Inner Ear Hair Cell Regeneration — Maybe We Can Know More

They did not change the delivery method.
So the method they use is the intratympanic method as described in the blog post?

It's also not clear to me that exo-AAV has been used in (or approved for use in) humans.
Good point! I have no such evidence.

It's also worth keeping in mind that a couple of weeks after the exo-AAV paper was published, a paper using Anc80L65 was published.
Are you referring to the Anc80 used in mice with Usher syndrome? Coincidentally, I just posted a new thread about the news of the Anc80 vector.

The second paper showed much better restoration of hearing, but the applications are different.
Applications are different? What do you mean by that?
 
Made it worse?... can you post a source?



Listen to both sides, then make up your own mind what to believe in.



You mean exo-AAV?



Why not? They have to follow through with the same?

It looks like they are using adenovirus 5 (Ad5).

Source: https://www.novartisclinicaltrials.com/TrialConnectWeb/aboutresult.nov?studyid=54904

Yes I mean exo-AAV
I guess they have to approve exo-AAV to use for human without damage. Thats why aaron said 'no'
In addition I couldn't see any detail for how anc80 work. Maybe It is different from AAV virus(Atoh)
 
Yes I mean exo-AAV
I guess they have to approve exo-AAV to use for human without damage. Thats why aaron said 'no'

Yes, it's likely that they would need approval before they can test exo-AAV in human trials. I am not very familiar with the approval process of FDA, so I can't say for sure what they can and cannot do.

See how it is now, they have several different vectors to try out and they can't decide which one to use first. They are like little kids who can't decide on what candy to put in their mouth. :) I see this as a good sign. This means that we are making steady progress.

But they got approval for Ad5 and they are using that now. It's best to keep it that way for now. Let's not get too excited and start testing things at random. They can't be restarting every time a new discovery is made. Once a work is started, they have to follow through, study the results and make some conclusion, and only then move on to the next big thing, or modify the previous work to try to improve it. It's simple scientific method at work.

In addition I couldn't see any detail for how anc80 work. Maybe It is different from AAV virus(Atoh)

AAV, exo-AAV and Anc80 are viral vectors, Atoh1 is the gene. Think of taxi cars (vectors) who transport passengers (genes) to street addresses (target cells). It's a little bit more complicated than that but that's the basic idea. Also note that this is gene therapy, which is different from stem cell therapy. Gene therapy is generally more complicated than stem cell therapy, but it has the highest potential to cure the broadest types of hearing loss and deafness.
 
Are you referring to the Anc80 used in mice with Usher syndrome? Coincidentally, I just posted a new thread about the news of the Anc80 vector.
Yes. And there is already a thread about the Usher syndrome paper which includes links to the actual papers.

Applications are different? What do you mean by that?

György et al. looked at AAV1 and exo-AAV1 with an application to "a mouse model of hereditary deafness (lipoma HMGIC fusion partner-like 5/tetraspan membrane protein of hair cell stereocilia [Lhfpl5/Tmhs−/−])" while Pan et al. looked at Anc80L65 in a mouse model of Usher 1C. György et al. found exo-AAV1 had higher rates of transduction than AAV1 and Pan et al. found Anc80L65 had higher transduction rates than AAV 1, 2, 6, 8, and 9. Pan et al. report rates of 100% for IHC and 95% for OHC. György et al. report rates of 95% for IHC and > 50% for OHC. Most importantly Pan et al. report much, much larger improvements in hearing. In fact, given the improvements in transduction, the György et al. hearing results are somewhat disappointing ("The results also raise some important questions that should be addressed in future studies. First, it is unclear why the high efficiency of hair cell transfection did not yield better functional improvements. More detailed assessment of hair cell structure and function may reveal subtle defects that remain in the treated ear." http://www.cell.com/molecular-therapy-family/molecular-therapy/fulltext/S1525-0016(17)30010-2). So I am tempted to say that this shows Anc80L65 is better than exo-AAV1. However, the applications (genetic defects) are different. It would now be good to see Anc80L65 in the Lhfpl5/Tmhs−/− model and/or exo-AAV1 in the Usher 1C model. (This is assuming that each method could handle the other payload.) All of that being said, the results definitely appear to be in favor of Anc80L65 at the moment.

I guess they have to approve exo-AAV to use for human without damage.
This is my assumption. György et al. do not provide any information on the use of exo-AAVs in humans. In contrast, Anc80L65 has not been used in humans. According to Pan et al. "Finally, while conventional AAV vectors have a good safety profile, next-generation AAVs, such as Anc80L65, have not yet been evaluated in humans and thus will require careful scrutiny." And according to Landegger et al. "Further validation of Anc80L65 as a gene transfer vector for use in human inner ear gene therapy will require targeting-efficiency studies in large-animal models; additional exploration of the window of opportunity for therapeutic intervention; and pharmacology and toxicology studies to investigate the safety of Anc80L65 upon cochlear administration."

Gene therapy is generally more complicated than stem cell therapy, but it has the highest potential to cure the broadest types of hearing loss and deafness.

Both are complicated, but in my opinion gene therapy is going to prove less complicated than stem cells but has, when used in the context of genetic deafness, more narrow application. The Novartis trial is a bit odd in that gene therapy is being used in an attempt to regenerate hair cells rather than to fix a specific genetic defect. Momentum is picking up for using gene therapy to deal with specific genetic defects, and I think we are on the way to seeing actual treatments for inherited forms of deafness. We are getting to the point that the main issue is going to be the therapeutic window.
 
Made it worse?... can you post a source?

One of the people in the novartis study, Jeff, did not see improvement, in fact from what I remember in the end it just made his hearing worst, but it was already pretty bad to begin with. He ended getting a cochlear implant shortly after he figured out it didnt do anything for him. I know another girl Amanda noted some improvement. Rob Gerk gained balance, but no hearing improvement from what I read also. These names are talked about on these forums. I don't know of any other participants that made any comments. I think it is all hush hush.

Penate, I know you are frustrated with the forums and answers, and so is everyone else. No one likes this, but reality is we are pretty far away from any type of cure for hearing loss, T, or H. Reading the research is great for hope, but anything that comes out of there must be analyzed, tested, trials must be done, etc. Your best case from a breakthrough to a cure would be 10 years if everything goes right. There are many positives right now, but as you can see from the posts, we are in clinical trials and newer better vectors are coming out. This would start the entire process all over again. At the end of the day we don't know how these therapies will work on humans and they are very careful now. Someone could end up with monster T or worst from any of these gene therapies so it is going to be slow going. There won't be any miracles, but there will be lots of articles to read of the breakthroughs we are experiencing.
 
[QUOTE="No one likes this, but reality is we are pretty far away from any type of cure for hearing loss, T, or H. Reading the research is great for hope, but anything that comes out of there must be analyzed, tested, trials must be done, etc. Your best case from a breakthrough to a cure would be 10 years if everything goes right. There are many positives right now, but as you can see from the posts, we are in clinical trials and newer better vectors are coming out. This would start the entire process all over again. At the end of the day we don't know how these therapies will work on humans and they are very careful now. Someone could end up with monster T or worst from any of these gene therapies so it is going to be slow going. There won't be any miracles, but there will be lots of articles to read of the breakthroughs we are experiencing.[/QUOTE]

@RB2014 do you really think that a less effective "cure" won't be available say at most 8 years from now. Personally I think a treatment will be available to restore hearing to ~45db levels for a lot of frequencies within that timeframe. It maybe experimental sure and not commercially available but something will exist for some people.
 
@RB2014 do you really think that a less effective "cure" won't be available say at most 8 years from now. Personally I think a treatment will be available to restore hearing to ~45db levels for a lot of frequencies within that timeframe. It maybe experimental sure and not commercially available but something will exist for some people.[/QUOTE]

If Novartis goes to clinical trial 3 we could see a less effective solution for hearing loss in the next 3-5 years. No one except for them really knows what worked and what didnt. Maybe they found the dosage that works best. I'm not sure that will get you 45 db though, but again its all speculation. Everyone else is 18 months away from the first clinical trial which could put you in the 8 year range. Now we have better vectors and understand more. I wouldnt be surprised if they scrap that trial since the results are not going to be what they thought, but just the fact that people gained some hearing and balance is a great breakthrough.

