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The WFS1 gene, responsible for low frequency sensorineural hearing loss and Wolfram syndrome, is expressed in a variety of inner ear cells.

Heterozygous mutations in the WFS1 gene are responsible for autosomal dominant low frequency hearing loss at the DFNA6/14 locus, while homozygous or compound heterozygous mutations underlie Wolfram syndrome. In this study we examine expression of wolframin, the WFS1-gene product, in mouse inner ear at different developmental stages using immunohistochemistry and in situ hybridization. Both techniques showed compatible results and indicated a clear expression in different cell types of the inner ear. Although there were observable developmental differences, no differences in staining pattern or gradients of expression were observed between the basal and apical parts of the cochlea. Double immunostaining with an endoplasmic reticulum marker confirmed that wolframin localizes to this organelle. A remarkable similarity was observed between cells expressing wolframin and the presence of canalicular reticulum, a specialized form of endoplasmic reticulum. The canalicular reticulum is believed to be involved in the transcellular movements of ions, an important process in the physiology of the inner ear. Although there is nothing currently known about the function of wolframin, our results suggest that it may play a role in inner ear ion homeostasis as maintained by the canalicular reticulum.

Animals↗

Steady-state free precession imaging of the inner ear.

The authors describe a steady-state free precession technique for imaging the inner ear. Although the signal-to-noise ratio is not as great as with other three-dimensional MR techniques, the inherent high contrast of inner ear structures makes this a valuable technique for patients with sensorineural hearing loss and for those who refuse paramagnetic contrast material.

Contrast Media↗

Congenital malformation of the inner ear and pediatric cochlear implantation.

OBJECTIVES: To study the surgical aspects and performance outcome of cochlear implantation in children with malformed inner ears. STUDY DESIGN: Clinical and audiometric evaluation in 13 patients. METHODS: Patient data concerning surgery, postoperative follow-up, and pre- and postimplantation audiometry were obtained from the cochlear implant center's database and evaluated. A review of the literature has been included. SETTING: Tertiary referral center. PATIENTS: The patients had a variety of inner ear malformations and profound hearing loss. One patient with recurrent meningitis had a severe cochlear malformation (common cavity). RESULTS: Major complications did not occur. In one patient with an abnormal position of the cochlea and concurring middle ear disease, it was difficult to find the scala tympani during surgery. A cerebrospinal fluid gusher was encountered in two patients and an aberrant facial nerve in another, which did not lead to any complications. The patients with mild cochlear malformation such as an incomplete partition demonstrated a good performance in speech perception tests. Even the child with the common cavity deformity had some open-set speech perception 1 year after implantation. CONCLUSIONS: Viewing the patients from this study and patients from a review of the literature concerning cochlear implantation in children with malformed inner ears including severe cochlear malformations, the occurrence of an aberrant facial nerve was 17%, which increases to 27% if one reviews the surgical findings in children with severe malformed cochleae such as a common cavity or a severe cochlear hypoplasia. In the latter patients, results in speech perception vary. Although the result of cochlear implantation may be promising, as in our patient with a common cavity, during preoperative counseling the child's parents must be informed that the result is uncertain.

Audiometry↗

NOX3, a superoxide-generating NADPH oxidase of the inner ear.

Reactive oxygen species (ROS) play a major role in drug-, noise-, and age-dependent hearing loss, but the source of ROS in the inner ear remains largely unknown. Herein, we demonstrate that NADPH oxidase (NOX) 3, a member of the NOX/dual domain oxidase family of NADPH oxidases, is highly expressed in specific portions of the inner ear. As assessed by real-time PCR, NOX3 mRNA expression in the inner ear is at least 50-fold higher than in any other tissues where its expression has been observed (e.g. fetal kidney, brain, skull). Microdissection and in situ hybridization studies demonstrated that NOX3 is localized to the vestibular and cochlear sensory epithelia and to the spiral ganglions. Transfection of human embryonic kidney 293 cells with NOX3 revealed that it generates low levels of ROS on its own but produces high levels of ROS upon co-expression with cytoplasmic NOX subunits. NOX3-dependent superoxide production required a stimulus in the absence of subunits and upon co-expression with phagocyte NADPH oxidase subunits p47(phox) and p67(phox), but it was stimulus-independent upon co-expression with colon NADPH oxidase subunits NOX organizer 1 and NOX activator 1. Pre-incubation of NOX3-transfected human embryonic kidney 293 cells with the ototoxic drug cisplatin markedly enhanced superoxide production, in both the presence and the absence of subunits. Our data suggest that NOX3 is a relevant source of ROS generation in the cochlear and vestibular systems and that NOX3-dependent ROS generation might contribute to hearing loss and balance problems in response to ototoxic drugs.

