Throughout my career in Audiology, the one thing I’ve been unable to do is cure or fix my patients’ problems. Don’t get me wrong, I feel that I provide the best audiological care and expertise available, and I know it makes a tremendous difference in the lives of my patients and their loved ones. But still, my patients are sometimes frustrated (and I’m frustrated for them) when their hearing aids can’t provide enough benefit to hear in a noisy restaurant or party, understand their British mystery on TV, or restore their appreciation of or the quality of music they once enjoyed.
I also know it’s not because of any failing on my part or the part of the hearing aid industry. It’s just that science hasn’t (yet) found a way to fix what’s causing the hearing loss in the first place, which is damage to the neural coding mechanism—the “hair cells” of the inner ear or cochlea. I have to counsel my patients about the limitations that hearing aids can provide, and I give them communication strategies to help address problematic areas or situations, because their hearing aids can’t bypass the problem.
Researchers have long been trying to find a way to address the problem at its source, to regenerate the damaged neural “hair cells” of the inner ear. Over the years, I’ve periodically run across research that highlights reported breakthroughs. It’s a tall order. Not only do we need to identify or create the mechanism by which the cells could be repaired or regenerated, but we also have to find a way to deliver it to the region of the inner ear for it to be effective.
Enter gene therapy. Gene therapy focuses on modifying cells at a genetic level for therapeutic effect. The idea is that by repairing, reconstructing, or “reprogramming” cells at a genetic level, we can cure or fix health problems by having the body fix itself. With the advent of this technology, a pathway has been created that has the potential to address the first of the challenges above.
A research paper recently published in Proceedings of the National Academy of Sciences (April 17, 2023) entitled “Reprogramming by drug-like molecules leads to regeneration of cochlear hair cell-like cells in adult mice” details work being done on hair cell regeneration by a team at Harvard Medical School. The researchers created a “cocktail” of small molecules and what’s known as “small interfering RNAs” (siRNA). This cocktail was able to remove genes in adult mice nerve cells that prevent the cells from becoming healthy, functional inner ear hair cells.
As I understand it (the paper was dizzyingly complex), they were able to effectively make the adult mice nerve cells revert back to a “younger” state so that the cells could then differentiate into healthy/functioning hair cells.
Wow, right?! And only a few years ago, at the annual California Academy of Audiology conference, I attended a presentation by a researcher who was having success using benign viruses as a vehicle to deliver therapeutics to the inner ear.
To be clear, all of this research is likely years and years away from hopefully allowing us to cure hearing loss. But, as they say, the longest journey begins with a single step.
Please continue to love our community by getting vaccinated/boosted and masking where and when appropriate AND supporting our local businesses.