I'm personally hoping for faster than that since these startup companies want to see a return on their investment. I don't think 8 years would be unreasonable to get back 45 db or so. What we aren't going to figure out anytime soon is T and H because that would require almost perfect hearing restored for those that suffer because of hearing loss. Some people get t with no hearing loss or only a 10db hearing loss at 8k. I think even the best current animal research gets us to within 25db of 0.
 
So I am tempted to say that this shows Anc80L65 is better than exo-AAV1. However, the applications (genetic defects) are different. It would now be good to see Anc80L65 in the Lhfpl5/Tmhs−/− model and/or exo-AAV1 in the Usher 1C model. (This is assuming that each method could handle the other payload.) All of that being said, the results definitely appear to be in favor of Anc80L65 at the moment.

I see your point now. Yes, I am also keen on believing that Anc80 might be better. But it's just a feeling, and it stems from a need to see progress. The exo-AAV might be better, for certain applications and given a certain set of conditions. We just don't know until we compare them in a test, side by side.

Both are complicated, but in my opinion gene therapy is going to prove less complicated than stem cells but has, when used in the context of genetic deafness, more narrow application.

I'm not sure what you mean here. Why would gene therapy have a more narrow application in the context of genetic deafness? Is it because it aims to treat genetic deafness? You said it yourself, that the Novartis trial "is a bit odd in that gene therapy is being used in an attempt to regenerate hair cells rather than to fix a specific genetic defect." Gene therapy doesn't have to be used in the context of genetic deafness. This is an example of that.

Now that I think about it, you may be referring to the window of opportunity here? Where gene therapy, even if it proves very effective in genetic deafness, needs to be delivered before birth, unlike in mice where it can be delivered up to 10 days after birth. Where these two types of therapies kind of switch places or roles? I mean stem cell therapy may be the only viable option even for genetic deafness, because of the narrow window of opportunity for gene therapy to be effective in humans?

Momentum is picking up for using gene therapy to deal with specific genetic defects, and I think we are on the way to seeing actual treatments for inherited forms of deafness. We are getting to the point that the main issue is going to be the therapeutic window.

There you mention that window of opportunity. What is your main argument for gene therapy having a more narrow application in context of genetic deafness? Is it the narrow window of opportunity? Or is it the selected few kinds of genetic deafness that can be treated with it?

For most of us here on these forums, either type of therapy will be beneficial, as most of us here don't have a genetic form of deafness. Most of us have acquired a hearing loss in our teen or adult years due to prolonged noise exposure or accidents. I expect the first treatments to be based on stem cell technology, but gene therapy is not too far behind.
 
Meanwhile, AGTC (Applied Genetic Technologies Corporation) has shown interest in "exploring genetic defects in cells in the inner ear that lead to deafness and expects to advance several product candidates into development within the next few years."

AGTC employs a highly targeted approach to selecting and designing its product candidates, choosing to develop therapies for indications having high unmet medical need, clinical feasibility and commercial potential. AGTC has a significant intellectual property portfolio and extensive expertise in the design of gene therapy products including capsids, promoters and expression cassettes, as well as, expertise in the formulation, manufacture and physical delivery of gene therapy products.

Source: http://www.nasdaq.com/press-release...-cell--gene-therapy-world-2017-20170112-00153

They participated in the Phacilitate Cell & Gene Therapy World 2017 conference that took place in Miami, Florida from January 17-20, 2017.

Merely 4 days ago, they were selected "Top Company in the University of Florida's 2017 Gator100".

Applied Genetic Technologies Corporation (NASDAQ:AGTC), a biotechnology company conducting human clinical trials of adeno-associated virus (AAV)-based gene therapies for the treatment of rare diseases, today announced that the company has been selected as the top company in the 2017 Gator100 awards.

The Gator100, named after the University of Florida's mascot, recognizes and celebrates the 100 fastest-growing businesses in the world that are either owned or led by University of Florida graduates.

Source: http://www.nasdaq.com/press-release...sity-of-floridas-2017-gator100-20170210-00878
 
Gene therapy doesn't have to be used in the context of genetic deafness.
It doesn't have to be, but that is its most natural use, and over time I suspect it will be the more common use. The number of people affected by genetic deafness is relatively small. However, editing a single or a few genes will be easier than doing anything with stem cells. The challenge so far with either technology is the short window of opportunity at least as things are understood now.
 
What is the window of opportunity

We were discussing treatment of genetic deafness, more specifically Usher 1 syndrome which is a genetic disorder that causes blindness and deafness. One of the two studies that used Anc80 vector was aimed at treating genetic deafness in mice which was caused by Usher 1 syndrome. For those mice, the window of opportunity was said to be 10 days or less for a successful therapy.

One caveat is that the mice were treated right after birth; hearing and balance were not restored when gene therapy was delayed 10-12 days. The researchers will do further studies to determine the reasons for this.

Source: https://www.eurekalert.org/pub_releases/2017-02/bch-gtr020117.php

There was a written statement in one of the articles (can't find the exact quote right now), that for a human offspring carrying the genetic disorder, this would mean that the gene therapy would have to be administered before birth because human cochlea is more developed at birth, relative to that of mice offspring.

Remember, this narrow window of opportunity primarily relates to using Anc80 as a delivery vehicle in gene therapy to treat hearing loss caused by Usher 1 syndrome. This is using gene therapy to treat hearing loss caused by genetic disorder. But gene therapy can also be used in other contexts than genetic disorders. It can be used to activate growth of hair cells in adult ears where the hearing loss is not necessarily caused by genetic disorders, but by noise or ototoxicity for example.

Regardless of underlying cause of hearing loss, gene therapy can be used to treat it. The Novartis trial is one example of that. They are using gene therapy to treat hearing loss that is not caused by a genetic disorder. The new Anc80 vector is very promising, not only in hearing loss caused by Usher 1 syndrome, but in hearing loss of other causes as well, and it may yield better results in future clinical trials.

There are currently no human trials I am aware of that use the Anc80 vector, not in treating hearing loss nor any other type of disease or disability in humans. The biotech company Selecta has obtained a license to use Anc80 in future human trials to treat rare diseases, but not for hearing loss. They are all using it in mice at the moment. They have to go through safety checks before they are allowed to use it in humans. That's why most gene therapies that have been used in humans are based on one of the common AAV vectors, including the Novartis trials.

Generally speaking though, the sooner you treat a medical condition, the better the results will be. Of course, it's not medically possible to treat sudden hearing loss right after the incident that caused it because treatment options are shining with their absence. This is the sad truth about current state of hearing medicine. There is none! Not even a pill, tablet or some operative procedure that would help protect the little hearing you have left.

All doctors can do is try to calm you down, assess the level of damage, tell you what you more or less already know, and give you general advice like how to protect your ears from further deterioration and give you hope in that your hearing might get back to normal if you give your ears time to recover. They don't mention that you might get secondary symptoms like tinnitus, as not to upset you further. That's another nut they haven't been able to crack yet.

But things are finally starting to turn around for the better. I know it has been turning for the better for some time now, without resulting in any treatment options. But I find hope in that things are turning much faster now. There is a noticeable increase in research and funding in this area. As they dive deeper and deeper they are discovering and learning new things about ears and hearing, and now even the brain is much more involved in the studies. When world health organization starts sending out warnings about risks of hearing damage in young people, you know that we are all hard pressed to find new ways to treat these conditions. We don't only use our ears to hear and communicate, we also use them to orientate, and to keep a steady balance as well.
 
It's a press release so not clear what to make of it, but Decibel is presenting some new results at the ARO meetings:

https://decibeltx.com/wp-content/up...earch-in-Otolaryngology-ARO-Meeting-FINAL.pdf

Yeah, I have seen that myself. I am also not sure what to make of it, other than that they are making progress.

It says they "announced the presentation of data from advancements in its end-to-end technology platform." What does that mean? What is "end-to-end technology platform"?

I have seen references to "technology platforms" before, by other companies as well. My understanding is it has to do with methodology and strategy for rapid discovery and development of new drugs. How exactly that works in detail I do not know. I imagine it as a conveyor belt machinery that spits out new drugs! (y) One after the other! End to end!

