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Lue PY, Oliver MH, Neeff M, Thorne PR, Suzuki-Kerr H. Sheep as a large animal model for hearing research: comparison to common laboratory animals and humans. Lab Anim Res 2023; 39:31. [PMID: 38012676 PMCID: PMC10680324 DOI: 10.1186/s42826-023-00182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
Sensorineural hearing loss (SNHL), caused by pathology in the cochlea, is the most common type of hearing loss in humans. It is generally irreversible with very few effective pharmacological treatments available to prevent the degenerative changes or minimise the impact. Part of this has been attributed to difficulty of translating "proof-of-concept" for novel treatments established in small animal models to human therapies. There is an increasing interest in the use of sheep as a large animal model. In this article, we review the small and large animal models used in pre-clinical hearing research such as mice, rats, chinchilla, guinea pig, rabbit, cat, monkey, dog, pig, and sheep to humans, and compare the physiology, inner ear anatomy, and some of their use as model systems for SNHL, including cochlear implantation surgeries. Sheep have similar cochlear anatomy, auditory threshold, neonatal auditory system development, adult and infant body size, and number of birth as humans. Based on these comparisons, we suggest that sheep are well-suited as a potential translational animal model that bridges the gap between rodent model research to the clinical use in humans. This is especially in areas looking at changes across the life-course or in specific areas of experimental investigation such as cochlear implantation and other surgical procedures, biomedical device development and age-related sensorineural hearing loss research. Combined use of small animals for research that require higher throughput and genetic modification and large animals for medical translation could greatly accelerate the overall translation of basic research in the field of auditory neuroscience from bench to clinic.
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Affiliation(s)
- Po-Yi Lue
- Department of Physiology, The University of Auckland, Auckland, New Zealand
- Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand
| | - Mark H Oliver
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- Ngapouri Research Farm Laboratory, University of Auckland, Waiotapu, New Zealand
| | - Michel Neeff
- Department of Physiology, The University of Auckland, Auckland, New Zealand
- Department of Surgery, Auckland District Health Board, Auckland, New Zealand
| | - Peter R Thorne
- Department of Physiology, The University of Auckland, Auckland, New Zealand
- Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand
- Section of Audiology, The University of Auckland, Auckland, New Zealand
| | - Haruna Suzuki-Kerr
- Department of Physiology, The University of Auckland, Auckland, New Zealand.
- Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand.
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2
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Huang Z, Chen S, Ali HE, Elkamchouchi DH, Hu J, Ali E, Zhang J, Huang Y. Application of CNN and ANN in assessment the effect of chemical components of biological nanomaterials in treatment of infection of inner ear and environmental sustainability. CHEMOSPHERE 2023; 331:138458. [PMID: 36966931 DOI: 10.1016/j.chemosphere.2023.138458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/23/2023] [Accepted: 03/17/2023] [Indexed: 05/05/2023]
Abstract
Nanoparticles (NPs) are a promising alternative to antibiotics for targeting microorganisms, especially in the case of difficult-to-treat bacterial illnesses. Antibacterial coatings for medical equipment, materials for infection prevention and healing, bacterial detection systems for medical diagnostics, and antibacterial immunizations are potential applications of nanotechnology. Infections in the ear, which can result in hearing loss, are extremely difficult to cure. The use of nanoparticles to enhance the efficacy of antimicrobial medicines is a potential option. Various types of inorganic, lipid-based, and polymeric nanoparticles have been produced and shown beneficial for the controlled administration of medication. This article focuses on the use of polymeric nanoparticles to treat frequent bacterial diseases in the human body. Using machine learning models such as artificial neural networks (ANNs) and convolutional neural networks (CNNs), this 28-day study evaluates the efficacy of nanoparticle therapy. An innovative application of advanced CNNs, such as Dense Net, for the automatic detection of middle ear infections is reported. Three thousand oto-endoscopic images (OEIs) were categorized as normal, chronic otitis media (COM), and otitis media with effusion (OME). Comparing middle ear effusions to OEIs, CNN models achieved a classification accuracy of 95%, indicating great promise for the automated identification of middle ear infections. The hybrid CNN-ANN model attained an overall accuracy of more than 0.90 percent, with a sensitivity of 95 percent and a specificity of 100 percent in distinguishing earwax from illness, and provided nearly perfect measures of 0.99 percent. Nanoparticles are a promising treatment for difficult-to-treat bacterial diseases, such as ear infections. The application of machine learning models, such as ANNs and CNNs, can improve the efficacy of nanoparticle therapy, especially for the automated detection of middle ear infections. Polymeric nanoparticles, in particular, have shown efficacy in treating common bacterial infections in children, indicating great promise for future treatments.
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Affiliation(s)
- Zhongguan Huang
- Department of Otolaryngology, Pingyang Hospital Affiliated to Wenzhou Medical University, Pingyang, Zhejiang, 325400, China
| | - Shuainan Chen
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - H Elhosiny Ali
- Department of Physics, Faculty of Science, King Khalid University, P.O. Box 9004, Abha, Saudi Arabia
| | - Dalia H Elkamchouchi
- Department of Information Technology, College of Computer and Information Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Jun Hu
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Elimam Ali
- Department of Civil Engineering, College of Engineering in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Jie Zhang
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
| | - Yideng Huang
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
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3
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Gay RD, Enke YL, Kirk JR, Goldman DR. Therapeutics for hearing preservation and improvement of patient outcomes in cochlear implantation—Progress and possibilities. Hear Res 2022; 426:108637. [DOI: 10.1016/j.heares.2022.108637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/04/2022]
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4
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Muacevic A, Adler JR, Qayyum A. Ototoxicity of Topical Antibiotic Ear Drops in Chronic Suppurative Otitis Media in Humans: A Review of the Literature. Cureus 2022; 14:e32780. [PMID: 36686080 PMCID: PMC9855291 DOI: 10.7759/cureus.32780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
An electronic search of the literature was performed for reported cases of ototoxicity associated with the use of topical antibiotic ear drops in humans. The dosage, duration, and type of ototoxic preparations involved were recorded. Due to the scant quantity of low-quality information that is currently available, there was uncertainty about the usefulness of topical antibiotics in enhancing the resolution of ear discharge in patients with chronic suppurative otitis media. However, despite this uncertainty, there are some data to show that using topical antibiotics in comparison to a placebo or in conjunction with a systemic antibiotic may be useful. Additionally, there is ambiguity regarding the relative efficacy of various kinds of antibiotics; it is impossible to say with absolute certainty whether quinolones are superior to or inferior to aminoglycosides. Although the adverse impact profiles of these two classes of chemicals varied, there are not enough data from the included trials to draw any conclusions about them. Negative effects were generally underreported.
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5
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Idiopathic sudden sensorineural hearing loss: A critique on corticosteroid therapy. Hear Res 2022; 422:108565. [PMID: 35816890 DOI: 10.1016/j.heares.2022.108565] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/10/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022]
Abstract
Idiopathic sudden sensorineural hearing loss (ISSNHL) is a condition affecting 5-30 per 100,000 individuals with the potential to significantly reduce one's quality of life. The true incidence of this condition is not known because it often goes undiagnosed and/or recovers within a few days. ISSNHL is defined as a ≥30 dB loss of hearing over 3 consecutive audiometric octaves within 3 days with no known cause. The disorder is typically unilateral and most of the cases spontaneously recover to functional hearing within 30 days. High frequency losses, ageing, and vertigo are associated with a poorer prognosis. Multiple causes of ISSNHL have been postulated and the most common are vascular obstruction, viral infection, or labyrinthine membrane breaks. Corticosteroids are the standard treatment option but this practice is not without opposition. Post mortem analyses of temporal bones of ISSNHL cases have been inconclusive. This report analyzed ISSNHL studies administering corticosteroids that met strict inclusion criteria and identified a number of methodologic shortcomings that compromise the interpretation of results. We discuss the issues and conclude that the data do not support present treatment practices. The current status on ISSNHL calls for a multi-institutional, randomized, double-blind trial with validated outcome measures to provide science-based treatment guidance.
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Barbara M, Margani V, Covelli E, Filippi C, Volpini L, El-Borady OM, El-Kemary M, Elzayat S, Elfarargy HH. The Use of Nanoparticles in Otoprotection. Front Neurol 2022; 13:912647. [PMID: 35968304 PMCID: PMC9364836 DOI: 10.3389/fneur.2022.912647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
The inner ear can be insulted by various noxious stimuli, including drugs (cisplatin and aminoglycosides) and over-acoustic stimulation. These stimuli damage the hair cells giving rise to progressive hearing loss. Systemic drugs have attempted protection from ototoxicity. Most of these drugs poorly reach the inner ear with consequent ineffective action on hearing. The reason for these failures resides in the poor inner ear blood supply, the presence of the blood-labyrinthine barrier, and the low permeability of the round window membrane (RWM). This article presents a review of the use of nanoparticles (NPs) in otoprotection. NPs were recently used in many fields of medicine because of their ability to deliver drugs to the target organs or cells. The studies included in the review regarded the biocompatibility of the used NPs by in vitro and in vivo experiments. In most studies, NPs proved safe without a significant decrease in cell viability or signs of ototoxicity. Many nano-techniques were used to improve the drugs' kinetics and efficiency. These techniques included encapsulation, polymerization, surface functionalization, and enhanced drug release. In such a way, it improved drug transmission through the RWM with increased and prolonged intra-cochlear drug concentrations. In all studies, the fabricated drug-NPs effectively preserved the hair cells and the functioning hearing from exposure to different ototoxic stimuli, simulating the actual clinical circumstances. Most of these studies regarded cisplatin ototoxicity due to the wide use of this drug in clinical oncology. Dexamethasone (DEX) and antioxidants represent the most used drugs in most studies. These drugs effectively prevented apoptosis and reactive oxygen species (ROS) production caused by ototoxic stimuli. These various successful experiments confirmed the biocompatibility of different NPs and made it successfully to human clinical trials.
