ABSTRACT
Noise induced hearing loss(NIHL) is an enormous social and economic cost to the country and represents a vital unmet medical need,for which there is now a solution.Currently there are no FDA-approved products for the prevention of NIHL.The protective device market,consisting of earplugs and earmuffs,is $243 million(in US),with 75% of sales coming from earplugs.While physical hearing protection can reduce sound pressure levels,they do not adequately prevent NIHL in very noisy environments.In addition,these barrier technologies compromise operation/activity requiring speech communication and hearing for personal safety.The past decade has witnessed a remarkable increase in our understanding of the molecular and biochemical mechanisms that determine cell survival and cell death with stress,pathology and aging.We have begun to define the apoptotic and necrotic pathways that lead to cell death,their external environmental and endogenous hereditary initiating factors,the genes and transduction factors that regulate these pathways and with that we have begun to define new interventions that attenuate or prevent cell death and cause cell survival.With this new understanding,now for the first time,we have an opportunity to prevent or treat diseases and disorders previously not possible.One of these disorders that now can be prevented is hearing loss.