These are the main points of the paper:
  • They mapped all the genes that are on or off within individual cells.
  • They found a way to find molecular-level differences between all the known major cell types.
  • They found that there are 40 unique cell types.
  • They are now able to study how each cell responds to a variety of different factor.
They talk about about "Atlas of Cell-Type-Specific Transcriptomes". I think Stefan Heller and his team at Stanford made the first "atlas" of all all the cell types in the cochlea one or two years ago. I think they were first to classify the 40 unique cell types based on their genetic expressions, and they also found that there are like 190 genes that control the cells in the cochlea.

Up until then they thought that for example inner hair cells are all the same, but they now know that there are genetic differences between them along the rows of cells. So an inner hair cell sitting at 5000 Hz is different from an inner hair cell at 500 Hz.

It seems like Decibel is now taking it a step further and trying to create genetic transcripts for each type of the 40 classifications of cells.

It also looks like the small size of the cochlea of a mouse is to their advantage. "Given the relatively small size of the mouse inner ear, recent improvements in throughput and sensitivity of technology permit organ-wide profiling of all the cell types in the cochlea in a single experiment." I guess this wouldn't work in a human cochlea. But once they figure out how this works in the mouse, they will be able to translate that knowledge to humans.
 
It's clear Decibel is working on basic research.

Someone from Decibel was lead and/or senior author on two papers/posters: PD 31 and PS 748. They participated in four other posters/papers: PD 32, PS 349, PS 747, and PS 749. Here are the abstracts.

PD 31

An Atlas of Cell-Type-Specific Transcriptomes in the Newborn Mouse Cochlea

Joseph C. Burns1; Adam Palermo1; Michael C. Kelly2; Matthew W. Kelley3 1Decibel Therapeutics; 2Laboratory of Cochlear Development, NIDCD, NIH; 3Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

Single-cell transcriptional profiling has emerged as a powerful, unbiased tool for dissecting cellular heterogeneity at the molecular level. qPCR of single cells from the developing inner ear has been used to characterize gene expression patterns critical for lineage specification, differentiation, and subtype identity. RNA-Seq of single cells from the sensory regions of the newborn mouse cochlea and utricle has demonstrated the feasibility of extending these studies to the whole transcriptome level, allowing for more comprehensive identification of genes and pathways. Collecting sufficient numbers of single cells in a cost- and time-efficient manner has been a critical limitation to these techniques, but recent adaptations in droplet microfluidics have improved the throughput 100-fold. Given the relatively small size of the mouse inner ear, this improvement in throughput theoretically permits organ-wide profiling of all the cell types in the cochlea in a single experiment. To test this, we separated the entire cochlear portion of the newborn mouse inner ear, dissociated the tissue, and captured single-cell transcriptomes for RNA-Seq using a droplet microfluidics platform from 10X Genomics. From an input of ~16,000 cells, we captured 4,251 single cells. The capture process took 5 min, demonstrating that tissue dissociation is the only substantial time constraint with this system. Unbiased clustering revealed 23 distinct clusters of cells. Based on expression of known marker genes, 15 of the 23 clusters were identified and included hair cells, supporting cells, neurons, glia, cells of the stria vascularis, interdental cells, and non-sensory epithelial cells of the inner and outer sulcus. Cells within the remaining clusters are likely fibrocytes, mesenchymal cells, immune cells, osteolineage cells, and mesothelial cells; however, their exact localization and identity remains to be determined. At least one cluster of cells could not be ascribed to any known cell type in the cochlea at this stage. The numbers of cells in each cluster were within expected ratios. Differential expression analysis revealed 5,821 genes driving the differences between the 23 cell types, many of which have not previously been localized within the inner ear. This dataset reveals that single-cell RNA-Seq technology has advanced sufficiently that all the major cell types in the cochlea can be profiled in a single experiment. Future applications include comprehensive resolution of cellular fate commitment during development and organ-wide, cell-type-specific responses to insults in adults.

PS 748

Technical Comparison of Four Single-Cell RNA-Seq Methodologies in Newborn Mouse Cochlea

Kathy So1; Matthew Nguyen1; Michael C. Kelly2; Hanna Sherrill3; Joseph C. Mays3; Matthew W. Kelley4; Joseph C. Burns1; Adam Palermo1 1Decibel Therapeutics; 2Laboratory of Cochlear Development, NIDCD, NIH; 3Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

A variety of new methodologies are emerging for profiling the levels of transcripts in dissociated single cells, several of which have been applied to inner ear biology. Whole transcriptome profiling of single cells with RNA-Seq is particularly attractive since it allows for unbiased identification of genes that have not been previously implicated in the model under study. There are a number of considerations when evaluating the pros and cons of these methods, including, but not limited to, throughput of single cell capture, fraction of input cells captured, protocol duration, fraction of the transcriptome recovered, and cost per cell. We have systematically compared these parameters for newborn mouse cochlea cells captured on four different platforms: Fluidigm C1 (microfluidics), FACS-based single-cell sorting, Drop-Seq (droplet microfluidics), and 10X Genomics Chromium (droplet microfluidics). The chemistry used for RT-PCR of single-cell mRNA is a major determinant of transcript yield and cost, so we also compared multiple RT-PCR chemistries using the FACS system. RT-PCR was performed according to published protocol with the non- FACS methods. We found that the Fluidigm C1 system has the greatest sensitivity, detecting the highest number of expressed genes per cell on average. However, the Fluidigm system had the lowest throughput, the longest capture duration, and the highest cost. Drop-Seq and the 10X Genomics Chromium systems detected the fewest numbers of genes per cell, but also had the highest throughput and lowest costs per cell. For droplet microfluidics systems, the 10X Genomics Chromium had several important advantages over Drop-Seq, such as higher numbers of genes detected per cell, 10-fold shorter capture durations, and a 4:1 ratio of input cells to captured cells. Interestingly, we found that resolution of cellular heterogeneity appeared to be more dependent upon the number of cells captured than the number of genes detected per cell, suggesting that sequencing large numbers of cells at shallow depth is advantageous for detecting distinct cell types and subtypes. Finally, we found that RT enzyme type and efficient removal of residual primers are critical parameters that should be considered when reverse transcribing and amplifying single-cell mRNA. In summary, we present an in-depth technical guide that should help researchers to select the appropriate methodology for experiments that could be aided by single-cell RNA-Seq.

PD 32

A Comprehensive Map of Mammalian Auditory Sensory Cell Development Generated Using High-Throughput Transcriptional Profiling

Michael C. Kelly1; Joseph C. Burns2; Adam Palermo2; Joseph C. Mays3; Kathryn L. Ellis4; Robert Morell5; Matthew W. Kelley6 1Laboratory of Cochlear Development, NIDCD, NIH; 2Decibel Therapeutics; 3Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 4NIDCD, NIH; 5Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA; 6Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

The exquisite structural and functional architecture of the mammalian organ of Corti is generated through a highly coordinated developmental program that involves cell-type specific gene expression. This program is composed of the dynamic and heterogeneous transcriptional states of diverse cells types within the developing organ of Corti. A characterization of these various states could provide powerful insight into the genes involved in the development of the mammalian auditory end organ. This information has been relatively inaccessible due to technical limitations, but recent advancements in single cell RNA-Seq (scRNA-Seq) techniques have now made analysis on this scale possible.

Through a combination of high-throughput droplet-based and cell-per-well scRNA-Seq approaches, we have built an extensive high-resolution gene expression database of the cells of the organ of Corti and their surrounding epithelial cells from multiple embryonic and early postnatal timepoints. The complete array of hair cells, supporting cells, and surrounding non-sensory cells types are uniquely identified using known marker genes, and additional genes that show cell-type specific expression are revealed. Moreover, the large number of independent observations of each cell type's transcriptional state over development allow a computational reconstruction of transitions representing cellular differentiation. We use these reconstructed models to identify potential transcriptional cascades that may direct cell fate decisions and changes in plasticity with the organ of Corti. By building branched relationship trees based on transcriptional similarities of cell types representing specific cell types at multiple stages of differentiation, we can also infer lineage relationships and anticipate restrictions. These lineage relationships are supported by preliminary genetic clonal lineage tracing studies, and candidate transcriptional regulators involved in cell fate decisions and differentiation can be evaluated by gain and loss of function studies.