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Affiliation(s)
- Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Valerio Margani
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Chiara Filippi
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Luigi Volpini
- Otolaryngology Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Ola M. El-Borady
- Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Maged El-Kemary
- Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Saad Elzayat
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Haitham H. Elfarargy
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
- *Correspondence: Haitham H. Elfarargy ;
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7
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Zhang Y, Li Q, Han C, Geng F, Zhang S, Qu Y, Tang W. Superoxide dismutase@zeolite Imidazolate Framework-8 Attenuates Noise-Induced Hearing Loss in Rats. Front Pharmacol 2022; 13:885113. [PMID: 35662706 PMCID: PMC9159373 DOI: 10.3389/fphar.2022.885113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/19/2022] [Indexed: 12/20/2022] Open
Abstract
Reactive oxygen species (ROS) and inflammation have been considered major contributors to noise-induced hearing loss (NIHL) that constituted a public health threat worldwide. Nanoantioxidants, with high antioxidant activity and good stability, have been extensively used in the study of ROS-related diseases. In this study, we constructed a superoxide dismutase (SOD)@zeolite imidazolate framework-8 (ZIF-8) nanoparticle based on biomimetic mineralization and applied it to a rat model of NIHL. Our results showed that SOD@ZIF-8 effectively protected the animals from hearing loss and hair cell loss caused by noise. ROS, oxidative damage, and inflammation of noise-damaged cochlea were attenuated considerably after SOD@ZIF-8 administration. Importantly, we found that SOD@ZIF-8 achieved nanotherapy for NIHL in rats via a primary effect on the Sirtuin-3 (SIRT3)/superoxide dismutase2 (SOD2) signaling pathway without obvious adverse side effects. Therefore, our study is expected to open up a new field for NIHL treatment, and lay a foundation for the application of nanomaterials in other ROS-related inner ear diseases.
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Affiliation(s)
- Yan Zhang
- Department of Otolaryngology, Hebei Medical University, Shijiazhuang, China.,Department of Otolaryngology, Tangshan People's Hospital, Tangshan, China
| | - Qing Li
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chengzhou Han
- Department of Otolaryngology, Hebei Medical University, Shijiazhuang, China
| | - Fang Geng
- Department of Otolaryngology, Hebei Medical University, Shijiazhuang, China
| | - Sen Zhang
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Qu
- Department of Otolaryngology, Hebei Medical University, Shijiazhuang, China
| | - Wenxue Tang
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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8
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Liu SS, Yang R. Inner Ear Drug Delivery for Sensorineural Hearing Loss: Current Challenges and Opportunities. Front Neurosci 2022; 16:867453. [PMID: 35685768 PMCID: PMC9170894 DOI: 10.3389/fnins.2022.867453] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/02/2022] [Indexed: 12/20/2022] Open
Abstract
Most therapies for treating sensorineural hearing loss are challenged by the delivery across multiple tissue barriers to the hard-to-access anatomical location of the inner ear. In this review, we will provide a recent update on various pharmacotherapy, gene therapy, and cell therapy approaches used in clinical and preclinical studies for the treatment of sensorineural hearing loss and approaches taken to overcome the drug delivery barriers in the ear. Small-molecule drugs for pharmacotherapy can be delivered via systemic or local delivery, where the blood-labyrinth barrier hinders the former and tissue barriers including the tympanic membrane, the round window membrane, and/or the oval window hinder the latter. Meanwhile, gene and cell therapies often require targeted delivery to the cochlea, which is currently achieved via intra-cochlear or intra-labyrinthine injection. To improve the stability of the biomacromolecules during treatment, e.g., RNAs, DNAs, proteins, additional packing vehicles are often required. To address the diverse range of biological barriers involved in inner ear drug delivery, each class of therapy and the intended therapeutic cargoes will be discussed in this review, in the context of delivery routes commonly used, delivery vehicles if required (e.g., viral and non-viral nanocarriers), and other strategies to improve drug permeation and sustained release (e.g., hydrogel, nanocarriers, permeation enhancers, and microfluidic systems). Overall, this review aims to capture the important advancements and key steps in the development of inner ear therapies and delivery strategies over the past two decades for the treatment and prophylaxis of sensorineural hearing loss.
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Affiliation(s)
- Sophie S. Liu
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, NY, United States
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
| | - Rong Yang
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, NY, United States
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
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9
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Lin Q, Guo Q, Zhu M, Zhang J, Chen B, Wu T, Jiang W, Tang W. Application of Nanomedicine in Inner Ear Diseases. Front Bioeng Biotechnol 2022; 9:809443. [PMID: 35223817 PMCID: PMC8873591 DOI: 10.3389/fbioe.2021.809443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
The treatment of inner ear disorders always remains a challenge for researchers. The presence of various physiological barriers, primarily the blood–labyrinth barrier (BLB), limits the accessibility of the inner ear and hinders the efficacy of various drug therapies. Yet despite recent advances in the cochlea for repair and regeneration, there are currently no pharmacological or biological interventions for hearing loss. Current research focuses on the localized drug-, gene-, and cell-based therapies. Drug delivery based on nanotechnology represents an innovative strategy to improve inner ear treatments. Materials with specific nanostructures not only exhibit a unique ability to encapsulate and transport therapeutics to the inner ear but also endow specific targeting properties to auditory hair cells as well as the stabilization and sustained drug release. Along with this, some alternative routes, like intratympanic drug delivery, can also offer a better means to access the inner ear without exposure to the BLB. This review discusses a variety of nano-based drug delivery systems to the ear for treating inner ear diseases. The main factors affecting the curative efficacy of nanomaterials are also discussed. With a deeper understanding of the link between these crucial factors and the clinical effect of nanomaterials, it paves the way for the optimization of the therapeutic activity of nanocarriers.
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Affiliation(s)
- Qianyu Lin
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Qiong Guo
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Mingchao Zhu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Juanli Zhang
- Henan Institute of Medical Device Inspection, Zhengzhou, China
| | - Bei Chen
- Department of Otology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tingting Wu
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Wei Jiang
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Jiang, ; Wenxue Tang,
| | - Wenxue Tang
- Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Jiang, ; Wenxue Tang,
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Jeong SH, Kim Y, Lyu AR, Shin SA, Kim TH, Huh YH, Je AR, Gajibhiye A, Yu Y, Jin Y, Park MJ, Park YH. Junctional Modulation of Round Window Membrane Enhances Dexamethasone Uptake into the Inner Ear and Recovery after NIHL. Int J Mol Sci 2021; 22:ijms221810061. [PMID: 34576224 PMCID: PMC8464844 DOI: 10.3390/ijms221810061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Delivery of substances into the inner ear via local routes is increasingly being used in clinical treatment. Studies have focused on methods to increase permeability through the round window membrane (RWM) and enhance drug diffusion into the inner ear. However, the clinical applications of those methods have been unclear and few studies have investigated the efficacy of methods in an inner ear injury model. Here, we employed the medium chain fatty acid caprate, a biologically safe, clinically applicable substance, to modulate tight junctions of the RWM. Intratympanic treatment of sodium caprate (SC) induced transient, but wider, gaps in intercellular spaces of the RWM epithelial layer and enhanced the perilymph and cochlear concentrations/uptake of dexamethasone. Importantly, dexamethasone co-administered with SC led to significantly more rapid recovery from noise-induced hearing loss at 4 and 8 kHz, compared with the dexamethasone-only group. Taken together, our data indicate that junctional modulation of the RWM by SC enhances dexamethasone uptake into the inner ear, thereby hastening the recovery of hearing sensitivity after noise trauma.
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Affiliation(s)
- Seong-Hun Jeong
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea; (S.-H.J.); (A.-R.L.); (A.G.)
| | - Yoonjoong Kim
- Department of Otolaryngology—Head and Neck Surgery, Chungbuk National University Hospital, Cheongju 28644, Korea;
| | - Ah-Ra Lyu
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea; (S.-H.J.); (A.-R.L.); (A.G.)
- Department of Otolaryngology—Head and Neck Surgery, Chungnam National University, Daejeon 35015, Korea; (S.-A.S.); (Y.Y.)
| | - Sun-Ae Shin
- Department of Otolaryngology—Head and Neck Surgery, Chungnam National University, Daejeon 35015, Korea; (S.-A.S.); (Y.Y.)
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Tae Hwan Kim
- Biomedical Research Institute, Chungnam National University Hospital, Daejeon 35015, Korea;
| | - Yang Hoon Huh
- Electron Microscopy Research Center, Korea Basic Science Institute, Cheongju 28116, Korea; (Y.H.H.); (A.R.J.)
| | - A Reum Je
- Electron Microscopy Research Center, Korea Basic Science Institute, Cheongju 28116, Korea; (Y.H.H.); (A.R.J.)
| | - Akanksha Gajibhiye
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea; (S.-H.J.); (A.-R.L.); (A.G.)
| | - Yang Yu
- Department of Otolaryngology—Head and Neck Surgery, Chungnam National University, Daejeon 35015, Korea; (S.-A.S.); (Y.Y.)
| | - Yongde Jin
- Department of Otolaryngology—Head and Neck Surgery, Yanbian University Hospital, Yanji 133000, China;
| | - Min Jung Park
- Department of Otolaryngology—Head and Neck Surgery, Chungnam National University, Daejeon 35015, Korea; (S.-A.S.); (Y.Y.)
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea
- Correspondence: (M.J.P.); (Y.-H.P.)
| | - Yong-Ho Park
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea; (S.-H.J.); (A.-R.L.); (A.G.)
- Department of Otolaryngology—Head and Neck Surgery, Chungnam National University, Daejeon 35015, Korea; (S.-A.S.); (Y.Y.)
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea
- Biomedical Research Institute, Chungnam National University Hospital, Daejeon 35015, Korea;
- Correspondence: (M.J.P.); (Y.-H.P.)
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11
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Nystagmus in adult patients with acute otitis media or otitis media with effusion without dizziness. PLoS One 2021; 16:e0250357. [PMID: 33983960 PMCID: PMC8118351 DOI: 10.1371/journal.pone.0250357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/05/2021] [Indexed: 11/19/2022] Open
Abstract
The present study aimed to investigate the incidence and patterns of nystagmus in adult patients with acute otitis media (AOM) or otitis media with effusion (OME) without dizziness or vertigo, and discuss possible mechanisms. From February 2018 to November 2018, 34 consecutive patients with AOM or OME without dizziness were included. Nystagmus was examined with video Frenzel glasses. Of 34 adult AOM or OME patients without dizziness, nystagmus was observed in 28 patients (82%). In unilateral AOM or OME (n = 30), the most commonly observed nystagmus pattern was irritative-type direction-fixed nystagmus (n = 13), followed by paretic-type direction-fixed nystagmus (n = 8), and direction-changing positional nystagmus (n = 4). In bilateral AOM or OME (n = 4), direction-fixed nystagmus and direction-changing positional nystagmus were observed in two and one patients, respectively. Nystagmus was observed in as many as 82% of adult AOM or OME patients even though they did not complain of dizziness, and the pattern of nystagmus was either direction-fixed or direction-changing. Direct effect of inflammatory mediators penetrated from the middle ear and biochemical alteration in the inner ear fluids due to blood-perilymph barrier dysfunction may result in the presence of nystagmus in AOM or OME patients without dizziness.
