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Wang J, Zhao L, Gu X, Xue Y, Wang S, Xiao R, Vandenberghe L, Peng KA, Shu Y, Li H. Efficient delivery of adeno-associated virus (AAV) into inner ear in vivo via trans-stapes route in adult guinea pig. Hum Gene Ther 2022; 33:719-728. [PMID: 35156857 DOI: 10.1089/hum.2021.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adeno-associated virus (AAV) are potent vectors to achieve treatment against hearing loss resulting from genetic defects. However, the effects of delivery routes and the corresponding transduction efficiencies for clinical applications remain elusive. Here, we screened AAV vectors of three serotypes (AAV 8, 9 and Anc80L65) into the inner ears of adult normal guinea pigs through trans-stapes (oval window) and trans-round window delivery routes in vivo. Trans-stapes route is akin to stape surgeries in humans. Then, auditory brainstem response (ABR) measurements were conducted to evaluate postoperative hearing, and inner ear tissues were harvested for transduction efficiency analysis. Results showed that AAV8 targeted partial inner hair cells (IHCs) in cochlear basal turn; AAV9 targeted IHCs in cochlear basal and second turn, also a part of vestibular hair cells (VHCs). In contrast, Anc80L65 contributed to GFP signals of 80%-95% IHCs and 67%-91% outer hair cells (OHCs), as well as 69% VHCs via the trans-round window route, with 15-20 dB ABR thresholds shifts. And, via trans-stapes (oval window) route, there were 71%-90% IHCs and 42%-81% OHCs, along with 64% VHCs demonstrating GFP positive, and the ABR thresholds shifts were within 10 dB. This study revealed AAV could be efficiently delivered into mammalian inner ear cells in vivo via trans-stapes (oval window) route with postoperative hearing preservation, and both delivery routes showed promise of virus-based clinical translation of hearing impairment treatment.
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Affiliation(s)
- Jinghan Wang
- Eye and ENT hospital of Fudan University, Department of Otorhinolaryngology, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Shanghai, China;
| | - Liping Zhao
- ENT institute, Eye & ENT Hospital, Fudan University, Department of Otorhinolaryngology, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
| | - Xi Gu
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
| | - Yuanyuan Xue
- ENT institute, Eye & ENT Hospital, Fudan University, Department of Otorhinolaryngology, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
| | - Shengyi Wang
- ENT institute, Eye & ENT Hospital, Fudan University, Department of Otorhinolaryngology, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
| | - Ru Xiao
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, United States.,Grousbeck Gene Therapy Center, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, United States;
| | - Luk Vandenberghe
- Harvard Medical School, Boston, United States.,Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, United States.,Grousbeck Gene Therapy Center, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, United States;
| | - Kevin A Peng
- House Ear Institute, 556621, Los Angeles, California, United States;
| | - Yilai Shu
- ENT institute, Eye & ENT Hospital, Fudan University, Department of Otorhinolaryngology, Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
| | - Huawei Li
- Eye and ENT Hospital, Shanghai Medical College, Fudan University, Department of Otolaryngology - Head and Neck Surgery, , Shanghai, China.,Fudan University Institutes of Biomedical Sciences, 262117, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.,The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China;
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Atturo F, Portanova G, Russo FY, Seta DD, Mariani L, Borel S, Greco A, Mosnier I, Mancini P. Cochlear implant in immune mediated inner ear diseases: Impedance variations and clinical outcomes. Cochlear Implants Int 2021; 23:70-79. [PMID: 34844527 DOI: 10.1080/14670100.2021.1992149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Immune-mediated inner ear disease (IMIED) might cause severe/profound hearing loss and these patients are considered ideal candidates to cochlear implant (CI) surgery. The aim of the study was to evaluate impedance changes over time. METHOD The Study Group (SG) was composed of CI IMIED patients (31 ears) and a Control Group (CG) of CI patients with hearing loss not related to their immune system (31 ears). Audiological performance and impedance values were measured and compared amongst groups at 3, 6, 12 and 18 months following the fitting sessions. RESULTS Speech perception was significantly better for SG in word and sentence recognition in quiet. Impedance values were, on average, significantly higher for apical and middle electrode segments in SG compared to CG at the 3- month follow-up and were maintained over time. Additionally, a subset of SG patients (active patients) experienced significantly greater impedance fluctuation corresponding to clinical symptom reactivation. CONCLUSION IMIED patients achieve good audiological performance. However, the relapsing inflammation could change the inner ear environment, causing impedance fluctuations and, consequently, more frequent CI fittings. Additionally, impedance evaluation could be utilized as an early warning sign of IMIED recurrence and as an aid to therapeutic decision-making.