These results further our understanding of the genetic pathways involved in organ of Corti development and patterning, provide a basis of comparison for potential aberrant states in mutant and disease models, and may help identify sets of transcriptional regulators that can direct the differentiation of unique cell types. This work also suggests a pattern of developmental lineage restrictions that provide important developmental context for cell type conversion strategies such as those proposed for auditory hair cell regeneration.

PS 349

Transcriptional Analysis of Heat-Shocked Mouse Utricle: Aligning Transcriptome to Drug Response


Matthew Ryals1; Lindsey May1; Katie Spielbauer1; Michael C. Kelly2; Joseph C. Burns3; Erich Boger1; Matthew W. Kelley4; Ronna Hertzano5; Robert Morell6; Lisa Cunningham1 1National Institute on Deafness and Other Communication Disorders, NIH; 2Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 3Decibel Therapeutics; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA; 5Department of Otorhinolaryngology, Department of Anatomy and Neurobiology, and Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD USA; 6Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA

Many instances of drug-induced hearing loss are caused by two major classes of ototoxic agents: aminoglycosides and cisplatin. Our lab has shown that heat shock can protect cultured utricles against aminoglycoside-induced hair cell death, and that heat shock results in increased expression of heat shock proteins (HSPs). Here we have used RNA-Seq in order to characterize the full transcriptional response to heat shock beyond the canonical HSP family.

Gene expression was analyzed at the whole tissue and single cell levels within the utricle epithelium. A subset of the differentially-expressed transcripts identified by RNA-Seq was validated using RT-qPCR. Actively-translated mRNA species from hair cell -specific populations were isolated via affinity-tagged ribosomal (Ribotag) immunoprecipitation. Enrichment for hair cell-derived transcripts was validated from these samples using RT-qPCR. Using the Library of Integrated Cellular Signatures (LINCS), a list of compounds (perturbagens) that induce gene expression profiles that are similar to the utricle heat shock response was determined. Ability of selected perturbagens to elicit heat shock like transcriptional changes was evaluated by RT-qPCR, and perturbagen capacity for otoprotection against aminoglycoside exposure was determined.

A profile of differentially-expressed transcripts, or signature, in the heat-shocked utricle was determined from whole-tissue RNA-Seq data. This signature contained transcripts from multiple gene families including those regulating proteostasis, stress signaling, and protein folding. Single cell cell RNA-Seq transcriptome data clearly delinated hair cells versus supporting cells within the epithelium, and a different expression profile was observed for heat shocked cells versus control cells. Ribotag immunoprecipitation of hair cell transcripts elucidated the actively- translated mRNA species within the hair cells following heat shock. A search of LINCS perturbagens with similar signatures identified several compounds including HSP90 inhibitors and proteasome inhibitors. Expression profiling of utricles exposed to selected perturbagens indicate that these compounds can induce a 'heat shock-like' expression within the utricle. Preliminary in vitro testing of selected perturbagenes suggests that some may offer protection against aminoglycoside ototoxicity.

A medium-throughput screen of perturbagens for otoprotective capacity may reveal additional compounds capable of mediating a heat-shock conditioned protective effect against ototoxicity. Analysis of cell-specific gene differences identified in the single-cell and Ribotag experiments will further hone the matching of perturbagen gene expression profiles and reveal cell-type specific responses to stress within the sensory epithelium of the inner ear. This work was supported by the NIDCD Division of Intramural Research.

PS 747

Drop-Seq as a Lower-Cost, High-Throughput Method for Single-Cell Gene Expression Profiling of Cochlear Cells

Joseph C. Mays1; Joseph C. Burns2; Matthew W. Kelley3; Michael C. Kelly1 1Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 2Decibel Therapeutics; 3Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

The mammalian cochlea is comprised of diverse cell types that vary significantly in structure and function. Single-cell mRNA sequencing (scRNA-seq) is able to provide transcriptomic profiles of individual cochlear cells to help to characterize the genetic heterogeneity between cell types. While this is a powerful method for studying complex tissues, commercial platforms for scRNA-seq can be prohibitively costly and low-throughput, preventing the generation of data sets from a sufficient number of cochlear cells of each type. Here, we utilize the Drop-Seq technique (Macosko et al., 2015) as a lower-cost, high-throughput method for performing single-cell RNA-seq on cochlear tissue. Drop- Seq allows for the generation of transcriptomes from individual dissociated cells by capturing mRNA from each cell with barcoded beads contained in nanoliter droplets. mRNA is reverse-transcribed and unique barcodes are used to map sequenced reads back to individual cells in order to efficiently generate expression data for each cell.

While the depth of coverage is lower than that of commercial platforms, Drop-Seq allows for a broad survey of cells to be processed at once. Utilizing this method, we have generated expression data from cochlear cells at late embryonic and early postnatal time points. We have compared these transcription profiles to existing scRNA-Seq data generated using the Fluidigm C1 platform and find that we can identify the same major cell types. The lower relative cost of droplet-based scRNA-Seq methods, such as Drop-Seq, make it a reasonable gene expression profiling technique to assess transcriptional changes at single-cell resolution in various experimental paradigms. To demonstrate this, we have compared Drop-Seq scRNA-Seq data from control cultured or HDAC-treated cochlear explants, which show cell type-specific morphological and molecular changes. Differential expression analysis shows transcriptional profile changes both at the whole-tissue level, and unique changes within individual cell types following HDAC inhibitor treatment, providing insight into the role that histone dynamics play in cochlear development and maintenance of cell states.

These results illustrate the potential use of droplet-based scRNA-Seq methods for surveying normal and perturbed gene expression profiles of cells within the mammalian cochlea. Though some trade-offs are made in sensitivity and ease of use, the lower cost and higher-throughput make Drop-Seq attractive for a variety of applications. In addition to using these methods to characterize transcriptional changes in mutant and drug-treated tissue, we also hope to utilize transcriptional profiles to help optimize culture conditions so that our in vitro models best represent in vivo conditions.

PS 749

Single-cell RNA-Seq Reveals Transcriptional Diversity in the Spiral Ganglion

Hanna Sherrill1; Michael C. Kelly1; Tessa Sanders1; Joseph C. Burns2; Robert Morell3; Matthew W. Kelley4 1Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 2Decibel Therapeutics; 3Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

Spiral ganglion (SG) neurons convey auditory information from the cochlea to the brainstem. Despite the importance of this structure for normal hearing and cochlear implant function, our understanding of the development and diversity of neuronal phenotypes within the SG is still limited, in part because the total number of neurons within the ganglia is relatively limited. The development of methods to isolate and transcriptionally profile single cells using RNA sequencing has led to the identification and characterization of cellular heterogeneity in a variety of tissues including the sensory epithelia of the inner ear. Based on these studies, it seems likely that a similar approach could be used to address questions related to cellular diversity and development within the SG.

As a first step, fluorescent SG neurons from MapT-EGFP mice were dissected and isolated at E16 or P1. Individual neurons were then captured using two different platforms, the microfluidics-based Fluidigm C1 system and FACS-based single cell sorting. A minimum of 40 cells were profiled at each age. Initial results indicated wide transcriptional heterogeneity at E16 stemming from cellular differentiation and maturational processes, and more discrete transcriptional heterogeneity at P1. At P1, three transcriptionally distinct groups of neurons were identified by unbiased clustering. The most transcriptionally distinct group corresponds to ~15% of SGN cells collected, but these cells do not express Prph, indicating that they are not type II neurons. The three groups are thus far not easily defined transcriptionally by known type I and type II markers such as Prph or EphA4.
 
It's clear Decibel is working on basic research.

Someone from Decibel was lead and/or senior author on two papers/posters: PD 31 and PS 748. They participated in four other posters/papers: PD 32, PS 349, PS 747, and PS 749. Here are the abstracts.