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12
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Tani T, Koike-Tani M, Tran MT, Shribak M, Levic S. Postnatal structural development of mammalian Basilar Membrane provides anatomical basis for the maturation of tonotopic maps and frequency tuning. Sci Rep 2021; 11:7581. [PMID: 33828185 PMCID: PMC8027603 DOI: 10.1038/s41598-021-87150-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/16/2021] [Indexed: 02/01/2023] Open
Abstract
The basilar membrane (BM) of the mammalian cochlea constitutes a spiraling acellular ribbon that is intimately attached to the organ of Corti. Its graded stiffness, increasing from apex to the base of the cochlea provides the mechanical basis for sound frequency analysis. Despite its central role in auditory signal transduction, virtually nothing is known about the BM's structural development. Using polarized light microscopy, the present study characterized the architectural transformations of freshly dissected BM at time points during postnatal development and maturation. The results indicate that the BM structural elements increase progressively in size, becoming radially aligned and more tightly packed with maturation and reach the adult structural signature by postnatal day 20 (P20). The findings provide insight into structural details and developmental changes of the mammalian BM, suggesting that BM is a dynamic structure that changes throughout the life of an animal.
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Affiliation(s)
- Tomomi Tani
- Marine Biological Laboratory, Eugene Bell Center, Woods Hole, MA, USA
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology, Ikeda, Osaka, Japan
| | - Maki Koike-Tani
- Marine Biological Laboratory, Eugene Bell Center, Woods Hole, MA, USA
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Osaka, Japan
| | - Mai Thi Tran
- Marine Biological Laboratory, Eugene Bell Center, Woods Hole, MA, USA
- College of Engineering and Computer Science, VinUniversity, Gia Lam District, Hanoi, Vietnam
| | - Michael Shribak
- Marine Biological Laboratory, Eugene Bell Center, Woods Hole, MA, USA
| | - Snezana Levic
- Marine Biological Laboratory, Eugene Bell Center, Woods Hole, MA, USA.
- Sensory Neuroscience Research Group, School of Pharmacy and Biomolecular Sciences, University of Brighton, Huxley Building, Brighton, BN2 4GJ, UK.
- Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK.
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13
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Perrelli A, Fatehbasharzad P, Benedetti V, Ferraris C, Fontanella M, De Luca E, Moglianetti M, Battaglia L, Retta SF. Towards precision nanomedicine for cerebrovascular diseases with emphasis on Cerebral Cavernous Malformation (CCM). Expert Opin Drug Deliv 2021; 18:849-876. [PMID: 33406376 DOI: 10.1080/17425247.2021.1873273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Cerebrovascular diseases encompass various disorders of the brain vasculature, such as ischemic/hemorrhagic strokes, aneurysms, and vascular malformations, also affecting the central nervous system leading to a large variety of transient or permanent neurological disorders. They represent major causes of mortality and long-term disability worldwide, and some of them can be inherited, including Cerebral Cavernous Malformation (CCM), an autosomal dominant cerebrovascular disease linked to mutations in CCM1/KRIT1, CCM2, or CCM3/PDCD10 genes.Areas covered: Besides marked clinical and etiological heterogeneity, some commonalities are emerging among distinct cerebrovascular diseases, including key pathogenetic roles of oxidative stress and inflammation, which are increasingly recognized as major disease hallmarks and therapeutic targets. This review provides a comprehensive overview of the different clinical features and common pathogenetic determinants of cerebrovascular diseases, highlighting major challenges, including the pressing need for new diagnostic and therapeutic strategies, and focusing on emerging innovative features and promising benefits of nanomedicine strategies for early detection and targeted treatment of such diseases.Expert opinion: Specifically, we describe and discuss the multiple physico-chemical features and unique biological advantages of nanosystems, including nanodiagnostics, nanotherapeutics, and nanotheranostics, that may help improving diagnosis and treatment of cerebrovascular diseases and neurological comorbidities, with an emphasis on CCM disease.
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Affiliation(s)
- Andrea Perrelli
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy.,CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy
| | - Parisa Fatehbasharzad
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy.,CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy
| | - Valerio Benedetti
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy.,CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy
| | - Chiara Ferraris
- Department of Drug Science and Technology, University of Torino, Torino, Italy.,Nanostructured Interfaces and Surfaces (NIS) Interdepartmental Centre, University of Torino, Torino, Italy
| | - Marco Fontanella
- CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy.,Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elisa De Luca
- Nanobiointeractions & Nanodiagnostics, Center for Biomolecular Nanotechnologies, Arnesano, Lecce, Italy.,Institute for Microelectronics and Microsystems (IMM), CNR, Lecce, Italy
| | - Mauro Moglianetti
- Nanobiointeractions & Nanodiagnostics, Center for Biomolecular Nanotechnologies, Arnesano, Lecce, Italy.,Istituto Italiano Di Tecnologia, Nanobiointeractions & Nanodiagnostics, Genova, Italy
| | - Luigi Battaglia
- Department of Drug Science and Technology, University of Torino, Torino, Italy.,Nanostructured Interfaces and Surfaces (NIS) Interdepartmental Centre, University of Torino, Torino, Italy
| | - Saverio Francesco Retta
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy.,CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, Torino Italy
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14
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Characterization of the Sheep Round Window Membrane. J Assoc Res Otolaryngol 2020; 22:1-17. [PMID: 33258054 DOI: 10.1007/s10162-020-00778-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022] Open
Abstract
Intratympanic injection is a clinically used approach to locally deliver therapeutic molecules to the inner ear. Drug diffusion, at least in part, is presumed to occur through the round window membrane (RWM), one of the two openings to the inner ear. Previous studies in human temporal bones have identified a three-layered structure of the RWM with a thickness of 70-100 μm. This is considerably thicker than the RWM in rodents, which are mostly used to model RWM permeability and assess drug uptake. The sheep has been suggested as a large animal model for inner ear research given the similarities in structure and frequency range for hearing. Here, we report the structure of the sheep RWM. The RWM is anchored within the round window niche (average vertical diameter of 2.1 ± 0.3 mm and horizontal diameter of 2.3 ± 0.4 mm) and has a curvature that leans towards the scala tympani. The centre of the RWM is the thinnest (55-71 μm), with increasing thickness towards the edges (< 171 μm), where the RWM forms tight attachments to the surrounding bony niche. The layered RWM structure, including an outer epithelial layer, middle connective tissue and inner epithelial layer, was identified with cellular features such as wavy fibre bundles, melanocytes and blood vessels. An attached "meshwork structure" which extends over the cochlear aqueduct was seen, as in humans. The striking anatomical similarities between sheep and human RWM suggest that sheep may be evaluated as a more appropriate system to predict RWM permeability and drug delivery in humans than rodent models.
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15
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Nanocarriers for drug delivery to the inner ear: Physicochemical key parameters, biodistribution, safety and efficacy. Int J Pharm 2020; 592:120038. [PMID: 33159985 DOI: 10.1016/j.ijpharm.2020.120038] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/26/2022]
Abstract
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.
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16
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Monsanto RDC, Penido NDO, Uchiyama M, Schachern P, Paparella MM, Cureoglu S. Quantitative assessment of cochlear and vestibular ganglion neurons in temporal bones with chronic otitis media. Eur Arch Otorhinolaryngol 2020; 278:331-338. [PMID: 32488375 PMCID: PMC10123924 DOI: 10.1007/s00405-020-06094-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In this study, we aimed to determine whether or not COM leads to loss of spiral and Scarpa ganglion neurons. METHODS From the human temporal bone (HTB) collection at the University of Minnesota we selected human temporal bones with COM, defined as the presence of clinically intractable tissue abnormalities in the middle ear (cholesteatoma, perforation of the eardrum, granulation tissue, fibrosis, tympanosclerosis, and cholesterol granuloma). We also selected HTBs from donors with no ear diseases as controls. We quantitatively analyzed the number of spiral and Scarpa ganglion cells and compared the results obtained in the control and study groups. RESULTS In both COM and control groups we observed a significant negative correlation between age and number of both spiral (R = -0.632; P < 0.001; 95% CI - 0.766 to - 0.434) and Scarpa ganglion (R = - 0.404; P = 0.008; 95% CI - 0.636 to - 0.051) cells. We did not find any significant differences in the number of spiral ganglion cells (in total or per segment) or in the density of Scarpa ganglion cells (in each vestibular nerve or both) in the COM group as compared with controls (P > 0.05). CONCLUSIONS AND RELEVANCE Our results did not demonstrate significant loss of cochlear or vestibular peripheral ganglion neuron loss in HTBs with COM as compared with controls.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), R dos Otonis, 700 - piso superior - Vila Clementino, São Paulo, SP, 04037-004, Brazil.
