Three-dimensional regular arrangement of the annular ligament of the rat stapediovestibular joint

Nanocarriers for drug delivery to the inner ear: Physicochemical key parameters, biodistribution, safety and efficacy

Despite the high incidence of inner ear disorders, there are still no dedicated medications on the market. Drugs are currently administered by the intratympanic route, the safest way to maximize drug concentration in the inner ear. Nevertheless, therapeutic doses are ensured for only a few minutes/hours using drug solutions or suspensions. The passage through the middle ear barrier strongly depends on drug physicochemical characteristics. For the past 15 years, drug encapsulation into nanocarriers has been developed to overcome this drawback. Nanocarriers are well known to sustain drug release and protect it from degradation. In this review, in vivo studies are detailed concerning nanocarrier biodistribution, their pathway mechanisms in the inner ear and the resulting drug pharmacokinetics. Key parameters influencing nanocarrier biodistribution are identified and discussed: nanocarrier size, concentration, surface composition and shape. Recent advanced strategies that combine nanocarriers with hydrogels, specific tissue targeting or modification of the round window permeability (cell-penetrating peptide, magnetic delivery) are explored. Most of the nanocarriers appear to be safe for the inner ear and provide a significant efficacy over classic formulations in animal models. However, many challenges remain to be overcome for future clinical applications.

Ethanol infiltration into the stapedio-vestibular joint reduces low-frequency vibration of the ossicular chain and round window membrane in the guinea pig

BACKGROUND

The synovial stapedio-vestibular joint (SVJ), which serves as a bridge between the stape and oval window, can be found in guinea pigs and most human adults. Unlike the fibrous SVJs in other animals, the contribution of the synovial SVJ to middle ear sound transmission remains unknown.

AIMS/OBJECTIVES

In this study, we investigate whether sclerosis of the synovial SVJ contributes to frequency-dependent vibration of the ossicular chain and round window membrane (RWM).

MATERIALS AND METHODS

A model of SVJ sclerosis model was established in the guinea pig using 75% ethanol. A laser Doppler vibrometer was then used to measure vibrations of the RWM and the long process of the incus (LPI) under pure tone sound stimulations of 0.25-16 kHz. The influence of SVJ sclerosis was analysed by comparing structural vibration displacement between the normal and sclerosis groups.

RESULTS

Both LPI and RWM vibrations significantly decreased at low frequencies after infiltration of ethanol, which caused SVJ sclerosis.

CONCLUSIONS

SVJ sclerosis reduces low-frequency vibration of the ossicular chain and RWM in the guinea pig, which indicates that the synovial SVJ is vital to low-frequency sound transmission in the middle ear.

SIGNIFICANCE

Providing useful data for further research regarding middle ear biomechanics.

Communication pathways to and from the inner ear and their contributions to drug delivery

The environment of the inner ear is highly regulated in a manner that some solutes are permitted to enter while others are excluded or transported out. Drug therapies targeting the sensory and supporting cells of the auditory and vestibular systems require the agent to gain entry to the fluid spaces of the inner ear, perilymph or endolymph, which surround the sensory organs. Access to the inner ear fluids from the vasculature is limited by the blood-labyrinth barriers, which include the blood-perilymph and blood-strial barriers. Intratympanic applications provide an alternative approach in which drugs are applied locally. Drug from the applied solution enters perilymph through the round window membrane, through the stapes, and under some circumstances, through thin bone in the otic capsule. The amount of drug applied to the middle ear is always substantially more than the amount entering perilymph. As a result, significant amounts of the applied drug can pass to the digestive system, to the vasculature, and to the brain. Drugs in perilymph pass to the vasculature and to cerebrospinal fluid via the cochlear aqueduct. Conversely, drugs applied to cerebrospinal fluid, including those given intrathecally, can enter perilymph through the cochlear aqueduct. Other possible routes in or out of the ear include passage by neuronal pathways, passage via endolymph and the endolymphatic sac, and possibly via lymphatic pathways. A better understanding of the pathways for drug movements in and out of the ear will enable better intervention strategies.

Dynamic property changes in stapedial annular ligament associated with acute otitis media in the chinchilla

Located at the end of the ossicular chain, the stapedial annular ligament (SAL) serves as a closed yet mobile boundary between the cochlear fluid and stapes footplate. It is unclear how SAL properties change with acute otitis media (AOM). This paper reports the measurements of SAL dynamic properties in chinchilla AOM model using dynamic mechanical analyzer (DMA) and frequency-temperature superposition (FTS) principle. AOM was analyzed in two infection groups: 4 days (4D) and 8 days (8D) post induction. SAL specimens were measured using DMA at three temperatures: 5, 25, and 37°C. To extend the testing frequencies to higher levels, FTS principle was employed. Then generalized Maxwell model was utilized to define the constitutive equations of the SAL. The complex shear moduli were obtained from seven samples of control, 4D, and 8D groups. Results show that the storage and loss shear moduli of SALs decreased due to AOM. The storage moduli for 4D and 8D ears were similar below 100Hz, and the loss modulus for 4D was significantly larger than 8D across the entire frequency range. This study reports data that contributes to ear biomechanics and improves understanding on the effects of AOM in middle ear tissues.

