Inner Ear Hair Cell Regeneration — Maybe We Can Know More

[jeff W]

I hope that Frequency Therapeutics did just that. They must have been working on these molecules for many years before coming out with there recent publications.

There is a lot of politics involved.

 

[acufenero]

I don't think any of these gene therapies or stem cell treatments will be deemed suitable for anyone with T or mild to moderate hearing loss. I can't see how they will be able to regrow the specific hair cells that a person with T or mild loss is missing or has damaged. I believe all these treatments will only be available and useful to give some hearing to a profoundly deaf person who uses a cochlear implant so they maybe get use of a hearing aid instead. I'm 39 with T for 10 years now and I expect it to be with me to the end of my life. I wouldn't be building my hopes up for a cure any time soon.

If tinnitus is and will be incurable, why are you wasting your precious time in a research forum?

 

[Jim51042]

This means that Spiral will complete the "feasibility assessment" by Q3 2017. In simple English, Spiral will see if they can use BN201 and BN119 for the inner ear.

We are coming up on the start of Q3 2017. Has anyone heard more from Spiral?

 

[Samir]

We are coming up on the start of Q3 2017. Has anyone heard more from Spiral?

It's not even June yet! Give it more time.

At least they have started working on their website now.

http://spiraltx.com/

 

[Michael Larsen]

http://houghear.org/research/ (At the bottom of the text)

their aim is to be able to obtain FDA approval within the next 3-5 years
Is this a product on the market, Or clinical trial?

 

[Rubenslash]

http://houghear.org/research/ (At the bottom of the text)

their aim is to be able to obtain FDA approval within the next 3-5 years
Is this a product on the market, Or clinical trial?

Market

 

[jeff W]

Maybe someone could do a post with all the known biotech corps. listed currently underway for cellular repair of the ear.

 

[Samir]

@jeff W, I have posted all the ones I know of in a new thread.

https://www.tinnitustalk.com/threads/companies-developing-cures.21781/

 

[Iliasp]

http://houghear.org/research/ (At the bottom of the text)

their aim is to be able to obtain FDA approval within the next 3-5 years
Is this a product on the market, Or clinical trial?

Yes, BUT they mention the preventive therapy not the regeneration therapy

 

[tomytl]

I think we have all reasons to be optimistic. The only thing which is very unclear in many statements of all these companies and researcher.
Could they ever regenerate hair cells in an adult cochlea? Most of the time they speak about embryo or new born..
Does someone know a statement where they claim in an adult cochlea?

 

[jeff W]

@jeff W, I have posted all the ones I know of in a new thread.

https://www.tinnitustalk.com/threads/companies-developing-cures.21781/

Thank you. I should really visit more threads on here.

 

[jeff W]

Was reading a vestibular implant paper by Fornos & Van De Berg, and look who got a mention. You don't often see language like this used in research articles, but somebody obviously brought it to their attention. They must have been in shock reading it, still subscribing eye exercises from the 1900's for dizziness, so reading Rivolta & Chen must be like alien technology to them.

Source https://www.docdroid.net/W2mckP1/th...the-human-balance-system-2017.pdf.html#page=2

 

[Samir]

Yes, BUT they mention the preventive therapy not the regeneration therapy

Yes, but there is also this:

We are using silencing RNA technology to change supporting inner ear hair cells into sensory hair cells essential to hearing. Along with this, we are also working on restoring the connection between the auditory nerve and the hair cells that are disconnected when the hair cells die.

They should probably formulate better what they mean by FDA approval, for what therapy, preventive or regenerative.

 

[Iliasp]

One of the aims of the research at HEI is to move the findings from the research bench to the clinic. Accordingly, the demonstration of the effectiveness of a combination of antioxidants on preventing hearing loss in animal models justified the funding of preclinical studies in humans and Phase I of FDA trials has now been completed. Our aim is to be able to obtain FDA approval within the next 3-5 years so that exposures to acoustic trauma both in civilian and military life need not lead to permanent hearing loss.

Prevention is what i understand as far as it has to do with the trials

 

[Jim51042]

I still don't get some companies whole antioxidant push. Why are they taking so much time to produce something that is a gloried multivitamin? Whats the payoff a margin improvement over multivitamins for a treatment that you have to apply within the first couple hours of noise damage. Its a kinda rhetorical question cause I know they will sell this to US military. But it just doesn't seem that ground breaking or useful imho.

 

[jeff W]

I still don't get some companies whole antioxidant push. Why are they taking so much time to produce something that is a gloried multivitamin? Whats the payoff a margin improvement over multivitamins for a treatment that you have to apply within the first couple hours of noise damage. Its a kinda rhetorical question cause I know they will sell this to US military. But it just doesn't seem that ground breaking or useful imho.

That's pharma for you. They will simply fail over and over again. Just sit back and laugh.