| | - Norma de Oliveira Penido
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), R dos Otonis, 700 - piso superior - Vila Clementino, São Paulo, SP, 04037-004, Brazil
| | - Mio Uchiyama
- Department of Otolaryngology, Showa University, Tokyo, Japan.,Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Patricia Schachern
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Michael M Paparella
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.,Paparella Ear Head and Neck Institute, Minneapolis, MN, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
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17
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Gausterer JC, Saidov N, Ahmadi N, Zhu C, Wirth M, Reznicek G, Arnoldner C, Gabor F, Honeder C. Intratympanic application of poloxamer 407 hydrogels results in sustained N-acetylcysteine delivery to the inner ear. Eur J Pharm Biopharm 2020; 150:143-155. [DOI: 10.1016/j.ejpb.2020.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/20/2020] [Accepted: 03/04/2020] [Indexed: 01/06/2023]
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18
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Anatomical and Functional Consequences of Microneedle Perforation of Round Window Membrane. Otol Neurotol 2020; 41:e280-e287. [DOI: 10.1097/mao.0000000000002491] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Szeto B, Chiang H, Valentini C, Yu M, Kysar JW, Lalwani AK. Inner ear delivery: Challenges and opportunities. Laryngoscope Investig Otolaryngol 2020; 5:122-131. [PMID: 32128438 PMCID: PMC7042639 DOI: 10.1002/lio2.336] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/21/2019] [Accepted: 11/21/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The treatment of inner ear disorders remains challenging due to anatomic barriers intrinsic to the bony labyrinth. The purpose of this review is to highlight recent advances and strategies for overcoming these barriers and to discuss promising future avenues for investigation. DATA SOURCES The databases used were PubMed, EMBASE, and Web of Science. RESULTS Although some studies aimed to improve systemic delivery using nanoparticle systems, the majority enhanced local delivery using hydrogels, nanoparticles, and microneedles. Developments in direct intracochlear delivery include intracochlear injection and intracochlear implants. CONCLUSIONS In the absence of a systemic drug that targets only the inner ear, the best alternative is local delivery that harnesses a combination of new strategies to overcome anatomic barriers. The combination of microneedle technology with hydrogel and nanoparticle delivery is a promising area for future investigation. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Betsy Szeto
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
| | - Harry Chiang
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
| | - Chris Valentini
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
| | - Michelle Yu
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
| | - Jeffrey W. Kysar
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
- Department of Mechanical Engineering, School of EngineeringColumbia UniversityNew YorkNew York
| | - Anil K. Lalwani
- Department of Otolaryngology–Head and Neck SurgeryColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew York
- Department of Mechanical Engineering, School of EngineeringColumbia UniversityNew YorkNew York
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20
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Lin YC, Chen HC, Chen HK, Lin YY, Kuo CY, Wang H, Hung CL, Shih CP, Wang CH. Ultrastructural Changes Associated With the Enhanced Permeability of the Round Window Membrane Mediated by Ultrasound Microbubbles. Front Pharmacol 2020; 10:1580. [PMID: 32047431 PMCID: PMC6997169 DOI: 10.3389/fphar.2019.01580] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/05/2019] [Indexed: 12/19/2022] Open
Abstract
The round window membrane (RWM) is the most common entryway for local drug and gene delivery into the inner ear, but its permeability can change the treatment outcome. We previously demonstrated a feasible and highly efficient approach using ultrasound-aided microbubble (USMB) cavitation to enhance the permeability of the RWM. Here, we investigated the safety of USMB exposure and the association between temporal changes in RWM permeability and ultrastructure. Experimental guinea pigs were divided into two treatment groups: a control group receiving round window soaking (RWS) with MBs and treatment (USM) groups undergoing 3 (USM-3) or 5 (USM-5) consecutive USMB exposures (1 min/exposure) at an acoustic intensity of 3 W/cm2 and 1 MHz frequency. The trans-RWM delivery efficiency of biotin-fluorescein isothiocyanate conjugates, used as permeability tracers, revealed a greater than 7-fold higher delivery efficiency for the USM groups immediately after 3 or 5 exposures than for the RWS group. After 24 h, the delivery efficiency was 2.4-fold higher for the USM-3 group but was 6.6-fold higher for the USM-5 group (and 3.7-fold higher after 48 h), when compared to the RWS group. Scanning electron microscopy images of the RWM ultrastructure revealed USMB-induced sonoporation effects that could include the formation of heterogeneous pore-like openings with perforation diameters from 100 nm to several micrometers, disruption of the continuity of the outer epithelial surface layer, and loss of microvilli. These ultrastructural features were associated with differential permeability changes that depended on the USMB exposure course. Fourteen days after treatment, the pore-like openings had significantly decreased in number and the epithelial defects were healed either by cell expansion or by repair by newly migrated epithelial cells. The auditory brainstem response recordings of the animals following the 5-exposure USMB treatment indicated no deterioration in the hearing thresholds at a 2-month follow-up and no significant hair cell damage or apoptosis, based on scanning electron microscopy, surface preparations, and TUNEL assays. USMBs therefore appear to be safe and effective for inner ear drug delivery. The mechanism of enhanced permeability may involve a disruption of the continuity of the outer RWM epithelial layer, which controls transmembrane transport of various substances.
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Affiliation(s)
- Yi-Chun Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hang-Kang Chen
- Teaching and Research Section, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Yuan-Yung Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chao-Yin Kuo
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hao Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Lien Hung
- Teaching and Research Section, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Cheng-Ping Shih
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hung Wang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taichung Armed Forces General Hospital, Taichung, Taiwan
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21
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Rybak LP, Dhukhwa A, Mukherjea D, Ramkumar V. Local Drug Delivery for Prevention of Hearing Loss. Front Cell Neurosci 2019; 13:300. [PMID: 31338024 PMCID: PMC6629775 DOI: 10.3389/fncel.2019.00300] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
Systemic delivery of therapeutics for targeting the cochlea to prevent or treat hearing loss is challenging. Systemic drugs have to cross the blood-labyrinth barrier (BLB). BLB can significantly prevent effective penetration of drugs in appropriate concentrations to protect against hearing loss caused by inflammation, ototoxic drugs, or acoustic trauma. This obstacle may be obviated by local administration of protective agents. This route can deliver higher concentration of drug compared to systemic application and preclude systemic side effects. Protective agents have been administered by intra-tympanic injection in numerous preclinical studies. Drugs such as steroids, etanercept, D and L-methionine, pifithrin-alpha, adenosine agonists, melatonin, kenpaullone (a cyclin-dependent kinase 2 (CDK2) inhibitor) have been reported to show efficacy against cisplatin ototoxicity in animal models. Several siRNAs have been shown to ameliorate cisplatin ototoxicity when administered by intra-tympanic injection. The application of corticosteroids and a number of other drugs with adjuvants appears to enhance efficacy. Administration of siRNAs to knock down AMPK kinase, liver kinase B1 (LKB1) or G9a in the cochlea have been found to ameliorate noise-induced hearing loss. The local administration of these compounds appears to be effective in protecting the cochlea against damage from cisplatin or noise trauma. Furthermore the intra-tympanic route yields maximum protection in the basal turn of the cochlea which is most vulnerable to cisplatin ototoxicity and noise trauma. There appears to be very little transfer of these agents to the systemic circulation. This would avoid potential side effects including interference with anti-tumor efficacy of cisplatin. Nanotechnology offers strategies to effectively deliver protective agents to the cochlea. This review summarizes the pharmacology of local drug delivery by intra-tympanic injection to prevent hearing loss caused by cisplatin and noise exposure in animals. Future refinements in local protective agents provide exciting prospects for amelioration of hearing loss resulting from cisplatin or noise exposure.
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Affiliation(s)
- Leonard P Rybak
- Department of Otolaryngology, School of Medicine, Southern Illinois University, Springfield, IL, United States.,Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Asmita Dhukhwa
- Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Debashree Mukherjea
- Department of Otolaryngology, School of Medicine, Southern Illinois University, Springfield, IL, United States
| | - Vickram Ramkumar
- Department of Pharmacology, School of Medicine, Southern Illinois University, Springfield, IL, United States
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22
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Santimetaneedol A, Wang Z, Arteaga DN, Aksit A, Prevoteau C, Yu M, Chiang H, Fafalis D, Lalwani AK, Kysar JW. Small molecule delivery across a perforated artificial membrane by thermoreversible hydrogel poloxamer 407. Colloids Surf B Biointerfaces 2019; 182:110300. [PMID: 31326623 DOI: 10.1016/j.colsurfb.2019.06.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022]
Abstract
Microperforations in the round window membrane have been suggested for enhancing the rate and reliability of drug delivery into the cochlea. Intratympanic injection, the most common delivery method, involves injecting therapy into the middle ear to establish a reservoir from which drug diffuses across the round window membrane into the cochlea. This process is highly variable because (i) the reservoir, if liquid, can lose contact with the membrane and (ii) diffusion across the membrane is intrinsically variable even with a stable reservoir. To address these respective sources of variability, we compared the thermoreversible hydrogel poloxamer 407 (P407) to saline as a drug carrier and studied the effect of membrane microperforations on drug diffusion rate. We used Rhodamine B as a drug proxy to measure permeance across an artificial membrane in a horizontal diffusion cell. We found that permeance of Rhodamine B from a saline reservoir was an order of magnitude higher than that from a P407 reservoir across unperforated membranes. Moreover, permeance increased with total perforation cross-sectional area regardless of number of perforations (p < 0.05 for all saline-based experiments), but the same association was not found with P407. Rather, for a P407 reservoir, only a large perforation increased permeance (p < 0.001), while multiple small perforations did not (p = 0.749). These results confirm that for drug dissolved in saline, multiple small perforations can effectively enhance diffusion. However, for drug dissolved in P407, larger perforations are necessary.
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Affiliation(s)
- A Santimetaneedol
- Department of Mechanical Engineering, Columbia University, New York, NY, United States
| | - Z Wang
- Department of Mechanical Engineering, Columbia University, New York, NY, United States
| | - D N Arteaga
- Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States
| | - A Aksit
- Department of Mechanical Engineering, Columbia University, New York, NY, United States
| | - C Prevoteau
- Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States
| | - M Yu
- Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States
| | - H Chiang
- Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States
| | - D Fafalis
- Department of Mechanical Engineering, Columbia University, New York, NY, United States
| | - A K Lalwani
- Department of Mechanical Engineering, Columbia University, New York, NY, United States; Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States.
| | - J W Kysar
- Department of Mechanical Engineering, Columbia University, New York, NY, United States; Department of Otolaryngology - Head & Neck Surgery, Columbia University Medical Center, New York, NY, United States
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23
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Silva SA, Maass JC. p27 Kip1 down-regulation as achieved by two clinically feasible means did not induce proliferation of supporting cells in the rat neonatal cochlea in vivo. Hear Res 2018; 373:10-22. [PMID: 30578960 DOI: 10.1016/j.heares.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 12/24/2022]
Abstract
In mammals, the cochlear sensory epithelium becomes quiescent early during development. After the first postnatal week, there is no cell replacement or proliferation, and severe damage leads to permanent deafness. Supporting cells' trans-differentiation has been suggested as a way to regenerate cochlear hair cells after damage. However, they are also needed for proper functionality. Cdkn1b (p27Kip1) participates in the cochlear terminal mitosis state achieved during development. Its expression is maintained in adult supporting cells and its postnatal deletion has induced cochlear proliferation in vitro and in vivo. Therefore, its manipulation has been proposed as a feasible way to induce proliferation of supporting cells after birth. Nevertheless, the literature is scarce regarding feasible methods to directly decrease p27Kip1 in the clinical domain. The effects of p27Kip1 knockdown using viral vectors are not completely elucidated and no pharmacological approaches to decrease p27Kip1 in the cochlea have been tested in vivo before. This study explores the ability of p27Kip1 messenger knockdown and pharmacological transcriptional inhibition to induce proliferation of supporting cells in the P0 neonatal rat cochlea in vivo. Respectively, lentiviral vectors transducing shRNA against p27Kip1 were administered into the scala media or Alsterpaullone 2-Cyanoethyl into the round window niche. Cell markers and gene expression were assessed through immunostaining and qRT-PCR. Despite both methods significantly decreasing p27Kip1 expression in vivo, signs of toxicity in the organ of Corti were not found; however, relevant proliferation was not found either. Finally, cochlear damage was added to increase the response in vitro, achieving only a mild to moderate proliferation induction. We conclude that our approaches were not able to stimulate the recall of supporting cell proliferation despite significantly decreased p27Kip1 levels in vivo. Considering the evaluation of the cochlea at a very responsive stage, we propose that the level of isolated modification of p27Kip1 expression in living mammals achievable through these approaches is insufficient to induce proliferation of supporting cells. Future proliferation induction experiments in the cochlea should study other methods and genes.