Elastic Properties of the Annular Ligament of the Human Stapes--AFM Measurement

Elastic properties of the human stapes annular ligament were determined in the physiological range of the ligament deflection using atomic force microscopy and temporal bone specimens. The annular ligament stiffness was determined based on the experimental load-deflection curves. The elastic modulus (Young's modulus) for a simplified geometry was calculated using the Kirchhoff-Love theory for thin plates. The results obtained in this study showed that the annular ligament is a linear elastic material up to deflections of about 100 nm, with a stiffness of about 120 N/m and a calculated elastic modulus of about 1.1 MPa. These parameters can be used in numerical and physical models of the middle and/or inner ear.

Pou3f4-mediated regulation of ephrin-b2 controls temporal bone development in the mouse

The temporal bone encases conductive and sensorineural elements of the ear. Mutations of POU3F4 are associated with unique temporal bone abnormalities and X-linked mixed deafness (DFNX2/DFN3). However, the target genes and developmental processes controlled by POU3F4 transcription factor activity have remained largely uncharacterized. Ephrin-B2 (Efnb2) is a signaling molecule with well-documented effects on cell adhesion, proliferation, and migration. Our analyses of targeted mouse mutants revealed that Efnb2 loss-of-function phenocopies temporal bone abnormalities of Pou3f4 hemizygous null neonates: qualitatively identical malformations of the stapes, styloid process, internal auditory canal, and cochlear capsule were present in both mutants. Using failed/insufficient separation of the stapes and styloid process as a quantitative trait, we found that single gene Efnb2 loss-of-function and compound Pou3f4/Efnb2 loss-of-function caused a more severe phenotype than single gene Pou3f4 loss-of-function. Pou3f4 and Efnb2 gene expression domains overlapped at the site of impending stapes-styloid process separation and at subcapsular mesenchyme surrounding the cochlea; at both these sites, Efnb2 expression was attenuated in Pou3f4 hemizygous null mutants relative to control. Results of immunoprecipitation experiments using chromatin isolated from nascent middle ear mesenchyme supported the hypothesis of a physical association between Pou3f4 and specific non-coding sequence of Efnb2. We propose that Efnb2 is a target of Pou3f4 transcription factor activity and an effector of mesenchymal patterning during temporal bone development.

Nanoparticle based inner ear therapy

Synthetic nanoparticles can be used to carry drugs, genes, small interfering RNA (siRNA) and growth factors into the inner ear, to repair, restore and induce cellular regeneration. Nanoparticles (NPs) have been developed which are targetable to selected tissue, traceable in vivo, and equipped with controlled drug/gene release. The NPs are coated with a ‘stealth’ layer, and decorated with targeting ligands, markers, transfection agents and endosomal escape peptides. As payloads, genes such as the BDNF-gene, Math1-gene and Prestin-gene have been constructed and delivered in vitro. Short-hairpin RNA has been used in vitro to silence the negative regulator of Math1, the inhibitors of differentiation and DNA binding. In order to facilitate the passage of cargo from the middle ear to the inner ear, the oval window transports gadolinium chelate more efficiently than the round window and is the key element in introducing therapeutic agents into the vestibule and cochlea. Depending upon the type of NPs, different migration and cellular internalization pathways are employed, and optimal carriers should be designed depending on the cargo. The use of NPs as drug/gene/siRNA carriers is fascinating and can also be used as an intraoperative adjunct to cochlear implantation to attract the peripheral processes of the cochlear nerve.

Gentamicin administration on the stapes footplate causes greater hearing loss and vestibulotoxicity than round window administration in guinea pigs

Clinically, gentamicin has been used extensively to treat the debilitating symptoms of Mèniére's disease and is well known for its vestibulotoxic properties. Until recently, it was widely accepted that the round window membrane (RWM) was the primary entry route into the inner ear following intratympanic drug administration. In the current study, gentamicin was delivered to either the RWM or the stapes footplate of guinea pigs (GPs) to assess the associated hearing loss and histopathology associated with each procedure. Vestibulotoxicity of the utricular macula, saccular macula, and crista ampullaris in the posterior semicircular canal were assessed quantitatively with density counts of hair cells, supporting cells, and stereocilia in histological sections. Cochleotoxicity was assessed quantitatively by changes in threshold of auditory brainstem responses (ABR), along with hair cell and spiral ganglion cell counts in the basal and second turns of the cochlea. Animals receiving gentamicin applied to the stapes footplate exhibited markedly higher levels of hearing loss between 8 and 32 kHz, a greater reduction of outer hair cells in the basal turn of the cochlea and fewer normal type I cells in the utricle in the vestibule than those receiving gentamicin on the RWM or saline controls. This suggests that gentamicin more readily enters the ear when applied to the stapes footplate compared with RWM application. These data provide a potential explanation for why gentamicin preferentially ablates vestibular function while preserving hearing following transtympanic administration in humans.