 

[Iliasp]

I think it is, unfortunately its not suitable for the majority of us inside here but it will be for sure a step forward, i just wish they will focus more on regeneration therapies

Ps. It just happens that i did get my acoustic trauma during my military service and during that time i had to deal with lots of them among the stuff as a doctor, believe me its really common and unfortunate among them

 

[Jim51042]

really common and unfortunate among them

I don't doubt it and understand that servicemen experience true suffering from tinnitus. My point is that the antioxidant route is not the most useful route for hearing damage. You need to either provide and ingest/get dosed with it prior to noise damage or very very shortly after. If you are going to anticipate noise damage (say shooting range) then people should be forced to wear earmuffs over earplugs. If noise damage is going to be unexpected then it might cause logistical problems accessing the medicine if the person was say in the field. Also the improvement factor is by definition limited.

I get that antioxidants are a lot easier to make then regeneration techniques but its also less practical and by definition not tremendously effective in real life.

sure a step forward

so I'm not sure it is clear that its a step forward.

 

[jeff W]

Yes, but there is also this:



They should probably formulate better what they mean by FDA approval, for what therapy, preventive or regenerative.

Look at Antinitus, they had some approval that made their product believable.

 

[jcloth]

Does anyone know if it's possible for stereocilia to be damaged by noise but the cell structures themselves live on, despite this damage? I hope not, as I worry that the distortions I have in my hearing may be because of damaged rather than lost cells (that could potentially be replaced with a regenerative therapy)

 

[Samir]

Does anyone know if it's possible for stereocilia to be damaged by noise but the cell structures themselves [to] live on, despite this damage?

Stereocilias are part of these cell structures.

There are several different locations where you can have a damage. Stereocilias can break off at the root. They can also break without breaking off completely. There is also something called a tip link that links stereocilias together. These can break off as well.

Tip links are extracellular tethers that link stereocilia, the tiny sensory projections on inner ear hair cells that convert sound into electrical signals, and play a key role in hearing.

https://medicalxpress.com/news/2013-06-two-step-mechanism-ear-link-regrowth.html

I hope not, as I worry that the distortions I have in my hearing may be because of damaged rather than lost cells (that could potentially be replaced with a regenerative therapy)

I would not wish or hope for that. Until we have a technology to peek inside a living cochlea and see what's actually damaged, it will all remain pretty much a guess work. Right now my own stereocilias, even if damaged, are probably doing a much better work than anything that scientists can come up with in a lab.

 

[Iliasp]

The distortions i guess are what we call recruitment right? I have it also much less now after two months from my acoustic trauma but i hope its gonna get better

 

[jeff W]

Does anyone know if it's possible for stereocilia to be damaged by noise but the cell structures themselves live on, despite this damage? I hope not, as I worry that the distortions I have in my hearing may be because of damaged rather than lost cells (that could potentially be replaced with a regenerative therapy)

I have heard different opinions on this. What you mean: is there sufficient cellular architecture post lesion for functional recovery of the organ. It is the 64 thousand dollar question. In severe acute neuritis of the vestibular organ, sometimes the disconnected canals begin to disintegrate a few months thereafter and the debris falls into the remaining functional canal causing secondary positional vertigo. Loose otoconia are also theorized to be a cause of menieres where the debris might clog up the various drainage systems of the ear. Whats interesting is that post postmortems often reveal different levels of remaining function. If the damage is localised to HC's themselves say for instance aminoglycoside poisoning you would theoretically still have fully functioning nerves under each, just with no sensory cell information to be passed down through the ganglion. But say it was a blunt trauma or a compression like a schwannomma this would essentially be an ischemic type injury that starves the ear cells of oxygenated blood, I have read in the literature before that a glass pipette placed over the primary vascular supply to the superior vestibular nerve (in mouse) for just 10 seconds can cause irreversible damage to the organ, so like the eye, the ear is "extremely" oxygen hungry. What we need is non invasive imaging of the ear that can show microscopic damage. What we need, is a time machine!

 

[jeff W]

Stereocilias are part of these cell structures.

View attachment 12929

There are several different locations where you can have a damage. Stereocilias can break off at the root. They can also break without breaking off completely. There is also something called a tip link that links stereocilias together. These can break off as well.

View attachment 12930




I would not wish or hope for that. Until we have a technology to peek inside a living cochlea and see what's actually damaged, it will all remain pretty much a guess work. Right now my own stereocilias, even if damaged, are probably doing a much better work than anything that scientists can come up with in a lab.

Yes we must appreciate what remains in our ears for now.
Do have a listen to this chap, he studies mechanotransduction and thinks we have greatly underestimated the capabilities of the ear. He does not think in straight lines.

 

[Samir]

The distortions i guess are what we call recruitment right?

What you describe as distortion may be the result of recruitment, yes.

Here is a good explanation of that.

Very simply, recruitment is when we perceive sounds as getting too loud too fast.

recruitment is always a by-product of a sensorineural hearing loss. If you do not have a sensorineural hearing loss, you cannot have recruitment.

there are two other phenomena that often get confused with recruitment. These are hyperacusis (super-sensitivity to normal sounds) and phonophobia (fear of normal sounds resulting in super-sensitivity to them). Both hyperacusis and phonophobia can occur whether you have normal hearing or are hard of hearing. In fact, if you have a sensorineural hearing loss, you could suffer from all three conditions at once!

result of recruitment is "fuzzy" hearing. Since each critical band sends one signal at the frequency of that critical band, when hair cells get recruited into adjacent bands, they stimulate each critical band they are a member of to send their signals also.

