Antihypertensive Drug May Help Patients With Non-Cancerous Brain Tumors Affecting Hearing: Study

Washington: A new study has indicated that the antihypertensive drug losartan may benefit patients with neurofibromatosis type 2 (NF2), an inherited disease associated with vestibular schwannomas or non-cancerous tumors along the brain nerves involved in hearing and balance. The research was conducted by researchers at the Massachusetts General Hospital (MGH) and the Massachusetts Eye and Ear. The results of the study were published in the journal “Science Translational Medicine”. The research results are particularly important because vestibular schwannomas are currently treated with surgery and radiation therapy (which carry risks of nerve damage), and no drugs are approved by the United States Food and Drug Administration to treat these tumors. or their associated hearing loss.

“The development of effective treatments to preserve hearing function in patients with NF2 is an urgent unmet medical need. The biggest barrier to managing NF2-related hearing loss is our incomplete understanding of how schwannomas cause hearing loss, ”said co-lead author Lei Xu, MD, PhD, researcher at Steele Laboratories for tumor biology in the Department of Radiation Oncology at the MGH.

A previous report showing that scarring, or fibrosis, exists in schwannomas and correlates with hearing loss prompted the team to test whether a drug that blocks fibrosis could be effective. Losartan blocks a component of the renin-angiotensin system, which is involved not only in regulating blood pressure but also in stimulating fibrosis and inflammation. The entire class of drugs targeting angiotensin, which includes losartan, has been shown to reduce collagen buildup in fibrotic heart and kidney disease. Using a mouse model of NF2, Xu and his colleagues found that losartan treatment had several effects on vestibular schwannomas and the brain: it reduced inflammatory signaling and swelling and thus prevented hearing loss, and it increased blood loss. ” supply of oxygen to improve the effectiveness of radiation therapy (which may help reduce the dose of radiation needed to control tumor growth and limit toxicities associated with radiation).

With a view to translating these findings into the clinic, lead co-author Konstantina Stankovic, MD, PhD, former head of the Division of Otology and Neurotology at Massachusetts Eye and Ear, now Professor Bertarelli and Chair of the Otorhinolist Department – Head and Neck Laryngology Surgery at Stanford University School of Medicine, reviewed patient samples and data. His team found that vestibular schwannomas associated with poor hearing exhibited more pronounced inflammatory signaling than tumors associated with good hearing. This inflammatory signaling in tumors was able to directly damage cochlear cells essential for hearing. In addition, patients with vestibular schwannoma who took losartan or other drugs in its class did not experience any progression in hearing loss, unlike patients taking other antihypertensive drugs or none. This study illustrates the benefits of an integrated approach and teamwork that encompasses basic research, translational investigation and clinical care.

“As one of the most commonly prescribed drugs for hypertension, the safety and low cost of losartan justifies a rapid translation of our research to patients with vestibular schwannoma in an attempt to prevent sensorineural hearing loss induced by tumor, ”Stankovic said.

The results support the need for a prospective clinical trial of losartan in patients with NF2 and vestibular schwannomas.