HSP32/HO-1 is the major mediator of celastrol's protective effect. (a) HSP32/HO-1 is required for the protective effect of celastrol. Utricles from both HSP70−/− and HSP70+/+ mice were treated with celastrol and the HSP32/HO-1 inhibitor ZnPPIX. Gentamicin resulted in significant hair cell death in utricles of both genotypes. Celastrol inhibited gentamicin-induced hair cell death in both HSP70−/− and HSP70+/+ utricles. ZnPPIX abolished the protective effect of celastrol in both HSP70−/− and HSP70+/+ utricles (1-way ANOVA F1,29=26.35, P<0.0001). Asterisks indicate significance (P<0.05) by post hoc analysis. (b) HSP32/HO-1 inhibits aminoglycoside-induced hair cell death. Utricles were treated with the HSP32/HO-1 inducer CoPPIX. HSP32/HO-1 induction inhibited aminoglycoside-induced hair cell death (2-way ANOVA F1,9=10.36, P<0.011). (c) HSP32/HO-1 inhibits aminoglycoside-induced JNK activation. Neomycin increased JNK activation, and this activation was inhibited by CoPPIX. (d) CO inhibits aminoglycoside-induced hair cell death. Utricles were treated with CORM2, a CO-releasing molecule. CORM2 partially inhibited neomycin-induced hair cell death (1-way ANOVA F1,25=79.29, P<0.0001)