Adaptor Proteins, Signal Transducing↗

Inner ear pathology following injury to the eighth cranial nerve and the labyrinthine artery.

Inner ear pathology following surgical sectioning of the eighth cranial nerve and labyrinthine artery in humans is compared histologically to the pathology observed following severance of the eighth cranial nerve. The case in which both the eighth cranial nerve and the labyrinthine artery were surgically severed revealed severe pathologic changes in the cochlea, including complete loss of the organ of Corti and moderate pathologic changes in the fairly well-preserved vestibular end-organs. Interestingly, the endolymphatic sac appeared to be normal. However, the second case in which the eighth cranial nerve was sectioned but the labyrinthine artery was preserved revealed the organ of Corti and vestibular end-organs to be well preserved and normal. These findings suggest that the blood supply from the labyrinthine artery plays a major role in maintaining most of the structures in the inner ear except for the endolymphatic sac, and that the vestibular end-organs are more resistant than the organ of Corti to the effects of damage of the labyrinthine artery.

Arteries↗

Evaluation of the middle and inner ear structures: comparison of hybrid rendering, virtual endoscopy and axial 2D source images.

Recent developments in 3D reconstructions can enhance the quality and diagnostic value of axial 2D image data sets with direct benefits for clinical practice. To show the possible advantages of a hybrid rendering method [color-coded 3D shaded-surface display (SSD)- and volume rendering method] with the possibility of virtual endoscopy we have specifically highlighted the use in relation to the middle and inner ear structures. We examined 12 patients with both normal findings and postoperative changes, using image data sets from high-resolution spiral computed tomography (HRSCT). The middle and inner ear was segmented using an interactive threshold interval density volume-growing method and visualized with a color-coded SSD rendering method. The temporal bone was visualized using a transparent volume rendering method. The 3D- and virtual reconstructions were compared with the axial 2D source images. The evaluated middle and inner ear structures could be seen in their complete form and correct topographical relationship, and the 3D- and virtual reconstructions indicated an improved representation and spatial orientation of these structures. A hybrid and virtual endoscopic method could add information and improve the value of imaging in the diagnosis and management of patients with middle or inner ear diseases making the understanding and interpretation of axial 2D CT image data sets easier. The introduction of an improved rendering algorithm aids radiological diagnostics, medical education, surgical planning, surgical training, and postoperative assessment.

Adult↗

Immunohistochemical identification of proteoglycans in gelatinous membranes of cat and gerbil inner ear.

Proteoglycans have been identified in gelatinous membranes of adult cat and gerbil inner ears using highly specific histochemical techniques. The tectorial and otoconial membranes and cupula of both species stained strongly with high iron diamine which is specific for sulfate esters and with monoclonal antibody against keratan sulfate proteoglycan (KSPG). The cat tectorial membrane also showed strong immunoreactivity with monoclonal antibody against chondroitin sulfate proteoglycan (CSPG) but the gerbil tectorial membrane reacted only weakly with this antibody. Otoconial membranes and the cupula of both species showed little if any immunostaining with antibodies against CSPG. Supporting cells in the vestibular neurosensory epithelium and planum semilunatum cells in the ampullae of the cat stained strongly with anti-KSPG, demonstrating the origin of KSPG in the cat. These cell types failed to stain in the gerbil, however, suggesting a different mechanism of secretion or a slower rate of turnover of membraneous KSPG in the gerbil. Interdental cells of both species failed to react with either antibody, leaving the origin of tectorial membrane proteoglycans in question. The approach used here provides a highly sensitive and reliable means of assessing the contribution of specific proteoglycans to inner ear structure and function.

Animals↗

Inner ear damage induced by Mycobacterium fortuitum.