PD 31

An Atlas of Cell-Type-Specific Transcriptomes in the Newborn Mouse Cochlea

Joseph C. Burns1; Adam Palermo1; Michael C. Kelly2; Matthew W. Kelley3 1Decibel Therapeutics; 2Laboratory of Cochlear Development, NIDCD, NIH; 3Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

Single-cell transcriptional profiling has emerged as a powerful, unbiased tool for dissecting cellular heterogeneity at the molecular level. qPCR of single cells from the developing inner ear has been used to characterize gene expression patterns critical for lineage specification, differentiation, and subtype identity. RNA-Seq of single cells from the sensory regions of the newborn mouse cochlea and utricle has demonstrated the feasibility of extending these studies to the whole transcriptome level, allowing for more comprehensive identification of genes and pathways. Collecting sufficient numbers of single cells in a cost- and time-efficient manner has been a critical limitation to these techniques, but recent adaptations in droplet microfluidics have improved the throughput 100-fold. Given the relatively small size of the mouse inner ear, this improvement in throughput theoretically permits organ-wide profiling of all the cell types in the cochlea in a single experiment. To test this, we separated the entire cochlear portion of the newborn mouse inner ear, dissociated the tissue, and captured single-cell transcriptomes for RNA-Seq using a droplet microfluidics platform from 10X Genomics. From an input of ~16,000 cells, we captured 4,251 single cells. The capture process took 5 min, demonstrating that tissue dissociation is the only substantial time constraint with this system. Unbiased clustering revealed 23 distinct clusters of cells. Based on expression of known marker genes, 15 of the 23 clusters were identified and included hair cells, supporting cells, neurons, glia, cells of the stria vascularis, interdental cells, and non-sensory epithelial cells of the inner and outer sulcus. Cells within the remaining clusters are likely fibrocytes, mesenchymal cells, immune cells, osteolineage cells, and mesothelial cells; however, their exact localization and identity remains to be determined. At least one cluster of cells could not be ascribed to any known cell type in the cochlea at this stage. The numbers of cells in each cluster were within expected ratios. Differential expression analysis revealed 5,821 genes driving the differences between the 23 cell types, many of which have not previously been localized within the inner ear. This dataset reveals that single-cell RNA-Seq technology has advanced sufficiently that all the major cell types in the cochlea can be profiled in a single experiment. Future applications include comprehensive resolution of cellular fate commitment during development and organ-wide, cell-type-specific responses to insults in adults.

PS 748

Technical Comparison of Four Single-Cell RNA-Seq Methodologies in Newborn Mouse Cochlea

Kathy So1; Matthew Nguyen1; Michael C. Kelly2; Hanna Sherrill3; Joseph C. Mays3; Matthew W. Kelley4; Joseph C. Burns1; Adam Palermo1 1Decibel Therapeutics; 2Laboratory of Cochlear Development, NIDCD, NIH; 3Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

A variety of new methodologies are emerging for profiling the levels of transcripts in dissociated single cells, several of which have been applied to inner ear biology. Whole transcriptome profiling of single cells with RNA-Seq is particularly attractive since it allows for unbiased identification of genes that have not been previously implicated in the model under study. There are a number of considerations when evaluating the pros and cons of these methods, including, but not limited to, throughput of single cell capture, fraction of input cells captured, protocol duration, fraction of the transcriptome recovered, and cost per cell. We have systematically compared these parameters for newborn mouse cochlea cells captured on four different platforms: Fluidigm C1 (microfluidics), FACS-based single-cell sorting, Drop-Seq (droplet microfluidics), and 10X Genomics Chromium (droplet microfluidics). The chemistry used for RT-PCR of single-cell mRNA is a major determinant of transcript yield and cost, so we also compared multiple RT-PCR chemistries using the FACS system. RT-PCR was performed according to published protocol with the non- FACS methods. We found that the Fluidigm C1 system has the greatest sensitivity, detecting the highest number of expressed genes per cell on average. However, the Fluidigm system had the lowest throughput, the longest capture duration, and the highest cost. Drop-Seq and the 10X Genomics Chromium systems detected the fewest numbers of genes per cell, but also had the highest throughput and lowest costs per cell. For droplet microfluidics systems, the 10X Genomics Chromium had several important advantages over Drop-Seq, such as higher numbers of genes detected per cell, 10-fold shorter capture durations, and a 4:1 ratio of input cells to captured cells. Interestingly, we found that resolution of cellular heterogeneity appeared to be more dependent upon the number of cells captured than the number of genes detected per cell, suggesting that sequencing large numbers of cells at shallow depth is advantageous for detecting distinct cell types and subtypes. Finally, we found that RT enzyme type and efficient removal of residual primers are critical parameters that should be considered when reverse transcribing and amplifying single-cell mRNA. In summary, we present an in-depth technical guide that should help researchers to select the appropriate methodology for experiments that could be aided by single-cell RNA-Seq.

PD 32

A Comprehensive Map of Mammalian Auditory Sensory Cell Development Generated Using High-Throughput Transcriptional Profiling

Michael C. Kelly1; Joseph C. Burns2; Adam Palermo2; Joseph C. Mays3; Kathryn L. Ellis4; Robert Morell5; Matthew W. Kelley6 1Laboratory of Cochlear Development, NIDCD, NIH; 2Decibel Therapeutics; 3Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 4NIDCD, NIH; 5Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA; 6Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

The exquisite structural and functional architecture of the mammalian organ of Corti is generated through a highly coordinated developmental program that involves cell-type specific gene expression. This program is composed of the dynamic and heterogeneous transcriptional states of diverse cells types within the developing organ of Corti. A characterization of these various states could provide powerful insight into the genes involved in the development of the mammalian auditory end organ. This information has been relatively inaccessible due to technical limitations, but recent advancements in single cell RNA-Seq (scRNA-Seq) techniques have now made analysis on this scale possible.

Through a combination of high-throughput droplet-based and cell-per-well scRNA-Seq approaches, we have built an extensive high-resolution gene expression database of the cells of the organ of Corti and their surrounding epithelial cells from multiple embryonic and early postnatal timepoints. The complete array of hair cells, supporting cells, and surrounding non-sensory cells types are uniquely identified using known marker genes, and additional genes that show cell-type specific expression are revealed. Moreover, the large number of independent observations of each cell type's transcriptional state over development allow a computational reconstruction of transitions representing cellular differentiation. We use these reconstructed models to identify potential transcriptional cascades that may direct cell fate decisions and changes in plasticity with the organ of Corti. By building branched relationship trees based on transcriptional similarities of cell types representing specific cell types at multiple stages of differentiation, we can also infer lineage relationships and anticipate restrictions. These lineage relationships are supported by preliminary genetic clonal lineage tracing studies, and candidate transcriptional regulators involved in cell fate decisions and differentiation can be evaluated by gain and loss of function studies.

These results further our understanding of the genetic pathways involved in organ of Corti development and patterning, provide a basis of comparison for potential aberrant states in mutant and disease models, and may help identify sets of transcriptional regulators that can direct the differentiation of unique cell types. This work also suggests a pattern of developmental lineage restrictions that provide important developmental context for cell type conversion strategies such as those proposed for auditory hair cell regeneration.

PS 349

Transcriptional Analysis of Heat-Shocked Mouse Utricle: Aligning Transcriptome to Drug Response


Matthew Ryals1; Lindsey May1; Katie Spielbauer1; Michael C. Kelly2; Joseph C. Burns3; Erich Boger1; Matthew W. Kelley4; Ronna Hertzano5; Robert Morell6; Lisa Cunningham1 1National Institute on Deafness and Other Communication Disorders, NIH; 2Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 3Decibel Therapeutics; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA; 5Department of Otorhinolaryngology, Department of Anatomy and Neurobiology, and Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD USA; 6Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA

Many instances of drug-induced hearing loss are caused by two major classes of ototoxic agents: aminoglycosides and cisplatin. Our lab has shown that heat shock can protect cultured utricles against aminoglycoside-induced hair cell death, and that heat shock results in increased expression of heat shock proteins (HSPs). Here we have used RNA-Seq in order to characterize the full transcriptional response to heat shock beyond the canonical HSP family.

Gene expression was analyzed at the whole tissue and single cell levels within the utricle epithelium. A subset of the differentially-expressed transcripts identified by RNA-Seq was validated using RT-qPCR. Actively-translated mRNA species from hair cell -specific populations were isolated via affinity-tagged ribosomal (Ribotag) immunoprecipitation. Enrichment for hair cell-derived transcripts was validated from these samples using RT-qPCR. Using the Library of Integrated Cellular Signatures (LINCS), a list of compounds (perturbagens) that induce gene expression profiles that are similar to the utricle heat shock response was determined. Ability of selected perturbagens to elicit heat shock like transcriptional changes was evaluated by RT-qPCR, and perturbagen capacity for otoprotection against aminoglycoside exposure was determined.