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Affiliation(s)
- Sebastián A Silva
- Department of Otolaryngology, Hospital Clínico Universidad de Chile and Interdisciplinary Program of Physiology and Biophysics, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, 8380453, Independencia, Santiago, Chile
| | - Juan C Maass
- Department of Otolaryngology, Hospital Clínico Universidad de Chile and Interdisciplinary Program of Physiology and Biophysics, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, 8380453, Independencia, Santiago, Chile; Department of Otolaryngology, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Av. Vitacura 5951, 7650568, Vitacura, Santiago, Chile.
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24
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Marques P, Duan M, Perez-Fernandez N, Spratley J. Gentamicin delivery to the inner ear: Does endolymphatic hydrops matter? PLoS One 2018; 13:e0207467. [PMID: 30440019 PMCID: PMC6237362 DOI: 10.1371/journal.pone.0207467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/31/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Middle ear application of gentamicin is a common medical treatment for uncontrolled Ménière’s disease. The objective of the study was to evaluate the impact of endolymphatic hydrops on inner ear delivery. Methods Perilymph gentamicin concentrations and correlation with endolymphatic hydrops in an animal model were assessed. A group of 24 guinea pigs was submitted to surgical obstruction of the endolymphatic sac and duct of the right ear. Gentamicin was applied either to the right ear’s round window niche or through a transtympanic injection. Perilymph specimens were collected at different times. Histologic morphometry was used to evaluate both turn-specific and overall hydrops degree. Results In animals with endolymphatic hydrops, lower concentrations of gentamicin were observed after 20 or 120 minutes of exposure and in both types of administration, when compared to controls. This difference reached statistical significance in the round window niche application group (Mann-Whitney, p = 0,007). A negative correlation between perilymphatic gentamicin concentration and hydrops degree could be observed in both groups, after 120 minutes of exposure (Spearman correlation, round window niche p<0,001; TT p = 0,005). Conclusions The study indicates that the endolymphatic hydrops degree has a negative interference on the delivery of gentamicin into the inner ear following middle ear application.
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Affiliation(s)
- Pedro Marques
- Department of Otorhinolaryngology, S.João Hospital Centre, Porto, Portugal
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
- * E-mail:
| | - Maoli Duan
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otolaryngology, Head and Neck Surgery, Karolinska Universisty Hospital, Karolinska Institutet, Stockholm, Sweden
| | | | - Jorge Spratley
- Department of Otorhinolaryngology, S.João Hospital Centre, Porto, Portugal
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), University of Porto Medical School, Porto, Portugal
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Musazzi UM, Franzé S, Cilurzo F. Innovative pharmaceutical approaches for the management of inner ear disorders. Drug Deliv Transl Res 2018; 8:436-449. [PMID: 28462501 DOI: 10.1007/s13346-017-0384-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The sense of hearing is essential for permitting human beings to interact with the environment, and its dysfunctions can strongly impact on the quality of life. In this context, the cochlea plays a fundamental role in the transformation of the airborne sound waves into electrical signals, which can be processed by the brain. However, several diseases and external stimuli (e.g., noise, drugs) can damage the sensorineural structures of cochlea, inducing progressive hearing dysfunctions until deafness. In clinical practice, the current pharmacological approaches to treat cochlear diseases are based on the almost exclusive use of systemic steroids. In the last decades, the efficacy of novel therapeutic molecules has been proven, taking advantage from a better comprehension of the pathological mechanisms underlying many cochlear diseases. In addition, the feasibility of intratympanic administration of drugs also permitted to overcome the pharmacokinetic limitations of the systemic drug administration, opening new frontiers in drug delivery to cochlea. Several innovative drug delivery systems, such as in situ gelling systems or nanocarriers, were designed, and their efficacy has been proven in vitro and in vivo in cochlear models. The current review aims to describe the art of state in the cochlear drug delivery, highlighting lights and shadows and discussing the most critical aspects still pending in the field.
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Affiliation(s)
- Umberto M Musazzi
- Department of Pharmaceutical Sciences, Università degli Studi di Milano, Via G. Colombo, 71, 20133, Milan, Italy.
| | - Silvia Franzé
- Department of Pharmaceutical Sciences, Università degli Studi di Milano, Via G. Colombo, 71, 20133, Milan, Italy
| | - Francesco Cilurzo
- Department of Pharmaceutical Sciences, Università degli Studi di Milano, Via G. Colombo, 71, 20133, Milan, Italy
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Glueckert R, Johnson Chacko L, Rask-Andersen H, Liu W, Handschuh S, Schrott-Fischer A. Anatomical basis of drug delivery to the inner ear. Hear Res 2018; 368:10-27. [PMID: 30442227 DOI: 10.1016/j.heares.2018.06.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/16/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Abstract
The isolated anatomical position and blood-labyrinth barrier hampers systemic drug delivery to the mammalian inner ear. Intratympanic placement of drugs and permeation via the round- and oval window are established methods for local pharmaceutical treatment. Mechanisms of drug uptake and pathways for distribution within the inner ear are hard to predict. The complex microanatomy with fluid-filled spaces separated by tight- and leaky barriers compose various compartments that connect via active and passive transport mechanisms. Here we provide a review on the inner ear architecture at light- and electron microscopy level, relevant for drug delivery. Focus is laid on the human inner ear architecture. Some new data add information on the human inner ear fluid spaces generated with high resolution microcomputed tomography at 15 μm resolution. Perilymphatic spaces are connected with the central modiolus by active transport mechanisms of mesothelial cells that provide access to spiral ganglion neurons. Reports on leaky barriers between scala tympani and the so-called cortilymph compartment likely open the best path for hair cell targeting. The complex barrier system of tight junction proteins such as occludins, claudins and tricellulin isolates the endolymphatic space for most drugs. Comparison of relevant differences of barriers, target cells and cell types involved in drug spread between main animal models and humans shall provide some translational aspects for inner ear drug applications.
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Affiliation(s)
- R Glueckert
- Department of Otolaryngology, Medical University of Innsbruck, Innsbruck, Austria; University Clinics Innsbruck, Tirol Kliniken, University Clinic for Ear, Nose and Throat Medicine Innsbruck, Austria.
| | - L Johnson Chacko
- Department of Otolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - H Rask-Andersen
- Department of Surgical Sciences, Section of Otolaryngology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden
| | - W Liu
- Department of Surgical Sciences, Section of Otolaryngology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden
| | - S Handschuh
- VetImaging, VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - A Schrott-Fischer
- Department of Otolaryngology, Medical University of Innsbruck, Innsbruck, Austria
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Aksit A, Arteaga DN, Arriaga M, Wang X, Watanabe H, Kasza KE, Lalwani AK, Kysar JW. In-vitro perforation of the round window membrane via direct 3-D printed microneedles. Biomed Microdevices 2018; 20:47. [PMID: 29884927 PMCID: PMC6091873 DOI: 10.1007/s10544-018-0287-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The cochlea, or inner ear, is a space fully enclosed within the temporal bone of the skull, except for two membrane-covered portals connecting it to the middle ear space. One of these portals is the round window, which is covered by the Round Window Membrane (RWM). A longstanding clinical goal is to reliably and precisely deliver therapeutics into the cochlea to treat a plethora of auditory and vestibular disorders. Standard of care for several difficult-to-treat diseases calls for injection of a therapeutic substance through the tympanic membrane into the middle ear space, after which a portion of the substance diffuses across the RWM into the cochlea. The efficacy of this technique is limited by an inconsistent rate of molecular transport across the RWM. A solution to this problem involves the introduction of one or more microscopic perforations through the RWM to enhance the rate and reliability of diffusive transport. This paper reports the use of direct 3D printing via Two-Photon Polymerization (2PP) lithography to fabricate ultra-sharp polymer microneedles specifically designed to perforate the RWM. The microneedle has tip radius of 500 nm and shank radius of 50 μ m, and perforates the guinea pig RWM with a mean force of 1.19 mN. The resulting perforations performed in vitro are lens-shaped with major axis equal to the microneedle shank diameter and minor axis about 25% of the major axis, with mean area 1670 μ m2. The major axis is aligned with the direction of the connective fibers within the RWM. The fibers were separated along their axes without ripping or tearing of the RWM suggesting the main failure mechanism to be fiber-to-fiber decohesion. The small perforation area along with fiber-to-fiber decohesion are promising indicators that the perforations would heal readily following in vivo experiments. These results establish a foundation for the use of Two-Photon Polymerization lithography as a means to fabricate microneedles to perforate the RWM and other similar membranes.
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Affiliation(s)
- Aykut Aksit
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Daniel N Arteaga
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA
| | - Miguel Arriaga
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Xun Wang
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Hirobumi Watanabe
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Karen E Kasza
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Anil K Lalwani
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA
| | - Jeffrey W Kysar
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA.
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA.
