Bionics Institute, East Melbourne, Victoria, Australia.
Department of Engineering, University of Melbourne, Australia.
Expert Opin Biol Ther. 2022 Jun;22(6):689-705. doi: 10.1080/14712598.2022.2072208. Epub 2022 May 11.
More than 5% of the world's population have a disabling hearing loss which can be managed by hearing aids or implanted electrical devices. However, outcomes are highly variable, and the sound perceived by recipients is far from perfect. Sparked by the discovery of progenitor cells in the cochlea and rapid progress in drug delivery to the cochlea, biological and pharmaceutical therapies are currently in development to improve the function of the cochlear implant or eliminate the need for it altogether.
This review highlights progress in emerging regenerative strategies to restore hearing and adjunct therapies to augment the cochlear implant. Novel approaches include the reprogramming of progenitor cells to restore the sensory hair cell population in the cochlea, gene therapy, and gene editing to treat hereditary and acquired hearing loss. A detailed review of optogenetics is also presented as a technique that could enable optical stimulation of the spiral ganglion neurons, replacing or complementing electrical stimulation.
Increasing evidence of substantial reversal of hearing loss in animal models, alongside rapid advances in delivery strategies to the cochlea and learnings from clinical trials will amalgamate into a biological or pharmaceutical therapy to replace or complement the cochlear implant.
全世界超过 5%的人口有听力损失，这可以通过助听器或植入式电子设备来解决。然而，效果差异很大，而且接受者感知到的声音远非完美。由于耳蜗内祖细胞的发现和药物快速递送至耳蜗的进步，目前正在开发生物和药物疗法，以改善耳蜗植入物的功能或完全消除对其的需求。
本综述重点介绍了新兴的再生策略的进展，以恢复听力和增强耳蜗植入物的辅助疗法。新方法包括祖细胞的重编程以恢复耳蜗中的感觉毛细胞群体、基因治疗和基因编辑以治疗遗传性和获得性听力损失。本文还详细介绍了光遗传学作为一种技术的应用，该技术可以实现对螺旋神经节神经元的光刺激，以替代或补充电刺激。
越来越多的动物模型中听力损失得到实质性逆转的证据，加上向耳蜗传递策略的快速进步和从临床试验中获得的经验教训，将融合成一种生物或药物疗法，以替代或补充耳蜗植入物。