We used electron microscopy to investigate Mycobacterium fortuitum-induced changes in the inner ears of mice. We found that the inner and outer hair cells had degenerated and disappeared in the organ of Corti. Changes in the lower turn of the cochlea were more severe than those of the upper turn while the changes of the outer hair cells were more severe than those of the inner hair cells. Disappearance, fusion and ballooning of the sensory hairs were observed in the vestibular organs. The bacterial extract also induced inner ear damage which was similar to that caused by live M. fortuitum.

Animals↗

[Viral origin of postnatally acquired inner ear damage].

Experimental and clinical data exist which point at a possible role of herpes virus infections in postnatally acquired inner ear disturbances. The presence of viral DNA in the inner ear and vestibular organ of experimentally infected mice and pigs suggests that not only primary infections but also the reactivation of latent herpes viruses can cause severe inner ear damage. Serological examinations are presented and therapeutic considerations discussed.

Acquired Immunodeficiency Syndrome↗

Expression pattern of adenylyl cyclase isoforms in the inner ear of the rat by RT-PCR and immunochemical localization of calcineurin in the organ of Corti.

Most studies concerning adenylyl cyclases in the inner ear were carried out before the advent of molecular biology. In a PCR approach using cDNAs of six inner ear tissues (stria vascularis, endolymphatic sac, organ of Corti, vestibulum, cochlear and vestibular nerve) we found tissue specific expression of adenylyl cyclase isoforms. Adenylyl cyclases types 2 and 4 are predominant in the fluid controlling tissues, i.e. in the stria vascularis and endolymphatic sac. In the organ of Corti and vestibulum the Ca2+-modulated isoforms types 1, 6 and 9 were expressed. The regulation of adenylyl cyclase 9, which is the major isoform expressed in the organ of Corti, proceeds via the Ca2+-activated protein phosphatase 2B (calcineurin, PPP3). PCR with specific primers for calcineurin demonstrated its abundant expression in the organ of Corti. Using a monoclonal antibody we localized calcineurin immunochemically to the cochlear nerve, the nerve fibers and the inner hair cells. In the cochlear and vestibular nerves a characteristic neuronal expression pattern of adenylyl cyclase isoforms was observed, i.e. adenylyl cyclases types 2, 3 and 8. The functional consequences of the adenylyl cyclase expression pattern in the inner ear are discussed in conjunction with its unique sensory performance.

Adenylyl Cyclases↗

Time course of inner ear degeneration and deafness in mice lacking the Kir4.1 potassium channel subunit.

The Kir4.1 gene (KCNJ10) encodes an inwardly rectifying K(+) channel subunit abundantly expressed in the CNS. Its expression in the mammalian inner ear has been suggested but its function in vivo in the inner ear is unknown. Because diverse human hereditary deafness syndromes are associated with mutations in K(+) channels, we examined auditory function and inner ear structure in mice with a genetically inactivated Kir4.1 K(+) channel subunit. Startle response experiments suggest that Kir4.1-/- mice are profoundly deaf, whereas Kir4.1+/- mice react like wild-type mice to acoustic stimuli. In Kir4.1-/- mice, the Reissner membrane is collapsed, the tectorial membrane is swollen, and type I hair cells and spiral ganglion neurons as well as their central processes degenerate over the first postnatal weeks. In the vestibular ganglia, neuronal cell death with apoptotic features is also observed. Immunostaining reveals that Kir4.1 is strongly expressed in stria vascularis of wild-type but not Kir4.1-/- mice. Within the spiral ganglion, Kir4.1 labeling was detected on satellite cells surrounding spiral ganglion neurons and axons. We conclude that Kir4.1 is crucial for normal development of the cochlea and hearing, via two distinct aspects of extracellular K(+) homeostasis: (1). in stria vascularis, Kir4.1 helps to generate the cochlear endolymph; and (2). in spiral and vestibular ganglia, Kir4.1 in surrounding glial cells helps to support the spiral and vestibular ganglion neurons and their projecting axons.

Animals↗

Does TUNEL staining during peri- and post-natal development of the mouse inner ear indicate apoptosis?