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Affiliation(s)
- Francesca Atturo
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - Ginevra Portanova
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | | | - Daniele De Seta
- Unit of Otorhinolaryngology, Department of Surgery, University of Cagliari, Cagliari, Italy
| | - Laura Mariani
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - Stephanie Borel
- Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, AP-HP, GHU Pitié-Salpêtrière, Paris, France
| | - Antonio Greco
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - Isabelle Mosnier
- Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, AP-HP, GHU Pitié-Salpêtrière, Paris, France
| | - Patrizia Mancini
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
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Konerding W, Arenberg JG, Kral A, Baumhoff P. Late electrically-evoked compound action potentials as markers for acute micro-lesions of spiral ganglion neurons. Hear Res 2020; 413:108057. [PMID: 32883545 DOI: 10.1016/j.heares.2020.108057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/13/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022]
Abstract
Cochlear implants (CIs) are the treatment of choice for profoundly hearing impaired people. It has been proposed that speech perception in CI users is influenced by the neural health (deafferentation, demyelination and degeneration) of the cochlea, which may be heterogeneous along an individual cochlea. Several options have been put forward to account for these local differences in neural health when fitting the speech processor settings, however with mixed results. The interpretation of the results is hampered by the fact that reliable markers of locally restricted changes in spiral ganglion neuron (SGN) health are lacking. The aim of the study was (i) to establish mechanical micro-lesions in the guinea pig as a model of heterogeneous SGN deafferentation and degeneration and (ii) to assess potential electrophysiological markers that can also be used in human subjects. First, we defined the extent of micro-lesions in normal hearing animals using acoustically-evoked compound action potentials (aCAPs); second, we measured electrically-evoked CAPs (eCAPs) before and after focal lesioning in neomycin-deafened and implanted animals. Therefore, we inserted guinea pig adjusted 6-contact CIs through a cochleostomy in the scala tympani. The eCAP was recorded from a ball electrode at the round window niche in response to monopolar or bipolar, 50 µs/phase biphasic pulses of alternating anodic- and cathodic-leading polarity. To exclude the large electrical artifact from the analysis, we focused on the late eCAP component. We systematically isolated the eCAP parameter that showed local pre- versus post-lesion changes and lesion-target specificity. Histological evaluation of the cleared cochleae revealed focal damage of an average size of 0.0036 mm3 with an apical-basal span of maximal 440 µm. We found that the threshold of the late N2P2 eCAP component was significantly elevated after lesioning when stimulating at basal (near the lesion), but not apical (distant to the lesion) CI contacts. To circumvent the potentially conflicting influence of the apical-basal gradient in eCAP thresholds, we used the polarity effect (PE=cathodic-anodic) as a relative measure. During monopolar stimulation, but not bipolar stimulation, the PE was sensitive to the lesion target and showed significantly better cathodic than anodic thresholds after soma lesions. We conclude that the difference in N2P2 thresholds in response to cathodic versus anodic-leading monopolar stimulation corresponds to the presence of SGN soma damage, and may therefore be a marker for SGN loss. We consider this electrophysiological estimate of local neural health a potentially relevant tool for human applications because of the temporal separation from the stimulation artifact and possible implementation into common eCAP measurements.
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Affiliation(s)
- Wiebke Konerding
- Department of Experimental Otology, Hannover Medical School, Stadtfelddamm 34, 30625 Hannover, Germany.
| | - Julie G Arenberg
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Andrej Kral
- Department of Experimental Otology, Hannover Medical School, Stadtfelddamm 34, 30625 Hannover, Germany; Cluster of Excellence "Hearing4all", Germany.
| | - Peter Baumhoff
- Department of Experimental Otology, Hannover Medical School, Stadtfelddamm 34, 30625 Hannover, Germany.
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Brown DJ, Pastras CJ, Curthoys IS. Electrophysiological Measurements of Peripheral Vestibular Function-A Review of Electrovestibulography. Front Syst Neurosci 2017; 11:34. [PMID: 28620284 PMCID: PMC5450778 DOI: 10.3389/fnsys.2017.00034] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/05/2017] [Indexed: 12/19/2022] Open
Abstract
Electrocochleography (EcochG), incorporating the Cochlear Microphonic (CM), the Summating Potential (SP), and the cochlear Compound Action Potential (CAP), has been used to study cochlear function in humans and experimental animals since the 1930s, providing a simple objective tool to assess both hair cell (HC) and nerve sensitivity. The vestibular equivalent of ECochG, termed here Electrovestibulography (EVestG), incorporates responses of the vestibular HCs and nerve. Few research groups have utilized EVestG to study vestibular function. Arguably, this is because stimulating the cochlea in isolation with sound is a trivial matter, whereas stimulating the vestibular system in isolation requires significantly more technical effort. That is, the vestibular system is sensitive to both high-level sound and bone-conducted vibrations, but so is the cochlea, and gross electrical responses of the inner ear to such stimuli can be difficult to interpret. Fortunately, several simple techniques can be employed to isolate vestibular electrical responses. Here, we review the literature underpinning gross vestibular nerve and HC responses, and we discuss the nomenclature used in this field. We also discuss techniques for recording EVestG in experimental animals and humans and highlight how EVestG is furthering our understanding of the vestibular system.
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Affiliation(s)
- Daniel J Brown
- Neurotology Laboratory, Sydney Medical School, The University of SydneySydney, NSW, Australia
| | - Christopher J Pastras
- Neurotology Laboratory, Sydney Medical School, The University of SydneySydney, NSW, Australia
| | - Ian S Curthoys
- Department of Psychology, The University of SydneySydney, NSW, Australia
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