A profile of differentially-expressed transcripts, or signature, in the heat-shocked utricle was determined from whole-tissue RNA-Seq data. This signature contained transcripts from multiple gene families including those regulating proteostasis, stress signaling, and protein folding. Single cell cell RNA-Seq transcriptome data clearly delinated hair cells versus supporting cells within the epithelium, and a different expression profile was observed for heat shocked cells versus control cells. Ribotag immunoprecipitation of hair cell transcripts elucidated the actively- translated mRNA species within the hair cells following heat shock. A search of LINCS perturbagens with similar signatures identified several compounds including HSP90 inhibitors and proteasome inhibitors. Expression profiling of utricles exposed to selected perturbagens indicate that these compounds can induce a 'heat shock-like' expression within the utricle. Preliminary in vitro testing of selected perturbagenes suggests that some may offer protection against aminoglycoside ototoxicity.

A medium-throughput screen of perturbagens for otoprotective capacity may reveal additional compounds capable of mediating a heat-shock conditioned protective effect against ototoxicity. Analysis of cell-specific gene differences identified in the single-cell and Ribotag experiments will further hone the matching of perturbagen gene expression profiles and reveal cell-type specific responses to stress within the sensory epithelium of the inner ear. This work was supported by the NIDCD Division of Intramural Research.

PS 747

Drop-Seq as a Lower-Cost, High-Throughput Method for Single-Cell Gene Expression Profiling of Cochlear Cells

Joseph C. Mays1; Joseph C. Burns2; Matthew W. Kelley3; Michael C. Kelly1 1Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 2Decibel Therapeutics; 3Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

The mammalian cochlea is comprised of diverse cell types that vary significantly in structure and function. Single-cell mRNA sequencing (scRNA-seq) is able to provide transcriptomic profiles of individual cochlear cells to help to characterize the genetic heterogeneity between cell types. While this is a powerful method for studying complex tissues, commercial platforms for scRNA-seq can be prohibitively costly and low-throughput, preventing the generation of data sets from a sufficient number of cochlear cells of each type. Here, we utilize the Drop-Seq technique (Macosko et al., 2015) as a lower-cost, high-throughput method for performing single-cell RNA-seq on cochlear tissue. Drop- Seq allows for the generation of transcriptomes from individual dissociated cells by capturing mRNA from each cell with barcoded beads contained in nanoliter droplets. mRNA is reverse-transcribed and unique barcodes are used to map sequenced reads back to individual cells in order to efficiently generate expression data for each cell.

While the depth of coverage is lower than that of commercial platforms, Drop-Seq allows for a broad survey of cells to be processed at once. Utilizing this method, we have generated expression data from cochlear cells at late embryonic and early postnatal time points. We have compared these transcription profiles to existing scRNA-Seq data generated using the Fluidigm C1 platform and find that we can identify the same major cell types. The lower relative cost of droplet-based scRNA-Seq methods, such as Drop-Seq, make it a reasonable gene expression profiling technique to assess transcriptional changes at single-cell resolution in various experimental paradigms. To demonstrate this, we have compared Drop-Seq scRNA-Seq data from control cultured or HDAC-treated cochlear explants, which show cell type-specific morphological and molecular changes. Differential expression analysis shows transcriptional profile changes both at the whole-tissue level, and unique changes within individual cell types following HDAC inhibitor treatment, providing insight into the role that histone dynamics play in cochlear development and maintenance of cell states.

These results illustrate the potential use of droplet-based scRNA-Seq methods for surveying normal and perturbed gene expression profiles of cells within the mammalian cochlea. Though some trade-offs are made in sensitivity and ease of use, the lower cost and higher-throughput make Drop-Seq attractive for a variety of applications. In addition to using these methods to characterize transcriptional changes in mutant and drug-treated tissue, we also hope to utilize transcriptional profiles to help optimize culture conditions so that our in vitro models best represent in vivo conditions.

PS 749

Single-cell RNA-Seq Reveals Transcriptional Diversity in the Spiral Ganglion

Hanna Sherrill1; Michael C. Kelly1; Tessa Sanders1; Joseph C. Burns2; Robert Morell3; Matthew W. Kelley4 1Laboratory of Cochlear Development, NIDCD, Bethesda, Maryland, USA; 2Decibel Therapeutics; 3Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA; 4Laboratory of Cochlear Development, NIDCD, NIH, Bethesda, Maryland, USA

Spiral ganglion (SG) neurons convey auditory information from the cochlea to the brainstem. Despite the importance of this structure for normal hearing and cochlear implant function, our understanding of the development and diversity of neuronal phenotypes within the SG is still limited, in part because the total number of neurons within the ganglia is relatively limited. The development of methods to isolate and transcriptionally profile single cells using RNA sequencing has led to the identification and characterization of cellular heterogeneity in a variety of tissues including the sensory epithelia of the inner ear. Based on these studies, it seems likely that a similar approach could be used to address questions related to cellular diversity and development within the SG.

As a first step, fluorescent SG neurons from MapT-EGFP mice were dissected and isolated at E16 or P1. Individual neurons were then captured using two different platforms, the microfluidics-based Fluidigm C1 system and FACS-based single cell sorting. A minimum of 40 cells were profiled at each age. Initial results indicated wide transcriptional heterogeneity at E16 stemming from cellular differentiation and maturational processes, and more discrete transcriptional heterogeneity at P1. At P1, three transcriptionally distinct groups of neurons were identified by unbiased clustering. The most transcriptionally distinct group corresponds to ~15% of SGN cells collected, but these cells do not express Prph, indicating that they are not type II neurons. The three groups are thus far not easily defined transcriptionally by known type I and type II markers such as Prph or EphA4.

Do these papers give any hints as to what they plan on doing? Does this hint that they are aiming to cure hearing loss that is lost via loud noise exposure or hearing loss in general? Just at loss of what to make of these papers. Anyone know if they have put a timeline out on when they feel they will have treatment in the clinic?
 
Do these papers give any hints as to what they plan on doing? Does this hint that they are aiming to cure hearing loss that is lost via loud noise exposure or hearing loss in general? Just at loss of what to make of these papers. Anyone know if they have put a timeline out on when they feel they will have treatment in the clinic?

The race for a cure is already launched and the successful winner will earn ££££$$$$€€€€, near 2035 in the worst case or near 2025 in the best case.
 
The race for a cure is already launched and the successful winner will earn ££££$$$$€€€€, near 2035 in the worst case or near 2025 in the best case.

So that's... that's hundreds of billions in 1000 pound, dollar, and euro bills? :eek:

That's some amount of money! :) There is no 1000 euro bill though, and neither is there a 1000 UK pound bill. But there is a 1 million "giant" and a 100 million "titan". Though not in circulation.

Either way, this crazy amount of money is reason enough for anyone to try to come up with a cure. I think 2025 is a pretty good estimate for a very successful medical treatment for some form of hearing loss. But I think we will almost definitely have something by the year 2020. (y)
 
Do these papers give any hints as to what they plan on doing?
As @Aaron123 said, they are doing basic research.

Many are interested in finding a "cure" and earn huge amounts of money on it. But they are getting ahead of themselves if they think they can just slap a few things together and have a cure for all forms of hearing loss.

Decibel Tx is building the foundational understanding of how the ear and hearing works at the cellular and sub-cellular level. It's a tedious work, and it takes time. But this is science at its best! Basic research is necessary, and it has proven very fruitful in the past. I don't see why it wouldn't this time around. It's about breaking down big problems into smaller attainable goals. This approach has the best potential for discovering all the right ingredients that are needed to write the recipe for a near-perfectly baked cake, with the highest and most consistent success rate.

We may be looking at a 10 year or even 20 year time frame before we have anything on the market. But this is where Decibel Tx wants to be. They are not just looking for a quick fix, they want to be at the very forefront in this emerging market. We need more companies like that. We can't afford not to do the basic research. Otherwise it will all just be a hit or miss game. Basic research, and fundamental understanding underpins all of science.