Terminal deoxyribonucleotidyl transferase (TDT)-mediated dUTP-digoxigenin nick end labelling (TUNEL) is being used more frequently to investigate programmed cell death (PCD). We have applied this method in order to examine how PCD is involved in the development of the mouse inner ear. In a series of studies, we identified a population of TUNEL-positive cells in the perinatal mouse ear that could not be regarded as apoptosis based upon morphological features of the nuclei. Theoretically, TUNEL detects DNA fragmentation, which can also occur in necrosis. Other authors regard TUNEL-positive cells in the sensory epithelia of the rat equilibrium organs between gestational day (GD) 19 and 7 days after birth (DAB) as apoptosis. We determined whether or not cells in the inner ear of perinatal and post-natal mice were TUNEL-positive due to apoptosis. We stained the inner ears of BALB/c mice aged GD17.5-4 weeks by the TUNEL method and analysed morphology by light microscopy and transmission electron microscopy (TEM). TUNEL-positive cells were distinct in the saccule from DAB3, and in the cochlea from DAB8. The number of TUNEL-positive cells in the hair cells of the saccule and in the cochlea increased with age, and seemed to reach a plateau just before 2 weeks of age. However, morphological analyses did not reveal findings characteristic of apoptosis. We conclude that these TUNEL-positive cells were labelled not because of apoptosis, but due to necrosis or post-mortem autolysis. We surmise that TUNEL staining can identify vulnerable cells of the inner ear that consume high levels of oxygen and easily undergo autolysis.

Animals↗

A novel microperfusion system for the long-term local supply of drugs to the inner ear: implantation and function in the rat model.

Local therapy is practiced for middle and inner ear diseases but is usually restricted to cases of ear drum perforation or repeated invasive intratympanic drug application. Perfusion of drugs on the round window or through the scalae of animals using a pump system suggests that the chronic local drug treatment might also be feasible in humans. However, drug delivery systems that are currently on the market involve repeated reimplantation if they are to be used for long-term drug supply. A bone-anchored, totally implantable micro-drug delivery system (MDS) for patient-controlled drug supply has been developed [Lehner et al., 1997]. In this study, we show the first successful long-term in vivo test of the MDS micro-pump in rats. The process of implantation and first functional tests will be described. The biomaterial used to manufacture the delivery system did not cause any inflammation reaction in any of the 9 animals successfully implanted. After activation of the micro-pump, the drug reservoir and port was found to be fluid-tight. Bolus applications of tetrodotoxin (TTX) to the round window induced a transient decrease of evoked brainstem responses. In 2 animals which carried the MDS for more than 8 months the proper functioning of the pumping device was examined in a 2-3 week interval over a 3 month period. The MDS can be autoclaved even after long-term implantation and can then be reused for subsequent implantations. Designed for life-long implantation in humans, the demonstration of an effective long-term drug supply to the inner ear using the MDS provides an encouraging first step towards future long-term drug treatment of the inner ear in humans.

Administration, Topical↗

Immortalized mouse inner ear cell lines demonstrate a role for chemokines in promoting the growth of developing statoacoustic ganglion neurons.

The target-derived factors necessary for promoting initial outgrowth from the statoacoustic ganglion (SAG) to the inner ear have not been fully characterized. In the present study, conditioned medium from embryonic Immortomouse inner ear cell lines that maintain many characteristics of developing inner ear sensory epithelia were screened for neurite-promoting activity. Conditioned medium found to be positive for promoting SAG neurite outgrowth and neuronal survival was then tested for the presence of chemokines, molecules that have not previously been investigated for promoting SAG outgrowth. One candidate molecule, monocyte chemotactic protein 1 (MCP-1), was detected in the conditioned medium and subsequently localized to mouse hair cells by immunocytochemistry. In vitro studies demonstrated that function-blocking MCP-1 antibodies decreased the amount of SAG neurite outgrowth induced by the conditioned medium and that subsequent addition of MCP-1 protein was able to promote outgrowth when added to the antibody-treated conditioned medium. The use of the Immortomouse cell lines proved valuable in identifying this candidate cofactor that promotes outgrowth of early-stage SAG nerve fibers and is expressed in embryonic hair cells.

Animals↗

Elevation of inner ear antibody levels following direct antigen challenge of the endolymphatic sac.

