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Age-related hearing loss (ARHL) is a predominant neurodegenerative disease with age.Here, we demonstrate for the first time that, in the aging process, the levels and activities of SIRT1 and SIRT3 are suppressed by reduction of intracellular NAD+ levels.We provide evidence that the decline in SIRT 1 and SIRT3 levels aggravates ARHL by increasing acetylation of NF-?B and p53, suggesting ARHL may occur through the induction of inflammatory responses and oxidative stress as well as the mitochondrial dysfunctions, playing an essential role for the apoptotic cell death in cochlear tissues.