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Long-term evaluation of the effect of middle ear effusion on the vestibular system in children. Int J Pediatr Otorhinolaryngol 2018; 109:13-16. [PMID: 29728166 DOI: 10.1016/j.ijporl.2018.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Otitis media with effusion (OME) is one of the most common clinical conditions in childhood. Fluid accumulation in the middle ear may impact inner ear. OBJECTIVES The purpose of this random sample cohort study was to investigate whether the past history of middle ear effusion has a long-term negative impact on the vestibular system in children. MATERIAL AND METHODS The study was carried out on 22 children aged 7-15 years who had undergone drainage of the middle ear 5 years before evaluation. The control group consisted of 29 healthy children aged 4-17 years. Vestibular function was examined using sway posturography and electronystagmography (ENG). RESULTS The stabilogram parameters of the study group and the control group were compared. The field of developed area (FDA) and the average body sway velocity (ASV) were analyzed. Elevated stabilogram parameters of FDA and ASV, both with eyes open and eyes closed, were found in the study group. Statistically significant values (p < 0.05) were present for ASV with eyes open and with eyes closed. The ENG recordings were analyzed in both groups. In the study group, spontaneous nystagmus was observed in 40.9% of the children and positional nystagmus occurred in 63.6% of the children. According to tests, eye tracking test was impaired in 27.3% of cases. Rotatory chair testing revealed asymmetry in 18.2% of the children. CONCLUSION The presence of effusion in the middle ear in the past has a negative impact on the vestibular part of the inner ear. Clinicians should be aware of the possible negative impact of middle ear effusion on the vestibular function in children with a history of otitis media with effusion. With seeimingly asymptomatic children clinicians should inquire parents about symptoms of dysequlibrium and imbalance.
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Tan YL, Ho HK. Navigating albumin-based nanoparticles through various drug delivery routes. Drug Discov Today 2018; 23:1108-1114. [PMID: 29408437 DOI: 10.1016/j.drudis.2018.01.051] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/19/2018] [Accepted: 01/31/2018] [Indexed: 10/18/2022]
Abstract
As a natural polymer, albumin is well-received for being nontoxic, nonimmunogenic, biodegradable and biocompatible. Together with its targeting potential on specific cells, albumin-based nanoparticles appear as an effective carrier for various therapeutics. In recent years, there has been an increasing number of studies investigating the use of albumin-based nanoparticles across different administration routes. Although each route and target tissue presents a distinct anatomical and physiological profile that demands specific consideration, pharmaceuticals could still be delivered effectively via albumin-based nanoparticles. Therefore, this review discusses the features that warrant such applications across various delivery routes and explores their possibilities in other administration routes. The challenges associated with its use will also be elaborated to provide a holistic consideration to realise their clinical potentials.
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Affiliation(s)
- Yeong L Tan
- Department of Pharmacy, Faulty of Science, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore
| | - Han K Ho
- Department of Pharmacy, Faulty of Science, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore.
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Nanomedicine for Inner Ear Diseases: A Review of Recent In Vivo Studies. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3098230. [PMID: 29130038 PMCID: PMC5654248 DOI: 10.1155/2017/3098230] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/30/2017] [Indexed: 02/04/2023]
Abstract
Nanoparticles are promising therapeutic options for inner ear disease. In this report, we review in vivo animal studies in the otologic field using nanoparticles over the past 5 years. Many studies have used nanoparticles to deliver drugs, genes, and growth factors, and functional and morphological changes have been observed. The constituents of nanoparticles are also diversifying into various biocompatible materials, including poly(lactic-co-glycolic acid) (PLGA). The safe and effective delivery of drugs or genes in the inner ear will be a breakthrough for the treatment of inner ear diseases, including age-related hearing loss.
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Monsanto RDC, Schachern P, Paparella MM, Cureoglu S, Penido NDO. Progression of changes in the sensorial elements of the cochlear and peripheral vestibular systems: The otitis media continuum. Hear Res 2017; 351:2-10. [PMID: 28578877 DOI: 10.1016/j.heares.2017.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 12/16/2022]
Abstract
Our study aimed to evaluate pathologic changes in the cochlear (inner and outer hair cells and stria vascularis) and vestibular (vestibular hair cells, dark, and transitional cells) sensorial elements in temporal bones from donors who had otitis media. We studied 40 temporal bones from such donors, which were categorized in serous otitis media (SOM), serous-purulent otitis media (SPOM), mucoid/mucoid-purulent otitis media (MOM/MPOM), and chronic otitis media (COM); control group comprised 10 nondiseased temporal bones. We found significant loss of inner and outer cochlear hair cells in the basal turn of the SPOM, MOM/MPOM and COM groups; significant loss of vestibular hair cells was observed in the MOM/MPOM and COM groups. All otitis media groups had smaller mean area of the stria vascularis in the basal turn of the cochlea when compared to controls. In conclusion, our study demonstrated more severe pathologic changes in the later stages of the continuum of otitis media (MOM/MPOM and COM). Those changes seem to progress from the basal turn of the cochlea (stria vascularis, then inner and outer hair cells) to the middle turn of the cochlea and to the saccule and utricle in the MOM/MPOM and COM stages.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA; Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Rua dos Otonis, 700 - Piso Superior - Vila Clementino, São Paulo, SP 04025 002, Brazil
| | - Patricia Schachern
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA
| | - Michael M Paparella
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA.
| | - Norma de Oliveira Penido
- Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Rua dos Otonis, 700 - Piso Superior - Vila Clementino, São Paulo, SP 04025 002, Brazil
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32
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Shim HS, Kim JS, Kim MG. Comparative Analysis of the Combined Therapeutic Effects of Lipoprostaglandin E 1 on Sudden Idiopathic Sensorineural Hearing Loss. J Audiol Otol 2017; 21:33-38. [PMID: 28417106 PMCID: PMC5392007 DOI: 10.7874/jao.2017.21.1.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/03/2016] [Accepted: 07/04/2016] [Indexed: 12/03/2022] Open
Abstract
Background and Objectives Viral and vascular disorders are considered to be a major cause of idiopathic sudden sensorineural hearing loss (ISSNHL). Lipoprostaglandin E1 (lipo-PGE1) has vasodilating activity and has been used to treat ISSNHL. The purpose of this study was to determine the specific therapeutic effects of lipo-PGE1 and compare them to other treatment modalities for ISSNHL. Subjects and Methods The study group had 1,052 patients diagnosed with ISSNHL. All were treated with steroid, carbogen inhalation, stellate ganglion block (SGB), or PGE1. The CP group (steroid, carbogen inhalation, and PGE1 injection; 288 patients) was treated with lipo-PGE1 and carbogen inhalation, the CS group (steroid, carbogen inhalation, and stellate ganglion block; 232 patients) with steroid, carbogen inhalation, and SGB, the C group (steroid and carbogen inhalation; 284 patients) with steroid and carbogen, and the control group (steroid only; 248 patients) with steroid only. Patients in the groups receiving lipo-PGE1 received a continuous infusion of 10 µL lipo-PGE1. Results The overall recovery rate after treatment was 52.2%, and recovery rates by group were 67.7% in the CP group, 54.3% in the CS group, 52.1% in the C group, and 32.2% in the control group. Therefore, the therapeutic results in groups treated with lipo-PGE1 were better than results in other groups. The difference was statistically significant. Conclusions The study results suggested that the CP group received effective treatment modalities for ISSNHL. The combined therapy of lipo-PGE1 with carbogen inhalation in patients with ISSNHL was more beneficial than other treatment modalities.
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Affiliation(s)
- Haeng Seon Shim
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Joon Soo Kim
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Myung Gu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Salt AN, Hartsock JJ, Gill RM, King E, Kraus FB, Plontke SK. Perilymph pharmacokinetics of locally-applied gentamicin in the guinea pig. Hear Res 2016; 342:101-111. [PMID: 27725177 DOI: 10.1016/j.heares.2016.10.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/20/2016] [Accepted: 10/06/2016] [Indexed: 01/08/2023]
Abstract
Intratympanic gentamicin therapy is widely used clinically to suppress the vestibular symptoms of Meniere's disease. Dosing in humans was empirically established and we still know remarkably little about where gentamicin enters the inner ear, where it reaches in the inner ear and what time course it follows after local applications. In this study, gentamicin was applied to the round window niche as a 20 μL bolus of 40 mg/ml solution. Ten 2 μL samples of perilymph were collected sequentially from the lateral semi-circular canal (LSCC) at times from 1 to 4 h after application. Gentamicin concentration was typically highest in samples originating from the vestibule and was lower in samples originating from scala tympani. To interpret these results, perilymph elimination kinetics for gentamicin was quantified by loading the entire perilymph space by injection at the LSCC with a 500 μg/ml gentamicin solution followed by sequential perilymph sampling from the LSCC after different delay times. This allowed concentration decline in perilymph to be followed with time. Gentamicin was retained well in scala vestibuli and the vestibule but declined rapidly at the base of scala tympani, dominated by interactions of perilymph with CSF, as reported for other substances. Quantitative analysis, taking into account perilymph kinetics for gentamicin, showed that more gentamicin entered at the round window membrane (57%) than at the stapes (35%) but the lower concentrations found in scala tympani were due to greater losses there. The gentamicin levels found in perilymph of the vestibule, which are higher than would be expected from round window entry alone, undoubtedly contribute to the vestibulotoxic effects of the drug. Furthermore, calculations of gentamicin distribution following targeted applications to the RW or stapes are more consistent with cochleotoxicity depending on the gentamicin concentration in scala vestibuli rather than that in scala tympani.