Of mice, moles and guinea pigs: functional morphology of the middle ear in living mammals

The middle ear apparatus varies considerably among living mammals. Body size, phylogeny and acoustic environment all play roles in shaping ear structure and function, but experimental studies aimed ultimately at improving our understanding of human hearing can sometimes overlook these important species differences. This review focuses on three groups of mammals, bringing together anatomical, zoological and physiological information in order to highlight unusual features of their middle ears and attempt to interpret their function. "Microtype" ears, found in species such as mice and bats, are associated with high-frequency hearing. The orbicular apophysis, the focus of some recent developmental studies on mouse ears, is characteristic of microtype mallei but is not found in humans or other "freely mobile" species. The apophysis increases ossicular inertia about the anatomical axis of rotation: its adaptive purpose in a high-frequency ear is still not clear. Subterranean mammals have convergently evolved a "freely mobile" ossicular morphology which appears to favour lower-frequency sound transmission. More unusual features found in some of these animals include acoustically coupled middle ear cavities, the loss of middle ear muscles and hypertrophied ossicles which are believed to subserve a form of inertial bone conduction. Middle ears of the rodent group Ctenohystrica (which includes guinea pigs and chinchillas, important models in hearing research) show some striking characteristics which together comprise a unique type of auditory apparatus requiring a classification of its own, referred to here as the "Ctenohystrica type". These characteristics include a distinctive malleus morphology, fusion of the malleus and incus, reduction or loss of the stapedius muscle, a synovial stapedio-vestibular articulation and, in chinchillas, enormously expanded middle ear cavities. These characteristics may be functionally linked and associated with the excellent low-frequency hearing found in these animals. The application of new experimental and imaging data into increasingly sophisticated models continues to improve our understanding of middle ear function. However, a more rigorous comparative approach and a better appreciation of the complex patterns of convergent and divergent evolution reflected in the middle ear structures of living mammals are also needed, in order to put findings from different species into the appropriate context. This article is part of a special issue entitled "MEMRO 2012".

Mechanical properties of stapedial annular ligament

Stapedial annular ligament (SAL) provides a sealed but mobile boundary between the stapes footplate and oval window bony wall. Mechanical properties of the SAL affect the transmission of ossicular movement into the cochlea in sound conduction. However, the mechanical properties of this tissue have never been investigated due to its complexity. In this paper, we report measurement of the viscoelastic properties of SAL on human cadaver temporal bones using a micro-material testing system with digital image correlation analysis. The measured load-deformation relations of SAL samples were converted into shear stress-shear strain relationship, stress relaxation function, and ultimate shear stress and shear strain of the SAL. The hyperelastic Ogden model was used to describe constitutive behavior of the SAL and a 3D finite element model of the experimental setup with SAL was created for assessing the effects of loading variation and measurement errors on results. The study demonstrates that the human SAL is a typical viscoelastic material with hysteresis, nonlinear stress-strain relationship and stress relaxation function. The shear modulus changes from 3.6 to 220 kPa when the shear stress increases from 2 to 140 kPa. These results provide useful information on quasi-static behavior of the SAL.

Histochemical localization of the extracellular matrix components in the annular ligament of rat stapediovestibular joint with special reference to fibrillin, 36-kDa microfibril-associated glycoprotein (MAGP-36), and hyaluronic acid

The annular ligament across the stapediovestibular joint connects the stapes footplate and the vestibular window and plays an important role in the sound conductive system of the ear. In this study, we investigated the distribution of extracellular matrix components in the ligament by histochemical methods at light and electron microscopic levels. As results, light microscopic immunohistochemistry of fibrillin and 36-kDa microfibril-associated glycoprotein (MAGP-36) showed intense immunoreactivities in the annular ligament between the stapes footplate and vestibular window. In addition, the histochemical localization of hyaluronic acid by using biotinylated hyaluronic acid-binding protein (HABP) clarifi ed the presence of hyaluronic acid in the annular ligament. At the electron microscopic level, the immunogold labeling of fibrillin showed intense labeling on the periphery of the electron-dense mantle. Furthermore, the labeling of fibrillin was preferentially seen on the fibrous components among the electronlucent amorphous substance. The immunogold labeling of MAGP-36 was seen on the electron-dense mantle and scattered on the electron-lucent amorphous substance. The gold labeling with biotinylated HABP clearly showed a distribution of hyaluronic acid throughout the amorphous space in the ligament. The present results provide a histochemical profile of the annular ligament of the rat stapediovestibular joint that may provide clues to elucidation of pathological changes in the ligaments and conductive hearing loss in humans.