The result is that we now often cannot distinguish similar sounding words from each other.

When this happens, basically all we hear is either silence or loud noise with little intelligence in it. Speech, when it is loud enough for us to even hear it, becomes just so much meaningless noise.

This is why many people with severe recruitment cannot successfully wear hearing aids. Their hearing aids make all sounds too loud—so that they hurt. Also, hearing aids cannot correct the results of our poor discrimination. We still "hear" meaningless gibberish.

http://hearinglosshelp.com/blog/recruitment-from-hearing-loss-explained/

I have it also much less now after two months from my acoustic trauma but i hope its gonna get better

I can only speak of my own experience. I had hyperacusis, and some phonophobia. After about 3 months it started getting better. This may depend on the severity of the damage. I have NIHL as a result of listening to music for long hours on headphones and earphones, and a recent acoustic trauma which is most likely the reason for my tinnitus.

My main issue right now is tinnitus. I am much more cautious about my hearing, but not overprotective. I try to preserve what I have left of my good hearing, until there is some kind of therapy available to "cure" tinnitus. I do think that an effective hearing restoration might help reduce tinnitus. But this will take some time. I can't wait to see an end to this discussion. Once the results come in from clinical trials for hearing restoration, we will know for sure if it helps tinnitus or not. If it does, that's great! If it doesn't, the sooner we can know, the sooner we can put our money elsewhere.

 

[LukeT130]

I know this has been asked a billion times but, are we close? I don't want the "every day we draw closer" answer. I mean are we *really* close. Like, within 5 years?

Also, if a cure is found and someone who has tinnitus has it reduce drastically or even disappear all together could that person be exposed to loud noise again and have loud noticeable tinnitus again? Would they be able to use the cure again? How would that even work?

 

[Reinier]

The distortions i guess are what we call recruitment right? I have it also much less now after two months from my acoustic trauma but i hope its gonna get better

I understand recruitment is quite rare. You can find sound-bites on the internet to recognise recruitment. Provided you still have one "good" ear like I have.
I also experience distortion. (not recruitment). My noise trauma happened over two years ago. I still experience this distortion, but at higher sound levels than , lets say, one year ago. So even after more than one year post trauma I experience small improvement. When I make a very rough guess, I think it happens with sound levels over 70 dB. Very rough guess, because it is also very frequency dependent.

 

[Iliasp]

Thats also my case, high dbs and i notice, lower and not so much

 

[RB2014]

I know this has been asked a billion times but, are we close? I don't want the "every day we draw closer" answer. I mean are we *really* close. Like, within 5 years?

Also, if a cure is found and someone who has tinnitus has it reduce drastically or even disappear all together could that person be exposed to loud noise again and have loud noticeable tinnitus again? Would they be able to use the cure again? How would that even work?

In order to hit the 5 year mark we are looking at a clinical trial beginning now and being successful. The general consensus is the Genvec trials are not going to pan out. Right now you have Frequency Therapeutics and Audion beginning clinical trials within 12 months or so. If they are successful then yes 5 years.

My advice at this point would be to try and carry on with your life knowing that we will have something in 10 to 20 years, but I think 5 is pushing it.

If you T is due to hearing loss and hearing is restored there is a lot of evidence that suggests T could go away or at least be minimally invasive at that point.

If they get your hearing fixed and you damage it again due to a loud noise, T will return. Theoretically with Frequency you could use the cure again since they don't use up your supporting cells. Each cure will be different so one that uses up your supporting cells, you may not be able to do again, but even then they could come out with something else.

 

[DARREN R]

If tinnitus is and will be incurable, why are you wasting your precious time in a research forum?

I don't mean to sound so pessimistic. I'm sorry for the suffering we're all going through. Life shouldn't be like this for any of us. I come here for hope just like everyone else. When you read all the research mentioned in these posts it's pretty clear that there is still a great deal unknown. The Genvec trials have been unsuccessful so far and they're only testing it on profoundly deaf candidates anyway. The frequency treatment is aimed at chronic hearing loss. Even if they are both successful these treatments will most likely only be available to people with severe hearing loss first.

Since most people with T usually have mild loss or even no loss there's simply no way they would try these treatments on them. Most of us here would need a much more precise treatment that could target the specific haircells we have lost or damaged ( assuming that's even the cause of your T). Birds can actually do this and regenerate the specific haircells lost like a new tooth sprouting up. We need to get that ability transfered to the human cochlea somehow.

We also need a ton of money and research put into this to accelerate the progress which is being made. All we can do is remain hopeful that these trials will be successful and some good insight gained from it. The treatments will need to be refined much further before they can be used for T or mild loss though. How long that takes is completely unknown at this stage. I'd like to believe it will be sooner rather than later but I'm sure we'd all agree that it's not going fast enough.