European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 10, pp 2783–2789 | Cite as

The lack of 4-hydroxynonenal in otosclerotic bone tissue in Ethiopian population

  • Milan RudicEmail author
  • Richard Wagner
  • Eric Willkinson
  • Giovanni Danese
  • Nega Kiros
  • Kamelija Zarkovic
  • Neven Zarkovic


In Ethiopians, like in other Africans, the incidence of otosclerosis is lower than in Western and Asian populations. Unfortunately, due to the lack of available otorhinolaryngology specialists many patients are not treated and suffer the progression of the disease and severe hearing loss. This program of the Global ENT Outreach Organization (GEO) together with the Ethiopian partners was done to help some of these patients and in parallel to evaluate the presence of the oxidative stress bioactive marker 4-hydroxynonenal (HNE), which is known as major lipid peroxidation product and the second messenger of free radicals, in the otosclerotic bone specimens. Namely, we described recently that as HNE acts as a bone growth regulator associated with pathogenesis of otosclerosis. The prospective study conducted at the ENT Department of the Migbare Senay General Hospital, Addis Ababa, Ethiopia in June 2012, under the auspices of the Global ENT Outreach Organization, USA. Altogether 36 patients (male = 12, female = 24) underwent surgery due to the previous otosclerosis diagnosis based on the clinical and audiometric findings. The bone samples were harvested from patients with intraoperatively confirmed otosclerosis diagnosis. Immunohistochemistry for HNE-modified proteins was carried out on formalin-fixed paraffin-embedded specimens. The presence of HNE was found in almost all bone samples analyzed, without particular difference in the HNE distribution pattern between the otosclerotic and respective control bone specimens. Although there was no significant association between the HNE appearance and otosclerotic bone outgrowth observed, several cases have shown tendency of higher HNE expression in patients with more severe hearing loss. The results of the present study are in contrast with our previous findings obtained on European patients most likely due to the differences between studied population groups.


Oxidative stress Otosclerosis Pathophysiology 



Migbare Senay General Hospital staff (ENT surgery department and operating theater staff) The Department of Pathology and Forensic Medicine staff, General Hospital Zadar, Croatia and EU grants COST Action CM1001.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Milan Rudic
    • 1
    Email author
  • Richard Wagner
    • 2
  • Eric Willkinson
    • 2
    • 3
  • Giovanni Danese
    • 2
    • 4
  • Nega Kiros
    • 5
  • Kamelija Zarkovic
    • 6
  • Neven Zarkovic
    • 7
  1. 1.ENT DepartmentGeneral Hospital ZadarZadarCroatia
  2. 2.Global ENT Outreach Organization (GEO)CoupevilleUSA
  3. 3.House Ear ClinicLos AngelesUSA
  4. 4.Bergamo University HospitalBergamoItaly
  5. 5.Migbare Senay General HospitalAddis AbabaEthiopia
  6. 6.Division of PathologyClinical Hospital Centre Zagreb, University Medical SchoolZagrebCroatia
  7. 7.Institute Ruđer BoškovićZagrebCroatia

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