The effect of direct antigen challenge of the endolymphatic sac (e.sac) on inner ear antibody levels was investigated in guinea pigs. Two weeks following e.sac antigen inoculation, perilymph antibody levels to keyhole limpet hemocyanin (KLH) were found to be significantly elevated in the challenged ear of those animals compared to the unchallenged, opposite ear. Moreover, when the endolymphatic duct (e.duct) in a group of animals were obstructed prior to antigen challenge of their e.sac then the rise in perilymph antibody was prevented. The local accumulation of plasma cells and lymphocytes in the perisaccular space and e.sac lumen was seen following these antigen injections. These experiments suggest that inner ear antibody emanates from the e.sac and reaches the perilymphatic compartment along the route of the e.duct. Furthermore, these findings emphasize the central role of the e.sac in inner ear immunity.

Animals↗

Morphological comparison of apoptotic with non-apoptotic dying cells in the developing inner ear of mouse embryos.

Dying cells studied by the TdT-mediated dUTP nick end-labeling (TUNEL) method have been classified as "apoptotic" and "non-apoptotic" cells. In this study, in which 12-day-old mouse embryos were used because of a high frequency of "natural cell death" due to changing inner ear morphology [Kaufman, M.H., 1992. The Atlas of Mouse Development, first ed., Academic Press, London, p. 147], the percentages of "apoptotic" and "non-apoptotic" dying cells (ADC and NADC) among total dying cells in the inner ear were calculated. Observation of consecutive paraffin sections showed about 90% of the dying inner ear cells to be ADC and about 10% to be NADC. ADC and NADC TUNEL positive dying cells in resin sections observed by light microscopy were examined again by transmission electron microscopy using a re-embedding procedure. ADC and NADC were then analyzed based on the classification of dying cells (types 1, 2, 3A, and 3B) as described by Clarke [Anat. Embryol. 181 (1990) 195]. It was clear that ADC were the equivalent of type 1 (apoptotic) dying cells and NADC were the equivalent of type 2 (autophagic) dying cells. We consider these findings to be important baselines for determining the process underlying abnormal development of the inner ear and its functional disorders such as hearing loss.

Animals↗

Aquaporin 4 expression in the mammalian inner ear and its role in hearing.

Aquaporin 4 (Aqp4), a member of a family of water transport proteins, is a candidate for playing a critical role in inner ear fluid homeostasis. In this study, we assess cross-species Aqp4 expression in the inner ear, sequence conservation in the 5'-UTR, and hearing in Aqp4 knockout mice. A single Aqp4 isoform was expressed in a highly conserved pattern within the supporting epithelia surrounding the sensory cells of the auditory and vestibular sensory organs and the glial cells surrounding the auditory nerve of the mouse and rat. In the 5'-UTR of mouse and rat Aqp4 gene, sequence conservation was highest in the region spanning the transcription start site. Aqp4 knockout mice demonstrated impaired hearing, but normal neural conduction time. Similar Aqp4 expression pattern and regulatory sequence conservation across species suggest a highly conserved role for Aqp4 in the inner ear. In the Aqp4 deficient mouse, cochlear dysfunction is suggested as the primary cause of hearing impairment in the absence of neural conduction abnormality.

5' Untranslated Regions↗

Transplanted human amniotic epithelial cells express connexin 26 and Na-K-adenosine triphosphatase in the inner ear.

Cochlear fibrocytes are the crucial component of the inner ear homeostasis and its defect by various causes; GJB2 (connexin [Cx] 26) mutation, for example, leads to hearing loss. In the present study, we investigated the potential use of human amniotic epithelial cells, proposed to possess pluripotential properties, as a source of transplantation therapy in inner ear disease. The mRNA of the gap junction protein Cx26 and Na-K-adenosine triphosphatase, the immunohistologic expression of these proteins, and the cells' intercellular communication capacity were detected in vitro. Their transplantation into the guinea pig cochlea revealed the survival and expression of the proteins even 3 weeks after transplantation. Transplanted human amniotic epithelial cells were localized at the site where the proteins function, strongly indicating their cooperation in the regional potassium ion recycling. This technology suggests the therapeutic potential for the treatment of hearing loss.

Amnion↗