress, mitochondrial damage, cell death receptors, members of the MAPK signal pathway and pro- and anti- cell death members of the Bcl-2 family are explored. The molecular interaction of these signal pathways that initiates the loss of stress damaged auditory hair cells following acoustic trauma is covered and possible therapeutic interventions that may protect these sensory damaged auditory hair cells from loss via apoptotic or non-apoptotic cell death are explored.