Does this hint that they are aiming to cure hearing loss that is lost via loud noise exposure or hearing loss in general?

Decibel Tx is aiming high! They are aiming to cure just about all forms of hearing loss under the Sun. They want to cure Drug-Induced Ototoxicity, Tinnitus, Noise-Induced Hearing Loss, Genetic Hearing Loss, and Presbycusis. You can read all about this on their website.

Just at loss of what to make of these papers

It indicates that they are making great progress. They also present how new advancements in science and technology is making their work much easier. Which is great! It may help them develop a treatment much faster.
 
When I see what Decibel Therapeutics is doing, I think of Stanford university. They also use the same approach if I am not mistaken.
I suppose if processes are so complex because of all the interaction between genes, this is the way to do it.
 
When I see what Decibel Therapeutics is doing, I think of Stanford university. They also use the same approach if I am not mistaken.
I suppose if processes are so complex because of all the interaction between genes, this is the way to do it.

You mean in terms of basic research? Well yes, Stanford is also doing a lot of basic research about the ear and hearing. Stanford has also made it its mission to find a cure for hearing loss. See Stanford Initiative to Cure Hearing.

I recently found a research paper from Stanford about designing a new diagnostic tool using OCT technology. I think this was done in collaboration with Texas A&M and it might predate the work of Harvard using the same technology with the same goal.

They of course all share ideas and collaborate, and follow each others work. So that's hardly surprising. But I get the feeling sometimes like Stanford is left behind in discussions. We should not forget other excellent research teams at other universities who also are contributing in their own way. I don't want to start listing them all up here, as not to leave someone behind. I have come across a handful of universities that do their own original research work concerning the ear.
 
I thought I would try to dissect the first article abstract (An Atlas of Cell-Type-Specific Transcriptomes in the Newborn Mouse Cochlea).

"Single-cell transcriptional profiling has emerged as a powerful, unbiased tool for dissecting cellular heterogeneity at the molecular level."

It's a technnique for sincle cell RNA sequencing used to identify molecular differences between cells.

"qPCR of single cells from the developing inner ear has been used to characterize gene expression patterns critical for lineage specification, differentiation, and subtype identity."

Quantitative Polymerase Chain Reaction (qPCR) is the type of single cell RNA sequencing technnique that allows detection and measuring of gene expression in small RNA samples by amplifying the gene transcripts. It essentially allows for measurements with small samples.

"RNA-Seq of single cells from the sensory regions of the newborn mouse cochlea and utricle has demonstrated the feasibility of extending these studies to the whole transcriptome level, allowing for more comprehensive identification of genes and pathways."

RNA-Seq is a next generation, high-throughput RNA sequencing technique. They want to extend its use to transcriptome level, which essentially means that they can use a single biological sample and have a machine detect the presence of and quantity of RNA in the sample at any given time. From newborn to adult cochlea. (Now, if they could just do the same thing in vivo... well, we can dream on, can't we?)

"Collecting sufficient numbers of single cells in a cost- and time-efficient manner has been a critical limitation to these techniques, but recent adaptations in droplet microfluidics have improved the throughput 100-fold. Given the relatively small size of the mouse inner ear, this improvement in throughput theoretically permits organ-wide profiling of all the cell types in the cochlea in a single experiment."

Improvement in technology now allows them to essentially have the machine analyze all the cell types in the organ and have them know the presence and quantity of RNA.

"To test this, we separated the entire cochlear portion of the newborn mouse inner ear, dissociated the tissue, and captured single-cell transcriptomes for RNA-Seq using a droplet microfluidics platform from 10X Genomics."

They used this machine from 10X Genomics, a company founded in 2012.

controller-gallery-2.jpg

They took the first place in The Scientist Top 10 Innovations 2015. Read more here.

"From an input of ~16,000 cells, we captured 4,251 single cells. The capture process took 5 min, demonstrating that tissue dissociation is the only substantial time constraint with this system."

Harvesting the cells from whole tissues takes more time than the capturing process of the machine.

"Unbiased clustering revealed 23 distinct clusters of cells. Based on expression of known marker genes, 15 of the 23 clusters were identified and included hair cells, supporting cells, neurons, glia, cells of the stria vascularis, interdental cells, and non-sensory epithelial cells of the inner and outer sulcus."

They grouped the cells according to their similarities and ended up with 23 groups of cells. Using previous knowledge of certain types of cells, they were able to identify which of the 23 groups consists of hair cells, which group consists of supporting cells, etc.

"Cells within the remaining clusters are likely fibrocytes, mesenchymal cells, immune cells, osteolineage cells, and mesothelial cells; however, their exact localization and identity remains to be determined."

Of the 23 groups, they identified 15 of them. They are hypothesizing that the remaining 8 could be fibrocytes, mesenchymal cells, etc. They don't know yet. Either because the work is not completed, or they know very little about thses cell types - assuming they had no markers to go by in order to identify them. They don't know what part of the organ some of these cells are coming from.

"At least one cluster of cells could not be ascribed to any known cell type in the cochlea at this stage. The numbers of cells in each cluster were within expected ratios. Differential expression analysis revealed 5,821 genes driving the differences between the 23 cell types, many of which have not previously been localized within the inner ear."

They might have accidentally discovered new cell types.

"This dataset reveals that single-cell RNA-Seq technology has advanced sufficiently that all the major cell types in the cochlea can be profiled in a single experiment."

This speaks for itself.

"Future applications include comprehensive resolution of cellular fate commitment during development and organ-wide, cell-type-specific responses to insults in adults."

They will essentially study what happens to the cells during aging. Presbycusis? They will also study how cells respond to insults. Noise induced hearing loss?
 
I don't know if this has been posted before or not, but mapping and profiling of inner ear cell types has been done previously by Stefan Heller and his team at Stanford.

fx1.jpg


Highlights:
  • Unbiased clustering of single organ of Corti cells based on gene expression data
  • Clusters correspond to nine major medial-to-lateral aligned organ of Corti cell types
  • Spatial reconstruction of apex-to-base localization of each organ of Corti cell
  • Statistical analysis reveals changes in gene expression along the tonotopic axis
This is the same type of work that Decibel is doing. But it looks like Decibel has taken it further with RNA-Seq.

We note that the number of preselected genes for this study (192) limits the overall power of this type of analysis. Whole transcriptome data derived from RNA-seq studies, on the other hand, would provide a viable opportunity to investigate gene-to-gene relationships in a rather complete fashion.

An article about it can be found here:
http://www.the-scientist.com/?articles.view/articleNo/43804/title/Inner-Ear-Cartography/

The full article can be found here:
http://www.cell.com/cell-reports/abstract/S2211-1247(15)00494-5
 
OTOSTEM is a EU-funded project (ID: 603029) that aims to advance the stem cell based technology. It has been around for some time now and others have reported about it previously, here on TT.

The lack of human otic cell models represents a significant roadblock hampering the development of drug-based or cell-based therapies. Hearing impairment is the most frequent
human sensory deficit and is mainly caused by the irreversible loss of neurosensory cells in the cochlea.

OTOSTEM addresses this urgent and unmet medical need for causal hearing loss therapies by focusing on human stem cell technology.

Visit the website here: http://www.otostem.org/

Stefan Heller of Stanford Initiative to Cure Hearing Loss (SICHL) was very excited and hopeful when this took off.

The start to 2014 has been very exciting with many new advances to be published by our laboratory, but also by many of my colleagues. Of course, each university will try to publicize these successes by generating lots of press, which seems to be the name of the game nowadays. I admit that this is tremendously confusing for patients and parents of children with hearing loss and it can be frustrating because it could raise the hope that cures are just around the corner. Unfortunately, there is still lots of work to be done. (Don't we know it!)
(...)
Perhaps the best news for the human approach comes from the European Union (surprise!). Our laboratory is part of a consortium funded by the European Union to investigate in collaborative manner human stem cell applications for the treatment of hearing loss. My hope for this concerted effort is that research will be faster, and that groups collaborate instead of compete with each other. So far so good – we just had our kickoff meeting and first coordination meeting to get the planned research started. Several of the limitations that hamper human stem cell applications are being addressed by this group effort, which makes me hopeful.