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Affiliation(s)
- A N Salt
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis MO, USA.
| | - J J Hartsock
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis MO, USA
| | - R M Gill
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis MO, USA
| | - E King
- Bionics Institute of Australia, Melbourne VIC, Australia
| | - F B Kraus
- Zentrallabor, Department of Laboratory Medicine, University Hospital Halle, Ernst Grube Str. 40, 06120 Halle (Saale), Germany
| | - S K Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Morphological changes in the round window membrane associated with Haemophilus influenzae-induced acute otitis media in the chinchilla. Int J Pediatr Otorhinolaryngol 2016; 88:74-81. [PMID: 27497390 PMCID: PMC4978205 DOI: 10.1016/j.ijporl.2016.06.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The round window membrane (RWM) encloses the round window, the opening into the scala tympani (ST) from the middle ear. During the course of acute otitis media (AOM), structural changes of the RWM can occur that potentially affect sound transmission into and out of the cochlea. The relationship between such structural changes and conductive hearing loss during AOM has remained unclear. The focus of the current study was to compare the thickness distribution across the RWM surface between normal ears and those with AOM in the chinchilla. We assessed the occurrence of AOM-associated histological changes in this membrane compared to uninfected control animals after AOM of two relatively short durations. MATERIAL AND METHODS AOM was induced by transbullar injection of the nontypeable Haemophilus influenzae strain 86-028NP into two groups of adult chinchillas (n = 3 each). Bullae were obtained from the two infected groups, at 4 days or 8 days post challenge. Structures and thickness of these RWMs were compared between the two infected treatment groups and to RWMs from uninfected control animals (n = 3) at seven different RWM locations. RESULTS RWM thickness in infected chinchillas increased significantly at locations along the central line on the 4th day post bacterial challenge compared to values found for uninfected control animals. Lymphocyte infiltration and edema were the primary contributors to these thickness increases. No significant further increases in RWM thickness were observed when RWMs from chinchillas ears infected for 4 and 8 days were compared. Thickness and structural changes at the RWM lateral and medial areas were less visually obvious and not statistically significant among the three treatment groups. These latter RWM regions clearly were less affected during AOM than the central areas. CONCLUSIONS This histological study establishes that H. influenzae-induced AOM causes significant acute changes in chinchilla RWM structure that are characterized by region-specific increases in thickness. Our new morphological findings comparing normal and diseased chinchilla RWMs identify yet another biomechanical mechanism by which nontypeable H. influenzae may contribute to hearing loss in AOM.
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Takeda H, Kurioka T, Kaitsuka T, Tomizawa K, Matsunobu T, Hakim F, Mizutari K, Miwa T, Yamada T, Ise M, Shiotani A, Yumoto E, Minoda R. Protein transduction therapy into cochleae via the round window niche in guinea pigs. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2016; 3:16055. [PMID: 27579336 PMCID: PMC4988354 DOI: 10.1038/mtm.2016.55] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/02/2016] [Accepted: 07/04/2016] [Indexed: 12/18/2022]
Abstract
Cell-penetrating peptides (CPPs) are short sequences of amino acids that facilitate the penetration of conjugated cargoes across mammalian cell membranes, and as such, they may provide a safe and effective method for drug delivery to the inner ear. Simple polyarginine peptides have been shown to induce significantly higher cell penetration rates among CPPs. Herein, we show that a peptide consisting of nine arginines ("9R") effectively delivered enhanced green fluorescent protein (EGFP) into guinea pig cochleae via the round window niche without causing any deterioration in auditory function. A second application, 24 hours after the first, prolonged the presence of EGFP. To assess the feasibility of protein transduction using 9R-CPPs via the round window, we used "X-linked inhibitor of apoptosis protein" (XIAP) bonded to a 9R peptide (XIAP-9R). XIAP-9R treatment prior to acoustic trauma significantly reduced putative hearing loss and the number of apoptotic hair cells loss in the cochleae. Thus, the topical application of molecules fused to 9R-CPPs may be a simple and promising strategy for treating inner ear diseases.
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Affiliation(s)
- Hiroki Takeda
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
| | - Takaomi Kurioka
- Department of Otolaryngology, National Defense Medical College , Tokorozawa, Japan
| | - Taku Kaitsuka
- Department of Molecular Physiology, Kumamoto University , Kumamoto, Japan
| | - Kazuhito Tomizawa
- Department of Molecular Physiology, Kumamoto University , Kumamoto, Japan
| | - Takeshi Matsunobu
- Department of Otolaryngology, National Defense Medical College , Tokorozawa, Japan
| | - Farzana Hakim
- Department of Molecular Physiology, Kumamoto University , Kumamoto, Japan
| | - Kunio Mizutari
- Department of Otolaryngology, National Defense Medical College , Tokorozawa, Japan
| | - Toru Miwa
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
| | - Takao Yamada
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
| | - Momoko Ise
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
| | - Akihiro Shiotani
- Department of Otolaryngology, National Defense Medical College , Tokorozawa, Japan
| | - Eiji Yumoto
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
| | - Ryosei Minoda
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University , Kumamoto, Japan
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da Costa Monsanto R, Erdil M, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S. Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media. Otolaryngol Head Neck Surg 2016; 155:494-500. [PMID: 27165677 DOI: 10.1177/0194599816646359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 04/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. STUDY DESIGN Comparative human temporal bone study. SETTING Otopathology laboratory. SUBJECTS AND METHODS To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. RESULTS In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P < .05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). CONCLUSION The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil
| | - Mehmet Erdil
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology, Head and Neck Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Henrique F Pauna
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Campinas State University, Campinas, Brazil
| | - Geeyoun Kwon
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patricia A Schachern
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vladimir Tsuprun
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael M Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Abstract
HYPOTHESIS Introduction of microperforations in round window membrane (RWM) will allow reliable and predictable intracochlear delivery of pharmaceutical, molecular, or cellular therapeutic agents. BACKGROUND Reliable delivery of medications into the inner ear remains a formidable challenge. The RWM is an attractive target for intracochlear delivery. However, simple diffusion across intact RWM is limited by what material can be delivered, size of material to be delivered, difficulty with precise dosing, timing, and precision of delivery over time. Further, absence of reliable methods for measuring diffusion across RWM in vitro is a significant experimental impediment. METHODS A novel model for measuring diffusion across guinea pig RWM, with and without microperforation, was developed and tested: cochleae, sparing the RWM, were embedded in 3D-printed acrylic holders using hybrid dental composite and light cured to adapt the round window niche to 3 ml Franz diffusion cells. Perforations were created with 12.5-μm-diameter needles and examined with light microscopy. Diffusion of 1 mM Rhodamine B across RWM in static diffusion cells was measured via fluorescence microscopy. RESULTS The diffusion cell apparatus provided reliable and replicable measurements of diffusion across RWM. The permeability of Rhodamine B across intact RWM was 5.1 × 10(9-) m/s. Manual application of microperforation with a 12.5-μm-diameter tip produced an elliptical tear removing 0.22 ± 0.07% of the membrane and was associated with a 35× enhancement in diffusion (P < 0.05). CONCLUSION Diffusion cells can be applied to the study of RWM permeability in vitro. Microperforation in RWM is an effective means of increasing diffusion across the RWM.
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Kurioka T, Mizutari K, Niwa K, Fukumori T, Inoue M, Hasegawa M, Shiotani A. Hyaluronic acid pretreatment for Sendai virus-mediated cochlear gene transfer. Gene Ther 2015; 23:187-95. [PMID: 26361273 DOI: 10.1038/gt.2015.94] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/19/2015] [Accepted: 09/04/2015] [Indexed: 12/14/2022]
Abstract
Gene therapy with viral vectors is one of the most promising strategies for sensorineural hearing loss. However, safe and effective administration of the viral vector into cochlear tissue is difficult because of the anatomical isolation of the cochlea. We investigated the efficiency and safety of round window membrane (RWM) application of Sendai virus, one of the most promising non-genotoxic vectors, after pretreatment with hyaluronic acid (HA) on the RWM to promote efficient viral translocation into the cochlea. Sendai virus expressing the green fluorescent protein reporter gene was detected throughout cochlear tissues following application combined with HA pretreatment. Quantitative analysis revealed that maximum expression was reached 3 days after treatment. The efficiency of transgene expression was several 100-fold greater with HA pretreatment than that without. Furthermore, unlike the conventional intracochlear delivery methods, this approach did not cause hearing loss. These findings reveal the potential utility of gene therapy with Sendai virus and HA for treatment of sensorineural hearing loss.
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Affiliation(s)
- T Kurioka
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - K Mizutari
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - K Niwa
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - T Fukumori
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - M Inoue
- DNAVEC Corporation, Ibaraki, Japan
| | | | - A Shiotani
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan
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Recent advances in local drug delivery to the inner ear. Int J Pharm 2015; 494:83-101. [PMID: 26260230 DOI: 10.1016/j.ijpharm.2015.08.015] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 07/31/2015] [Accepted: 08/05/2015] [Indexed: 12/14/2022]
Abstract
Inner ear diseases are not adequately treated by systemic drug administration mainly because of the blood-perilymph barrier that reduces exchanges between plasma and inner ear fluids. Local drug delivery methods including intratympanic and intracochlear administrations are currently developed to treat inner ear disorders more efficiently. Intratympanic administration is minimally invasive but relies on diffusion through middle ear barriers for drug entry into the cochlea, whereas intracochlear administration offers direct access to the colchlea but is rather invasive. A wide range of drug delivery systems or devices were evaluated in research and clinic over the last decade for inner ear applications. In this review, different strategies including medical devices, hydrogels and nanoparticulate systems for intratympanic administration, and cochlear implant coating or advanced medical devices for intracoclear administration were explored with special attention to in vivo studies. This review highlights the promising systems for future clinical applications as well as the current hurdles that remain to be overcome for efficient inner ear therapy.
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Safety of transtympanic application of 4 % manuka honey in a chinchilla animal model. Eur Arch Otorhinolaryngol 2013; 272:537-42. [DOI: 10.1007/s00405-013-2842-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/24/2013] [Indexed: 01/22/2023]
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Gentamicin administration on the stapes footplate causes greater hearing loss and vestibulotoxicity than round window administration in guinea pigs. Hear Res 2013; 304:159-66. [PMID: 23899413 DOI: 10.1016/j.heares.2013.07.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 11/21/2022]
Abstract
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.
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Zhang X, Chen G, Wen L, Yang F, Shao AL, Li X, Long W, Mu L. Novel multiple agents loaded PLGA nanoparticles for brain delivery via inner ear administration: in vitro and in vivo evaluation. Eur J Pharm Sci 2013; 48:595-603. [PMID: 23354153 DOI: 10.1016/j.ejps.2013.01.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 12/21/2022]
Abstract
The aim of this study was to develop novel multiple agents loaded poly (D,L-lactide-co-glycolide acid) (PLGA) nanoparticles (NPs) and evaluate their potential for brain delivery via inner ear administration. PLGA NPs loaded with salvianolic acid B (Sal B), tanshinone IIA (TS IIA) and panax notoginsenoside (PNS) were prepared by double emulsion/solvent evaporation method. It was observed that optimized NPs displayed satisfactory encapsulation efficiency and desired sustained-release characteristics. NPs following intratympanic administration (IT) in guinea pigs greatly improved drug distribution within the inner ear, cerebrospinal fluid (CSF) and brain tissues compared with intravenous administration (IV). Pharmacodynamic studies demonstrated that NPs following IT markedly inhibited oxidizing reactions and protected the brain from cerebral ischemia reperfusion (I/R) injury by upregulating superoxide dismutase (SOD) activity both in serum and brain tissues, simultaneously significantly reducing the levels of malondialdehyde (MDA) and nitric oxide synthase (NOS). Moreover intratympanic delivery did not cause injury of cochlear function by preliminary study on the toxicity. These findings suggested that PLGA NPs-based delivery system via inner ear administration was a promising candidate to brain delivery for the treatment of brain diseases.
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Affiliation(s)
- Xiao Zhang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China
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Perilymph pharmacokinetics of markers and dexamethasone applied and sampled at the lateral semi-circular canal. J Assoc Res Otolaryngol 2012; 13:771-83. [PMID: 22968908 DOI: 10.1007/s10162-012-0347-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/13/2012] [Indexed: 10/27/2022] Open
Abstract
Perilymph pharmacokinetics was investigated by a novel approach, in which solutions containing drug or marker were injected from a pipette sealed into the perilymphatic space of the lateral semi-circular canal (LSCC). The cochlear aqueduct provides the outlet for fluid flow so this procedure allows almost the entire perilymph to be exchanged. After wait times of up to 4 h the injection pipette was removed and multiple, sequential samples of perilymph were collected from the LSCC. Fluid efflux at this site results from cerebrospinal fluid (CSF) entry into the basal turn of scala tympani (ST) so the samples allow drug levels from different locations in the ear to be defined. This method allows the rate of elimination of substances from the inner ear to be determined more reliably than with other delivery methods in which drug may only be applied to part of the ear. Results were compared for the markers trimethylphenylammonium (TMPA) and fluorescein and for the drug dexamethasone (Dex). For each substance, the concentration in fluid samples showed a progressive decrease as the delay time between injection and sampling was increased. This is consistent with the elimination of substance from the ear with time. The decline with time was slowest for fluorescein, was fastest for Dex, with TMPA at an intermediate rate. Simulations of the experiments showed that elimination occurred more rapidly from scala tympani (ST) than from scala vestibuli (SV). Calculated elimination half-times from ST averaged 54.1, 24.5 and 22.5 min for fluorescein, TMPA and Dex respectively and from SV 1730, 229 and 111 min respectively. The elimination of Dex from ST occurred considerably faster than previously appreciated. These pharmacokinetic parameters provide an important foundation for understanding of drug treatments of the inner ear.
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Intratympanic dexamethasone perfusion versus injection for treatment of refractory sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2012; 270:861-7. [DOI: 10.1007/s00405-012-2061-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 05/15/2012] [Indexed: 11/26/2022]
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Addams-Williams J, Munaweera L, Coleman B, Shepherd R, Backhouse S. Cochlear implant electrode insertion: in defence of cochleostomy and factors against the round window membrane approach. Cochlear Implants Int 2012; 12 Suppl 2:S36-9. [PMID: 21917217 DOI: 10.1179/146701011x13074645127478] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The round window membrane (RWM) is an increasingly popular route for electrode insertion in cochlear implantation especially for hearing preservation. Limitations to this route include anatomical, physiological, and surgical aspects. The established soft-tissue cochleostomy route for electrode insertion is thought to place the basilar membrane and spiral ligament at risk. However, the mammalian model response to soft-tissue cochleostomy has not yet been quantified. METHODS Firstly, an on-line literature search was conducted to gather evidence of the anatomical and physiological functions of the RWM and adjacent structures. Secondly, experimental guinea pigs underwent left soft-surgery cochlestomy. Four weeks post-operatively they were euthanased and the cochlea's harvested for histology. Surgical damage to the cochlea and auditory neurons was assessed. RESULTS The literature review with regard to the RWM anatomy revealed evidence for difficulty in approach/visualization, possible absence, and impedance of electrode insertion by the hook region. It also has a number of higher functions including immune defence and absorption/secretion of molecules. Experimental cochlea's 4 weeks post-soft-tissue cochleostomy showed only mild and localized inflammatory response adjacent to the scala tympani cochleostomy site. There was no spiral neuronal ganglion loss. CONCLUSIONS The RWM route may be compromised or absent. Electrode insertion via the RWM could interfere with its higher functions. Mammalian soft-tissue cochleostomy has been shown to elicit a limited tissue response and does not reduce the number of cochlear spiral ganglion neurones. It should therefore remain within the hearing implant surgeon's armamentarium.
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Affiliation(s)
- J Addams-Williams
- researchENT*Wales & South Wales Cochlear Implant Programme Bridgend, Princess of Wales Hospital, Bridgend, UK.
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Peleva E, Mourad S, Citra D, Daniel SJ. Assessment of the ototoxicity of almond oil in a chinchilla animal model. Laryngoscope 2011; 121:2661-4. [PMID: 22109768 DOI: 10.1002/lary.22385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Almond oil is frequently prescribed as a ceruminolytic, to soften ear wax or relieve ventilation tube occlusion. Ceruminolytics could lead to ototoxicity in the presence of a tympanic perforation. Reports on the safety of almond oil as a ceruminolytic is limited. The present study aimed to assess the effect of ototopic almond oil on hearing. STUDY DESIGN Prospective, randomized, controlled trial in a chinchilla animal model. METHODS Bilateral myringotomies were performed in 19 female chinchilla. One randomly selected ear received almond oil, whereas the other ear received saline applied transtympanically. Auditory Brainstem Response (ABR) testing was performed prior to application and at 14 and 30 days following application. Postmortem Scanning Electron Microscopy (SEM) images were obtained to assess cochlear hair cell status. RESULTS At 30 days following application, there was no significant change in ABR thresholds at 16, 20, or 25 kHz. No cochlear hair cell loss was observed with SEM. CONCLUSIONS In the chinchilla, when a tympanic perforation is present, almond oil does not seem to cause ototoxicity. Further studies are needed to better assess the effect of almond oil on hearing in humans.
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Affiliation(s)
- Emilia Peleva
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
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Rutt AL, Hawkshaw MJ, Sataloff RT. Incidence of tympanic membrane perforation after intratympanic steroid treatment through myringotomy tubes. EAR, NOSE & THROAT JOURNAL 2011; 90:E21. [PMID: 21500156 DOI: 10.1177/014556131109000416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intratympanic (IT) steroids are often used to treat inner ear disorders such as sudden idiopathic sensorineural hearing loss, autoimmune inner ear disease, and Ménière disease. Administration of corticosteroids via IT injection, via application with a pledget to the round window, or via catheter has been used for this purpose. The frequency of adverse events related to the IT injection of steroids is low, with pain, short-lasting vertigo, otitis media, and tympanic perforations being the most common complications. However, the safety of IT steroid therapy has not yet been established in a randomized clinical trial. In this article, we discuss a group of 11 patients with sensorineural hearing loss who underwent myringotomy and tube placement for home-based dexamethasone instillation and subsequently developed the complication of tympanic membrane perforation. It appears that there is a significantly increased incidence of tympanic membrane perforations in this population.
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Affiliation(s)
- Amy L Rutt
- Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center/Michigan State University, Detroit, MI, USA
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Daniel SJ, Sahmkow S, Akinpelu OV. Is ototopical nystatin ototoxic? A chinchilla model. Otolaryngol Head Neck Surg 2011; 145:1022-4. [PMID: 21860059 DOI: 10.1177/0194599811418407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this prospective controlled animal study, the authors investigated the potential ototoxic effects of ototopical application of nystatin through a tympanostomy tube, using their established chinchilla animal model. Each of the 10 animals used had ventilation tubes inserted in both ears; 1 ear was randomly assigned to receive nystatin suspension, whereas the other ear did not receive any medication, serving as control. Distortion product otoacoustic emissions (DPOAEs) were measured in each animal before application of nystatin and at 45 and 60 days after application. Each cochlea was also processed for scanning electron microscopy (SEM) at the end of the experiment. There was no significant difference in the DPOAEs and SEM appearances of the experimental and control ears over the 60-day period of the experiment. The authors conclude that transtympanic nystatin did not produce any long-term ototoxic effects detectable by DPOAEs or SEM.
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Affiliation(s)
- Sam J Daniel
- Department of Pediatric Otolaryngology-Head and Neck Surgery, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.
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Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice. Eur Arch Otorhinolaryngol 2011; 269:363-80. [DOI: 10.1007/s00405-011-1738-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
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Zou J, Sood R, Ranjan S, Poe D, Ramadan UA, Kinnunen PK, Pyykkö I. Manufacturing and in vivo inner ear visualization of MRI traceable liposome nanoparticles encapsulating gadolinium. J Nanobiotechnology 2010; 8:32. [PMID: 21167059 PMCID: PMC3016339 DOI: 10.1186/1477-3155-8-32] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 12/18/2010] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Treatment of inner ear diseases remains a problem because of limited passage through the blood-inner ear barriers and lack of control with the delivery of treatment agents by intravenous or oral administration. As a minimally-invasive approach, intratympanic delivery of multifunctional nanoparticles (MFNPs) carrying genes or drugs to the inner ear is a future therapy for treating inner ear diseases, including sensorineural hearing loss (SNHL) and Meniere's disease. In an attempt to track the dynamics and distribution of nanoparticles in vivo, here we describe manufacturing MRI traceable liposome nanoparticles by encapsulating gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) (abbreviated as LPS+Gd-DOTA) and their distribution in the inner ear after either intratympanic or intracochlear administration. RESULTS Measurements of relaxivities (r1 and r2) showed that LPS+Gd-DOTA had efficient visible signal characteristics for MRI. In vivo studies demonstrated that LPS+Gd-DOTA with 130 nm size were efficiently taken up by the inner ear at 3 h after transtympanic injection and disappeared after 24 h. With intracochlear injection, LPS+Gd-DOTA were visualized to distribute throughout the inner ear, including the cochlea and vestibule with fast dynamics depending on the status of the perilymph circulation. CONCLUSION Novel LPS+Gd-DOTA were visible by MRI in the inner ear in vivo demonstrating transport from the middle ear to the inner ear and with dynamics that correlated to the status of the perilymph circulation.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology, University of Tampere, Medical School, Tampere, Finland.
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