Source: https://hearinglosscure.stanford.ed...l-like-cells-from-human-embryonic-stem-cells/

This project was started 2013-11-01, and will end soon, on 2017-10-31. Unless of course they extend it. Or maybe start another one, perhaps one that focuses on gene therapy this time.

I have finally found at least one research project that focuses on inner ear restoration that Sweden is involved in! (y)

It's Uppsala University that's involved in this. They had at least one postdoc opening for this project. I would be surprised if Helge Rask Andersen is not on this project as well. He's a senior investigator at Uppsala, and he specializes in inner ear hair cells, he has been studying and profiling cochlear nerve cells for years, and his research has resulted in improvements of cochlear implants. I think Uppsala and this guy might be the best Sweden has to offer. I am having hard time finding any information about research of inner ear being done at any other academic institution in Sweden. There is research into regenerative medicine in Sweden but not concerning the ear.

Like in most countries, bad hearing and tinnitus are neglected conditions. Because the healthy decision makers that have good hearing (in a physiological sense, rarely ever in a political sense) seem to think that we can go on living with these conditions like it's no big deal. Also, the healthcare systems in nearly all countries are reactive, and costing a lot of money. Instead of being proactive, and costing much less. In the 21st century, we still have 20th century healthcare systems. All they have to offer is CBT therapies and hearing aids.

Anyway! With time I'm sure this will change too. It will have to, there will be no other choice. With the increasing population and life expectancy. I just wish the change would take on much faster.

With all the participants put together, they have invested 236188743 EUR or 250702541 USD. That's 236 million EUR or 251 million USD in round numbers.

They are obligated by EU rules to make periodic reports on their progress, and the latest and probably the last report summery came in 3 days ago.

Periodic Report Summary 2 :
http://cordis.europa.eu/result/rcn/194765_en.html

I haven't read it all yet. Hyperlinking took me more time than I expected, and it's already late night here. So I will go sleep on it, knowing that there is tremendous work being done around the world, and across country borders and time zones to find a medical treatment that has the potential to restore hearing and balance, and to cure tinnitus.
 
@Samir
I have been reading this topic lately and I personally thank you for your dedicated effort here about the information collected!
Very useful and more easy to understand and follow....(at least for me!) :)


Like in most countries, bad hearing and tinnitus are neglected conditions. Because the healthy decision makers that have good hearing (in a physiological sense, rarely ever in a political sense) seem to think that we can go on living with these conditions like it's no big deal. Also, the healthcare systems in nearly all countries are reactive, and costing a lot of money. Instead of being proactive, and costing much less. In the 21st century, we still have 20th century healthcare systems. All they have to offer is CBT therapies and hearing aids.

Absolutely true!
 
Another name that comes to my mind when I think of Sweden and hearing disorders is Ingmar Klockhoff. I learned about this guy only recently. This is the guy that first described what we now know as TTTS or Tonic Tensor Tympani Syndrome.

I learned about him when I was reading some papers by Myriam Westcott, a well known audiologist from Australia who I feel is among the few that studies and understands TTTS and ASD (Acoustic Shock Disorder), both of which are disorders that can develop following an acoustic incident or shock (AS) such as electronic interference on telephone lines, audio equipment, exploding bombs, or car engines blowing up. These disorders are equally important to understand as tinnitus itself, and there is very strong connection between tinnitus and these disorders in many tinnitus patients. Ingemar presented his findings about "TTTS" at the "International Symposium on Acoustic Impedance Measurements" in Lisbon, Portugal, in 1979.

Ingmar Klockhoff passed away in November of year 2000 at the age of 77. He was a docent and chief physician of audiology at Uppsala University Hospital form 1968 to 1988. Before that, he worked at Karolinska. (Source (in Swedish): DagensNyheter)

His family name is sometimes misspelled as Klochoff. He died in year 2000, just around the time that Internet was becoming generally available to everyone, and Bredbandsbolaget started rolling out first true broadband services in Sweden to regular people (10 Mbps FTTB fiber-LAN). The reason I mention this is because there is very little written about him on the web. Not in English, nor in Swedish. He predated the Internet! :) So you can't "just google" him. You won't find much! I think we were too preoccupied with playing Quake III Arena, sharing files on Napster, and "social networking" on Lunarstorm. :cool:

This brings another important thing to my mind. The importance of Internet! Basically all of Ingmar's work and research papers are documented in books and printed papers. This makes it almost completely inaccessible to anyone interested in it. This makes me appreciate the Internet and online publication of research "papers". I found only one of Ingmar's research papers from 1972 in a database, and it's not the one he became famous for, namely TTTS. So not only is the material inaccessible over the Internet, most of it is not even indexed in online databases.

In the past, each university and research institution in Sweden has its own database for research publications and theses. So you had to check them all to find something if you didn't know where it was. But since then a new web tool called DiVA (Digitala Vetenskapliga Arkivet) that integrates all the databases has been developed and allows centralized search and is accessible over the Internet to anyone. In the past though, these systems were not accessible to the outside world. You had to visit one of the university or maybe a public library to use a computer terminal to do the search.

The latest is the development of SwePub which I think is aimed to be a replacement for DiVA and it has its own sub-domain under the Swedish national library (Kungliga Biblioteket), the same kind of structure you see in the USA.

This is all great news, but I think a lot of useful material is still not indexed nor scanned into digital form, and is just laying in some dusty old library shelf. The access to information, and to research publications and results is very important not only for the curious few percentage of the general public (myself included) but also to domestic researchers and foreign researchers. Research is a lot about collaboration, and Internet plays an instrumental role in that. Many of us take it for granted. This thread is titled Maybe We Can Know More. But maybe we can't know more?... not without Internet? Eh?! :cool:

Academia in Sweden has humor, don't you think? Just look at "Diva" and "SwePub". :beeranimation: There are more examples but I will save those for later. (y)
 
has been done previously by Stefan Heller and his team at Stanford.
That was what I was referring to (-;
http://www.the-scientist.com/?articles.view/articleNo/43804/title/Inner-Ear-Cartography/
When I read the following in this article: "Within the mammalian cochlea, apical cells retain regenerative capacity for a few weeks after birth, but basal cells do not."
This was in 2015. By now researchers should have the information what the difference is between these cells?
Most inner ear hearing loss is in this area.
What makes it such a challenge?
 
I didn't see this posted anywhere on the forums, so I thought I would post it here. Apparently, Karolinska has established a new research hub in Hong Kong last year. It's their first overseas establishment. It's called Ming Wai Lau Centre for Reparative Medicine. It will consist of two "nodes", one in Stockholm and one in Hong Kong, both of which will be managed by Karolinska. It was made possible thanks to the donation of 50,000,000 USD by the young tycoon Ming Wai Lau.

The facility in Hong Kong is located in the Hong Kong Science (and Technology) Park, and it has room for about 50 researchers. Researchers from around the world will be able to conduct research into regenerative medicine at the new facility.

http://ki.se/en/news/ki-is-establishing-a-centre-in-hong-kong-for-regenerative-medicine
http://ki.se/en/news/maria-masucci-hong-kong-opens-up-fantastic-scientific-opportunities
http://ki.se/en/news/kis-research-center-in-hong-kong-inaugurated

Web page of the center at KI:
http://ki.se/en/research/ming-wai-lau-centre-for-reparative-medicine

Web page of the center at HKSTP:
https://www.hkstp.org/hkstp_web/en/Directory/Tenant HKSP/Karolinska Institutet/

We can see from the application call just what kind of work they will be doing.

Candidates in all areas of regenerative medicine are welcome to apply, whereas we are particularly interested in leveraging strengths in technologies such as genome editing, single cell analysis, RNA technologies, and biomedical engineering, and candidates with focus on these areas are particularly encouraged to apply.
  • Genome editing
  • Single cell analysis
  • RNA technologies
  • Biomedical engineering
They will likely be doing basic research, not inner ear specific research. But this is very much welcome addition to help further advance regenerative medicine.

Ola Hermanson, the scientific director of the new center hints on what diseases they might focus on initially.

Looking into the future, the research can be relevant to the treatment of diseases such as severe heart failure, liver failure, spinal cord damage and Parkinson's disease.

Any success with these diseases will also help further advance technology and science to be able to treat hearing problems as well.
 

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